A federal whistleblower lawsuit accuses 6 Chicago orthopedic surgeons and the facilities at which they operate of fraudulently billing Medicare for surgeries performed by residents, putting patient safety at risk.
The lawsuit, filed by Rush University Medical Center orthopedic surgeon Robert S. Goldberg, MD, and June Beecham, a former administrator at the center, describes physicians filing Medicare claims for surgeries performed by residents, surgeries at which they were occasionally not present or which they observed on video monitors while performing surgeries elsewhere.
In addition to the medical center and the Rush SurgiCenter, which the suit accuses of being complicit in violating Medicare billing rules, defendants include Richard Berger, MD, a leader in minimally invasive hip and knee replacements and until recently a paid consultant to implant manufacturer Zimmer Holdings; Brian Cole, MD; Craig Della Valle, MD; Wayne Paprosky, MD; Aaron Rosenberg, MD; Mitchell Sheinkop, MD; and the physicians' practice, Midwest Orthopaedics at Rush.
Dr. Goldberg and Ms. Beecham argue that the reimbursements and recognition to be gained by increasing case volume led the physicians, practice and facilities to endanger patients by skirting Medicare requirements that surgeons supervise residents and certain aspects of a procedure. "This case raises important red flags about what can happen when a medical group like [Midwest Orthopaedics] and its doctors, encouraged by the hospital where its surgeons practice and tempted by easy money, focus exclusively on maximizing profits, instead of serving patients," says the lawsuit.
In a statement, a spokeswoman for Rush says the hospital "believes the lawsuit has no merit and intends to vigorously defend the case." An attorney for Dr. Goldberg and Ms. Beecham did not immediately return a call seeking comment.
The lawsuit, originally filed in November 2004, was only recently released for public view in an amended form, following the medical center's settlement of earlier allegations that it traded office space for patient referrals. Rush paid the U.S. Department of Justice $1.5 million but did not admit wrongdoing. A representative for the U.S. Attorney's office in Chicago was not available for comment.
David Bernard
