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  • Writer's pictureJames A. Gustino

Patient care be damned!

Every physician and hospital that elects to participate in he Medicare and Medicaid programs (yes, it is purely voluntary) pledges to abide by all regulations enacted to ensure that patients receive quality care. Honoring those regs is not terribly onerous, but way too many physicians and hospitals try to "game" the system in order to maximize their profits. 


Hopefully, nobody died as as result of this fraud, and U.S taxpayers got $15M (less the whistleblower's share) back...


//The whistleblower alleged Coselli, Lamelas and Ott - three heart surgeons who performed at St. Luke’s - engaged in a regular practice of running two operating rooms at once and delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents. The heart surgeries at issue are some of the most complicated operations performed at any hospital including coronary artery bypass grafts, valve repairs and aortic repair procedures. These surgeries typically involve opening a patients’ chest and placing the patient on the bypass machine for some portion of time. 


Medicare regulations dictate when teaching physicians can leave the operating room for any operation, no matter how complex. 


The settlement resolves allegations that from June 3, 2013, to Dec. 21, 2020, Ott, Coselli and Lamelas violated these rules in various respects. Surgeons often ran two operating rooms at once and 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.


Additionally, surgeons would allegedly enter a second or occasionally a third operation without designating a backup surgeon. At times, the surgeons allegedly hid these activities by falsely attesting on medical records they were physically present for the “entire” operation. In addition, medical staff did not inform patients the surgeon would be leaving the room to perform another operation. //


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