Dr. Lisa Wollman, a former anesthesiologist at Massachusetts General Hospital (Mass General), has alleged in a recently unsealed qui tam False Claims Act complaint that surgeons at Mass General routinely scheduled multiple patients for surgery at the same time – which resulted in patients being left fully anesthetized for dangerously long periods of time and longer than medically necessary.

Dr. Wollman alleges that Mass General and at least five surgeons at the hospital defrauded the government by submitting bills to government healthcare programs such as Medicare and Medicaid for surgeries in which the surgeon was not in the operating room for critical portions of surgical procedures.  Under Medicare and Medicaid regulations surgeons must be present for all “critical portions” of an operation for the operation to be reimbursable by government healthcare programs.

Dr. Wollman also alleges that in order to keep patients unconscious for unnecessarily long periods of time, more anesthesia was used on patients than was medically necessary.  Therefore, as alleged, billing federal healthcare programs for unnecessary anesthesia fraudulently inflated the anesthesia costs associated with potentially thousands of surgeries.

While the United States Attorney for the District of Massachusetts has declined to intervene in Dr. Wollman’s qui tam action, the False Claims Act allows relators — such as Dr. Wollman — to continue to pursue qui tam actions without the government joining the case.  Relators that successfully resolve non-intervened cases — through settlement or at trial —  are entitled to receive a larger portion of any relator’s award – between 25-30 percent of the government’s gross recovery.  Whereas relators in intervened cases are entitled to 15-25 percent of the government’s gross recovery.

For more information about Medicare and Medicaid fraud, click here