Whistleblower Suit Against Rush University Orthopedic Surgeons Unsealed

In a newly unsealed suit under the False Claims Act, a fellow surgeon has alleged that his colleagues at Chicago’s prestigious Rush University Medical Center routinely overbooked their schedules and relied on residents to perform surgeries in violation of federal Medicare billing rules.  A total of 6 surgeons, Rush University Medical Center, Rush SurgiCenter, and Midwest Orthopaedics are named as defendants in the suit.  Although the government has declined to intervene in this case, it reserves the right to do so at a later date.

Under the Medicare reimbursement rules for surgical procedures, a teaching physician must “be present during all critical portions of the procedure and immediately available to furnish services during the entire service.”  The Complaint alleges, among other incidents, that on one occasion in 2004, one of the defendants, Dr. Mitchell Sheinkop, performed a procedure in operating room number 7, while a resident performed a knee replacement on a 67-year-old patient in opeating room number 9.  The resident was allegedly instructed by Dr. Sheinkop to falsify the medical records.  It is further alleged on another date in 2004 that defendant Dr. Brian Cole scheduled two surgeries at 7:30 a.m., one surgery at 8:00 a.m., another surgery at 8:30 a.m., and one more at 9:30 a.m.  The 8:00 a.m. procedure occurred in operating room number 5, while the others were in the SurgiCenter.  Cole allegedly “monitored” simultaneous surgical procedures through an electronic video link of images taken by a fiberoptic arthroscopy camera.

Rush settled a portion of this lawsuit with the Justice Department, related to the use of office space in return for patient referrals, for more than $1.5 million; the medical center has admitted no wrongdoing.

For more information, see www.chicagotribune.com/business/ct-biz-0708-berger-rush–20100708,0,5506101.story

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