MASS GENERAL HOSPITAL TO PAY $14.6 MILLION TO RESOLVE OVERLAPPING SURGERY CLAIMS; STANDARDIZED CONSENT FORMS TO BE AMENDED – QNT Press Release

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BOSTON, Feb. 19, 2022 /PRNewswire/ — Massachusetts General Hospital (MGH), the clinical teaching arm for Harvard Medical School and one of the world’s most prestigious hospitals, has resolved a federal whistleblower case stemming from allegations that some of the hospital’s orthopedic surgeons engaged in overlapping surgeries that violated federal Medicare and Commonwealth of Massachusetts Medicaid rules.

MGH will pay $14.6 million to the federal government and Massachusetts and change its informed consent language to better apprise patients of when their surgeon has an overlapping surgical obligation.

The settlement – ​​reached after extensive discovery – resolves claims brought by an anesthesiologist, Dr. Lisa Wollmanin the matter of United States ex rel. Lisa WollmanMD et. al. v. Massachusetts General Hospital, et al., No. 1:15-CV-11890-ADB.

Dr. Wollman brought her suit under the Federal and Massachusetts False Claims Acts. These statutes allow individuals, under certain circumstances, to bring suit in the name of the government to return money to the government treasury.

Dr. Wollman, known under the False Claims Act as the “Relator,” brought her suit as a vehicle to address patient care issues; she alleged the following:

  • Teaching surgeons were not present for or performing the key and critical portions of certain surgeries;
  • Teaching surgeons did not wait until the key and critical portions of one surgery had been completed before beginning a second, overlapping surgery;
  • Teaching surgeons did not designate another qualified surgeon to be immediately available to assist as needed in the non-key and non-critical portions of the overlapping surgeries for which the teaching surgeons were not present;
  • The government was billed for excessive anesthesia services;
  • Informed consent was not adequate for overlapping surgeries.

In addition to the monetary payment, Mass General Brigham shall add the following language to its standardized procedural consent form for Massachusetts-based hospitals within its system:

My surgeon has informed me that my surgery is scheduled to overlap with…

Full story available on Benzinga.com

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