Amy Faith Ho, MD MPH after CMS proposed yet another cut to physician reimbursements in 2025.

Surgeries & Interventions

Baylor St. Luke’s Settles Concurrent Cardiac Surgery Case

Cardiac surgeon compensation is generally a numbers game – the more procedures you do, the more you make. However, a Medicare fraud settlement featuring some of Houston’s most prominent institutions and cardiac surgeons reveals the pitfalls of this incentive structure.

Allegations claim that between 2013 to 2020 three decorated Baylor St. Luke’s heart surgeons regularly operated in two to three rooms simultaneously, while “delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents.”

• Each of the surgeons claimed in medical records that they were present throughout the procedures, even if they weren’t.

Since getting flagged by a whistleblower in 2019, the U.S. District Attorney’s office decided that this amounted to Medicare fraud.

Baylor St. Luke’s Medical Center and Baylor College of Medicine finally settled the case for $15M last month, representing the largest settlement ever involving concurrent surgeries, while awarding $3M to the whistleblower (St. Luke’s previous director of transplant surgery).

Although charges against the surgeons were dismissed as part of the settlement, and the defending parties still attest that they followed all laws, the details from the case were alarming…

• The three physicians performed over 5,000 simultaneous surgeries that generated $150M for the hospital.
• The physicians achieved four-times higher compensation than the average cardiac surgeon in Houston, and two-to-four times higher procedure volumes than the average U.S. cardiac surgeon.
• The most prolific surgeon earned over $2M in a year, and was once scheduled to perform 32 hours of surgery over a 16-hour period.
• These simultaneous operations led to longer procedure and anesthesia times, and involved at least four patient deaths, cases of redo surgeries, and other adverse events.

This settlement is yet another sign that the HHS-OIG is cracking down on Medicare fraud, following a number of other notable cardiology cases that were also tipped off by whistleblowers.

The Takeaway

Given current workloads and incentives, you can bet that Baylor St. Luke’s isn’t the only teaching hospital where cardiac surgeons are treating multiple patients simultaneously. In fact, there’s probably some physicians reading this who believe they could treat multiple patients without sacrificing patient care. 

However, there could be some potential whistleblowers reading this too… and given the message sent by Baylor St. Luke’s massive settlement and whistleblower payout, extreme cases of concurrent cardiac surgeries might soon become a thing of the past.

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