According to a lawsuit that was unsealed in federal court the end of last week, three former anesthesiologists at Vanderbilt Medical Center in Nashville, Tenn., are alleging that the hospital has been systematically billing Medicare fraudulently for at least a decade.
According to a story in The Tennessean on Friday, the three former employees are claiming that Vanderbilt encouraged physicians to regularly schedule simultaneous multiple surgeries in different locations and bill Medicare for each one even though Medicare requires attending physicians at teaching hospitals to be present at surgeries. According to the lawsuit, Vanderbilt also used its information management software to carry out a portion of the fraud by taking advantage of its remote access features to schedule physicians to be in multiple places at one time.
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The suit was originally filed in 2011. Federal investigators asked the judge for additional time to investigate but that request was denied, which led to the case being unsealed.
The suit names Jeffrey Balser, current dean of the school of medicine, as a key proponent of the software and claims that Vanderbilt's actions, including the building of its software, are part of an intentional scheme. According to The Tennessean, Vanderbilt officials deny this claim.
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"We do not believe these allegations have merit," Vanderbilt spokesperson John Howser said in a written statement obtained by the newspaper. "Vanderbilt University Medical Center has been cooperating with the government over the past two years regarding a civil inquiry related to treatment documentation and billing records. (To) date, we have not found evidence supporting the allegations." The newspaper also reported that Howser said in the statement that Vanderbilt is prepared to "defend itself vigorously."
The Tennessean reported that the next court appearance in the case is scheduled for late October and that no specific total damages are requested in the suit. Instead, the suit asks for a judgment at three times the overpayments for each claim (the number of claims was not specified) and additional penalties and fees.
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