$14.6M settlement awarded in overlapping surgery case

The practice of overlapping surgeries, when a surgeon participates in two procedures that overlap in time, is common at teaching hospitals and some ASCs.

It can increase operating room efficiency, allowing more patients to receive care. CMS allows billing for overlapping surgeries that meet certain requirements, but there is a point where the practice becomes a liability.

A 2015 False Claims Act lawsuit led to Boston-based Massachusetts General Hospital, the Massachusetts General Hospital's Physician's Organization and Mass General Brigham agreeing to a $14.6 million settlement on Feb. 18 over overlapping surgeries that allegedly violated federal and state requirements, JDSupra reported March 9.

A former MGH anesthesiologist alleged the hospital billed payers for excessive, medically unnecessary anesthesia services performed during some overlapping surgeries, JDSupra reported. The case also included allegations that informed consent was not obtained from patients.

In addition to the $14.6 million sum, MGH agreed to add language on overlapping surgeries to its procedural consent form.

In the time since the lawsuit was filed, overlapping surgeries have received heightened scrutiny across the country. Recently, a top University of Pittsburgh Medical Center surgeon was sued over alleged violations of procedures related to overlapping surgery.

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