DOJ orders Houston medical centers to pay $15M over concurrent billing false claims

Houston-based medical center institutions agreed to jointly pay $15 million to settle allegations for improperly billing Medicare for concurrent surgeries in violation of teaching physician and informed consent regulations.

Baylor St. Luke’s Medical Center (BSLMC), a joint venture between national hospital chain CommonSpirit Health and Baylor College of Medicine (BCM), along with Surgical Associates of Texas P.A. (SAT), employed three heart surgeons who “engaged in a regular practice of running two operating rooms at once … delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents,” the DOJ alleged in a press release Monday.

The case resolved claims brought under the qui tam provisions of the False Claims Act by an unnamed whistleblower. The whistleblower will receive more than $3 million of the settlement total.