Boston-based Massachusetts General Hospital has agreed to pay $14.6 million to settle a federal whistleblower lawsuit alleging that the hospital violated Medicare and Medicaid rules when some of its orthopedic surgeons engaged in concurrent surgeries, according to The Boston Globe.
The settlement resolves claims brought by Lisa Wollman, MD, an anesthesiologist who used to work at the Harvard-affiliated teaching facility, under the Massachusetts and federal false claims acts.
Dr. Wollman alleged that at least five orthopedic surgeons jeopardized patient safety while conducting concurrent surgeries from 2010 to 2015, when she worked at the hospital.
She also alleged that the hospital violated Medicare and Medicaid rules when teaching surgeons weren't present for or weren't performing the key and critical portions of certain operations, her attorneys said in a news release.
Additionally, her allegations included that physicians failed to designate a backup surgeon to be immediately available as needed to assist in parts of the overlapping surgeries for which the teaching surgeons were absent, and that the hospital billed the government for excessive anesthesia services, according to her attorneys and the Globe.
Dr. Wollman filed her initial lawsuit in 2015, but she revised the suit in June 2017 after the government declined to intervene and the court dismissed the original filing.
Under the settlement, reached Feb. 18, Massachusetts will pay $14.6 million to the federal government and state, including Massachusetts health insurers.
"Patients should be fully informed about the details of any medical procedure, especially when it comes to simultaneous surgeries," Massachusetts Attorney General Maura Healey said in a statement cited by the Globe. "This resolution returns nearly $2 million to MassHealth and the Group Insurance Commission, and requires updated consent forms at Mass General Brigham to improve transparency."
Massachusetts General Hospital did not admit liability as part of the settlement, and leaders sent an email to the hospital community saying the hospital "continues to believe it always has complied with legal requirements regarding overlapping surgery" and "determined that it would be most prudent to resolve the matter fully by settlement at this time," according to the newspaper.
Dr. Wollman said in a news release: "MGH has new leadership, and I am pleased this case put us in the position where we could have a dialogue that will improve patient care and, as importantly, transparency."
The claim by Dr. Wollman is the latest regarding concurrent surgeries at Massachusetts General Hospital. Since 2019, the hospital has reached three settlements regarding claims stemming from these surgeries, totaling $32.7 million, according to the Globe.
To read the full Globe report, click here.