Erlanger whistleblowers have reached an undisclosed settlement with the health system, bringing an end to a federal lawsuit that claimed hospital staff illegally billed government insurance providers for overlapping surgeries.
The hospital's former chief information officer, Stephen Adams, and orthopedic surgeons Julie Adams and Scott Steinmann brought the complaint against Erlanger in April 2021 under the False Claims Act and Tennessee Medicaid False Claims Act.
On April 15, District Judge Travis McDonough signed off on the termination of the yearslong legal battle, dismissal records show.
Erlanger is a teaching hospital, so medical students or residents gain on-the-job experience there. A resident can perform an entire surgery in some cases.
Tennessee's Medicaid program, TennCare, and Medicare require a supervising physician be present for "key and critical" portions of a surgery performed by a resident in order to receive insurance payouts.
Three former Erlanger employees alleged they raised concerns, which ultimately cost them their jobs, about hospital staff regularly billing for two or three surgeries completed at the same time without patient consent or proper oversight.
The False Claims Act allows people with nonpublic information to bring a lawsuit in the name of the government to safeguard public funding. The United States can then decide whether to intervene after it investigates any allegations of false statements or fraudulent representations used to secure...
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