On February 18, 2022, Massachusetts General Hospital (MGH), the Massachusetts General Hospital’s Physician’s Organization, and Mass General Brigham Incorporated (collectively, Defendants) agreed to pay $14.6 million to resolve a False Claims Act lawsuit. The case included allegations Defendants billed government healthcare programs for certain overlapping surgeries that violated federal and state requirements.
The practice of overlapping surgeries, or when an attending surgeon participates in two procedures that overlap in time, is a common practice at teaching hospitals. Efficiencies gained by overlapping surgeries can allow more patients to receive care from top surgeons. CMS allows billing for overlapping surgeries only when they meet certain requirements concerning physician presence during procedures and documentation.
Allegations regarding MGH’s overlapping surgery practices first garnered significant attention in the fall of 2015 when the Boston Globe published a detailed investigative story. Since that time, the practice of overlapping surgeries across the country has received increased public and enforcement scrutiny.
The MGH False Claims Act lawsuit was initially filed in 2015 by relator Lisa Wollman, M.D., a former MGH anesthesiologist. In addition to allegations that certain overlapping procedures were not in compliance with applicable CMS and state requirements, Dr. Wollman also alleged that Defendants billed for excessive, medically unnecessary anesthesia...
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