Massachusetts General Hospital will pay $14.6 million to settle allegations that it allowed for overlapping surgeries that violated federal Medicare and Commonwealth of Massachusetts Medicaid rules.

Anesthesiologist Dr. Lisa Wollman brought the healthcare system to court under the federal and Massachusetts False Claims Acts. Both allow individuals, under certain circumstances, to file suits on behalf of the government.

In her suit, Wollman claims that MGH, the clinical teaching arm for Harvard Medical School, allowed orthopedic surgeons to inappropriately perform multiple procedures at the same time. She alleges that teaching surgeons were not present for or performing critical portions of certain surgeries and that they did not wait until these key parts of one procedure were completed before beginning a second operation. They also did not designate another qualified surgeon to be immediately available to assist in non-key portions of the surgeries when the teaching surgeons were not present.

She alleges that the government was billed for excessive anesthesia services and that patients did not provide adequate informed consent for the overlapping procedures. Under the Whistleblower provisions of both acts, Wollman is entitled to a portion of the recovered funds.

"MGH has new leadership, and I am pleased this case put us in the position where we could have a dialogue that will improve patient care and, as importantly, transparency," said Wollman in a statement.

Many hospitals encourage surgeons to utilize concurrent surgery as it saves on waiting times and operating room costs and allows more patients to be treated by a hospital’s most in-demand specialists. While a study in 2019 said that concurrent surgery is generally a safe practice, some patient groups may face small increased risks, including stroke and heart attack. Risk of death was also slightly higher in overlapping surgeries involving coronary artery bypass grafting and high-risk individuals, according to Stat News.

A patient by the name of Tony Meng was left paralyzed after undergoing surgery at MGH for a degenerative condition that was compressing his spinal cord. While the exact cause is unknown, the surgeon at the time, Dr. Kirkham Wood had performed Meng’s procedure at the same time as another patient and dipped out at certain parts to attend to her in a different operating room. Meng filed a malpractice suit against the hospital, which defended its actions and those of Wood and denied that the practice of concurrent surgeries had resulted in Meng’s paralysis, reported The Boston Globe.

“We haven’t found a single case where the concurrency has caused harm, so I don’t think patients should be alarmed about it,” Dr. Peter Slavin, Mass. General’s president, said during an interview in the hospital’s historic Bulfinch Building.

Another surgeon, Dr. Dennis Burke, fought the hospital for years in a suit opposed to double booking. MGH officials said that Burke violated hospital rules and possibly federal privacy laws by supplying the Boston Globe with copies of some internal records.

In 2016, the Senate Finance Committee held hearings and published a report on the subject, saying that it had several concerns about the practice, reported Stat News.

Initially filed in 2015, the government refused to intervene in Wollman’s case and the court dismissed it. She amended her complaint, which resulted in a court decision, United States ex rel. Wollman v. Massachusetts General Hospital. The case became the basis for other overlapping surgery cases that have since been resolved in New York and Arizona and laid the legal groundwork for the government to challenge improper overlapping surgeries.

"This lawsuit was a catalyst for an important dialogue that will cause a world-renowned institution to set a precedent for a new standard of care in informed consent for overlapping surgeries," said Reuben Guttman of Guttman, Buschner & Brooks, PLLC, the lead counsel for Dr. Wollman.