July 29, 2010
Whistleblower Case Against Rush University Medical Center and Orthopedic Surgeons Recently Unsealed
A Health Care False Claims Bulletin
After the Department of Justice recently declined to intervene in a whistleblower action filed by a Rush University Medical Center surgeon and a former hospital executive who alleged that six orthopedic surgeons routinely failed to meet Medicare supervision requirements, the case was unsealed and the allegations were made public. The lawsuit names Rush, six surgeons, Rush SurgiCenter, and Midwest Orthopaedics as defendants and alleges that during 2004 and 2005, orthopedic surgeons at Rush overbooked their schedules and violated Medicare rules that require teaching physicians to be present during all critical portions of procedures and to be immediately available to furnish services during the entire service.
The whistleblowers allege that overlapping surgeries were booked and that in one instance a surgeon never entered the operating room to supervise a procedure. In other instances, surgeons monitored residents performing operations via video feed while simultaneously performing their own surgeries in another operating room. According to the lawsuit, these practices violated Medicare rules.
Rush previously settled a portion of the lawsuit with DOJ back in March, related to the use of office space in return for patient referrals. In that settlement, Rush paid more than $1.5 million. We will have to wait to see what happens with this case. Although the government declined to intervene, it always has the right to re-enter the case and take over.
While it remains to be seen whether the allegations in this case are valid, the lawsuit should serve as a reminder to teaching hospitals to ensure they are complying with the rules governing physician supervision of residents.