Credits to the owner
HOUSTON — A whistleblower’s complaint has triggered a federal investigation into surgeons at Baylor St. Luke’s Medical Center, culminating in a record $15 million settlement.
Federal authorities allege that three surgeons—Dr. Joseph Coselli, 71, Dr. Joseph Lamelas, 63, of Miami, Florida, and Dr. David Ott, 77—routinely left operating rooms during complex and high-risk heart surgeries, leaving patients under the care of unqualified medical residents.
“Patients entrusted these surgeons with their lives—submitting to operations where one missed cut is the difference between life and death,” said U.S. Attorney Alamdar S. Hamdani. “Allegedly, the patients were unaware their doctor was leaving for another operating room.”
Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM), and Surgical Associates of Texas P.A. (SAT) have agreed to pay $15 million to resolve claims of billing Medicare for concurrent heart surgeries. This practice, according to the allegations, compromised patient safety and violated Medicare regulations.
Houston FBI Special Agent in Charge Douglas Williams emphasized the breach of trust: “Doctors gambled with their patients’ care, during complicated open-heart surgeries no less, compromising quality of care over quantity and then falsely billed Medicare for reimbursement of services they improperly delegated.”
The investigation, which began in 2019, was prompted by allegations that Coselli, Lamelas, and Ott left residents to perform parts of complicated coronary artery bypass grafts, valve repairs, and aortic repair procedures. These surgeries involve opening a patient’s chest and using a bypass machine.
The Justice Department revealed that surgeons would move between surgeries without designating a backup surgeon, sometimes falsifying medical records to indicate their presence for the entire operation.
“The complete disregard for patient safety exhibited by these three doctors put patients at risk and violated Medicare regulations for their own convenience and greed,” said Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General.
The $15 million recovery is the largest settlement to date involving concurrent surgeries, with a portion of the settlement awarded to the whistleblower.
Baylor St. Luke’s Medical Center issued a statement confirming the settlement with the Department of Justice (DOJ) over documentation and billing issues, emphasizing that the settlement is not an admission of liability and that the hospital remains committed to compliance with CMS regulations.
“Baylor St. Luke’s Medical Center has reached an agreement with the Department of Justice (DOJ) to resolve a documentation and billing matter involving compliance and billing requirements set forth by the Centers for Medicare and Medicaid Services (CMS). The DOJ claims are strictly allegations and the settlement by Baylor St. Luke’s is not an admission of liability. Baylor St. Luke’s remains committed to complying with all CMS regulations.”
Baylor College of Medicine, which employs the teaching physicians, also released a statement, asserting no federal law violations occurred and that the decision to settle was to avoid the costs of a trial. They highlighted that no patients were harmed.
“Baylor College of Medicine did not engage in conduct that violates any applicable federal law or regulation. It is also important to note that no patients were harmed. The settlement agreement acknowledged that BCM disputed that any violations of federal law occurred and that the College being a party to the agreement is not an admission of liability by Baylor. The College decided to amicably resolve the dispute prior to a trial on the merits after considering the cost and expense incurred by Baylor to date, and anticipated future costs and expenses, including attorneys’ fees.”