Baylor St. Luke’s agrees to $15 million settlement for heart surgeries

A whistleblower’s complaint led to a federal investigation into surgeons at Baylor St. Luke’s Medical Center and a record $15 million settlement.

Three surgeons at Baylor St. Luke’s are accused of routinely leaving operating rooms during complicated and risky heart surgeries and leaving their patients in the hands of unqualified resident doctors, according to the federal government.

“Patients have entrusted their lives to these surgeons – submitting to operations where a missed cut means the difference between life and death,” said United States Attorney Alamdar S. Hamdani. “It appears that patients were unaware that their doctor was leaving for another operating room.”

Now, Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM), and Surgical Associates of Texas PA (SAT) have jointly agreed to pay $15 million to resolve claims they billed to Medicare for concurrent heart surgeries.

“Every time one of us goes under the knife as a vulnerable patient, we implicitly trust that surgeons and medical professionals have our best interests at heart, especially here at world-renowned hospitals of Houston,” said Houston Special Agent in Charge Douglas Williams. of the FBI. “In this case, the doctors gamed their patients’ care, including complicated open-heart surgeries, compromising quality of care over quantity, and then falsely billed Medicare for reimbursement for the services they had delegated inappropriately.”

The investigation began in 2019 when the whistleblower alleged that doctors let residents perform parts of complex coronary artery bypass grafts, valve repairs and aortic repair procedures. These surgical procedures typically involve opening a patient’s chest and placing them on a bypass device.

According to the Ministry of Justice, surgeons would leave a practice and go to another operating room without appointing a replacement surgeon. At times, surgeons allegedly concealed these activities by falsely attesting in medical records that they were physically present during “the entirety” of the operation, federal authorities said.

“These three doctors’ complete disregard for patient safety put patients at risk and violated Medicare regulations for their own convenience and greed,” said Special Agent in Charge Jason E. Meadows of the Bureau of the Inspector General of the Department of Health and Social Services.

The $15 million recovery is the largest settlement involving concurrent surgeries to date. The whistleblower will receive part of the settlement.

Baylor St. Luke’s sent the following statement.

“Baylor St. Luke’s Medical Center has reached an agreement with the Department of Justice (DOJ) to resolve a documentation and billing issue involving compliance and billing requirements set forth by the Centers for Medicare and Medicaid Services (CMS) The DOJ’s claims are strictly the allegations and settlement by Baylor St. Luke’s do not constitute an admission of liability. Baylor St. Luke’s remains committed to complying with all CMS regulations.

Baylor St. Luke’s is a world-renowned academic medical center that cares for patients from around the world with the most complex conditions. The hospital provides its patients with safe, high-quality care and remains committed to complying with all applicable regulations. »

Baylor College of Medicine, which employs the teaching physicians, said it had not engaged in any conduct that violated federal law, but they decided to resolve the dispute amicably to avoid a costly lawsuit. They go on to say that it is important to note that no patients were harmed.

Below is the full statement from Baylor College of Medicine.

“Baylor College of Medicine has not engaged in conduct that violates any applicable federal law or regulation. It is also important to note that no patients were injured. The settlement agreement acknowledged that BCM disputed any violation of federal law and that the fact that the College was a party to the agreement did not constitute an admission of liability on the part of Baylor. The College has decided to resolve the dispute amicably prior to a trial on the merits, after considering the costs and expenses incurred by Baylor to date, as well as anticipated future costs and expenses, including attorneys’ fees.

We checked the licenses of these doctors, and according to the Texas Medical Board website as of Monday, the doctors named in this lawsuit do not list any information about malpractice, criminal history or disciplinary actions.

Two of the three doctors have active licenses in Texas.

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