The exclusive anesthesia services provider for Chattanooga, Tenn.-based Erlanger Health System, Anesthesiology Consultants Exchange, also of Chattanooga, has alleged that its anesthesiologists repeatedly raised concerns that Erlanger surgeons were not complying with the hospital's overlapping surgery policy, according to a Jan. 11 report from the Chattanooga Times Free Press.
In 2021, two former Erlanger orthopedic surgeons and its former chief information officer filed a federal whistleblower complaint against the health system under the False Claims Act and Tennessee Medicaid False Claims Act alleging Erlanger physicians illegally billed government insurance for overlapping operations wherein residents and interns completed surgeries alone without proper oversight or patient consent.
Evidence is being collected and reviewed for the trial. In a recent motion to sever and dismiss itself from the lawsuit, ACE testified that it continuously opposed Erlanger's practices and did not conspire with the hospital.
The orthopedic surgeons and Erlanger's former CIO concurred and have made statements on behalf of ACE requesting all claims against ACE be dismissed.
Christopher Young, MD, a spokesperson for ACE, claims the provider was made aware of overlapping Erlanger procedures in 2015. In 2017, Erlanger implemented rules to address overlapping procedures.
Shortly after, Dr. Young and ACE claimed the new rules were not being followed.
Erlanger is a teaching hospital, which allows young physicians in training to be used during surgeries with supervision.
While it's not illegal for a teaching physician to oversee multiple operations at the same time, a supervising physician must be present for the "key and critical" portions of each procedure to bill Tennessee's Medicaid program, TennCare and Medicare.
ACE is not responsible for scheduling patients but continued to express concerns about overlapping surgeries and its desire to limit improper practices, according to court documents.
It was alleged that on typical weekends, an orthopedic surgeon would start one long surgery and a resident would start a shorter surgery. Dr. Young claimed that once, a physician left an operating room and a resident was left alone doing spine surgery without an attending surgeon present.