Three Texas Medical Center institutions have agreed to pay a record-breaking $15 million settlement to resolve claims they billed for concurrent heart surgeries in violation of Medicare teaching physician and informed consent regulations, the U.S. Attorney’s Office announced.
Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. (SAT) are the three institutions that have agreed to the settlement.
Court records show an investigation into the intuitions, and three of their surgeons, began in August of 2019 when a whistleblower filed a complaint.
“Well, it became apparent looking at the document that there was a whistleblower who was inside, looking at the organization and seeing that these very prominent doctors were going from operating room to operating room, and charging for doing the complete procedure when they could not have done the complete procedure, just from a pure time standpoint,” Attorney Randy Sorrels said. “They certified that they did those procedures and that’s what the government alleged, and whistleblower alleged.”
Those prominent surgeons named in court documents include Dr. Joseph Coselli, 71, Houston, and Dr. Joseph Lamelas, 63, Miami, Florida. SAT is a medical practice group affiliated with various cardiothoracic surgeons, including Dr. David Ott, 77, Houston
The U.S. Attorney’s Office said the allegations also included the doctors delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents.
They also failed to attend the surgical “timeout”— a critical moment where the entire team would pause and identify key risks to prevent surgical errors, according to the allegations.
“Yeah, these are some of the most well-known heart surgeons in the country, and so students would come to Baylor to learn from the very best, and they would be putting their hands literally inside the chest of patients. And you should have the attending physician there, but the allegations are as they weren’t there and present at all times,” Sorrels said.
Sorrels said it’s important that patients know, they can try and keep that from happening by advocating for themselves.
“What you want to do as a patient, especially before you go under anesthesia, is let it be known in the paperwork. Only the attending physician, the doctor that, you know, does the entire procedure,” said Sorrels.
KPRC 2 also asked Sorrels if there’s anything that can be done if you’re a former patient, and believe your life was put at risk.
“Yeah, Texas law is not very patient-friendly,” Sorrels said. “The allegations were between 2013 and 2019, and Texas law requires you to bring a claim against a doctor within two years. So if you didn’t bring your claim by 2021 at the latest, you can’t bring a claim against any of these doctors or Baylor itself.”
Sorrels added that after examining the settlement it appears nobody would be criminally charged.
“This $15 million payment is to settle all issues,” Sorrels said.