Anesthesiologist Sues Mass. General Hospital in False Claims Act Lawsuit

Bradley/Grombacher, LLP • November 20, 2017

A Boston anesthesiologist recently argued before a district court judge that her False Claims Act lawsuit has sufficient merit to move forward. The lawsuit accuses Boston’s renowned Massachusetts General Hospital of Medicare and Medicaid fraud.



The plaintiff, Dr. Lisa Wollman, alleges that Mass. General, her former employer, engaged in the practice of double-booking surgeries and having residents and fellows perform the procedures without a supervising doctor. According to the lawsuit, this practice is a material violation of Medicare and Medicaid regulations.


Allegations in the False Claims Act Lawsuit

According to the False Claims Act lawsuit filed by Dr. Wollman, the hospital’s “policy” provided financial incentives for its doctors to perform more surgeries yet never disclosed to patients that their doctor would be going back and forth between operating rooms.


Legal news service Law 360 reported that lawyers representing Mass. General asked a federal judge to dismiss Wollman’s False Claims Act case on the grounds that federal regulations dictating when a surgeon must be present in the operating room are vague.


According to Mass. General’s motion to dismiss, Medicare and Medicaid permit surgeons to “decide what parts of surgeries are critical or key and therefore what they need to be in the room for and what they do not need to be present for.”


Medicare and Medicaid regulations allow fellows and residents to perform some parts of surgery without a supervising doctor in the room, but federal healthcare rules require a licensed surgeon be present for all “key and critical parts,” Law 360 writes.


Mass. General’s motion to dismiss also states, that the False Claims Act lawsuit should be dismissed because Wollman did not name a specific surgery, did not provide proof of improper billing, did not name an instance of overlapping surgeries, and did not detail any particular surgery during which a licensed surgeon was missing during “key or critical” portions.


Wollman counters these claims by arguing that “the fraud occurred in MGH operating rooms sealed off from regular traffic” and not the insurance claims processing department. She also maintains that, as a physician, she does not have access to all patients’ insurance information and claims, but said its “highly implausible” that “none of the thousands of patients involved in these surgeries were covered” by the federal health plan.


Wollman states that while she doesn’t have written documentation, she personally witnessed entire surgeries performed without a licensed surgeon ever present. The False Claims Act lawsuit also alleges that:


  • Patients were endangered by at least five surgeons who regularly performed simultaneous surgeries,
  • The doctors committed fraud against the government by billing for surgeries for which they were absent during “critical portions” or didn’t attend at all, “leaving the work to unsupervised trainees.”
  • Between 2010 and 2015, Mass General orthopedic surgeons repeatedly kept patients anesthetized longer than medically necessary or safe so they could juggle two to three operations at the same time, according to the newspaper.


According to Dr. Wollman, not only were Medicare and Medicaid billed for the additional anesthesia the alleged practice “constitutes unnecessary, excessive and dangerous prescribing.”


The False Claims Act suit states that “this often meant an unwitting patient was left fully anesthetized — unconscious, paralyzed, intubated, dependent on a ventilator to breathe — for longer than medically necessary, often in the care of trainees, without the backup of a properly qualified surgeon, despite legal requirements.’’


The False Claims Act lawsuit referenced above is filed in the US District Court for the District of Massachusetts and is US et al v. Massachusetts General Hospital Inc. et al, case number 1:15-cv-11890.


Do you have knowledge that your employer violated the False Claims Act by committing Medicare fraud, Medicaid fraud, or other type of insurance billing fraud? See if you have a case by filling out the form on this page for a FREE and confidential case evaluation. 


By kileygrombacher January 16, 2025
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Photograph and Videotape: Take extensive photos and videos of all damage to your property, both inside and out, before any cleanup or repairs begin. Capture wide shots and close-ups, documenting the full extent of the destruction. Create a Detailed Inventory: Compile a comprehensive list of all damaged, destroyed, or lost personal belongings. Include descriptions, quantities, estimated values, and any available receipts, purchase records, or appraisals. Keep All Receipts: Save every receipt related to expenses incurred due to the fire, including temporary housing, meals, clothing, transportation, and any other out-of-pocket costs. Throwing Away Damaged Items Before the Adjuster's Inspection: Resist the urge to discard damaged items before the insurance adjuster has had a chance to inspect them. These items serve as crucial evidence to support your claim. If you must dispose of anything for safety or health reasons, take detailed photographs and videos first, and notify your adjuster. Not Understanding Your Policy: Your homeowners insurance policy is a complex legal document. Failing to thoroughly understand its terms, coverage limits, exclusions, and your responsibilities as a policyholder can lead to costly mistakes. If anything is unclear, seek clarification from your agent or an attorney. Pay particular attention to: Dwelling Coverage Limits: The maximum amount your insurer will pay to repair or rebuild your home. Personal Property Coverage: The limits for replacing your belongings. Loss of Use/Additional Living Expenses (ALE): The extent of coverage for temporary housing and other living expenses. Deductibles: The amount you must pay out-of-pocket before your coverage kicks in. Exclusions: Any specific types of damage or losses that are not covered. Accepting the First Offer Without Question: The first settlement offer from your insurance company is often a lowball offer, especially after a major event like a wildfire. They are hoping you'll accept it out of desperation or lack of knowledge. Don't be afraid to negotiate or seek a second opinion from an independent contractor or a lawyer. Downplaying Your Losses or Damages: Be honest and thorough when describing your losses to the insurance adjuster. Don't minimize the damage or omit items from your inventory. It's better to overestimate initially than to leave something out and have to fight for it later. Making Permanent Repairs Before Authorization: Avoid making any permanent repairs to your property before obtaining authorization from your insurance company. They may deny coverage for repairs made without their approval. Emergency repairs to prevent further damage are usually acceptable, but document them thoroughly and notify your insurer as soon as possible. Not Keeping Records of Communication: Document every interaction with your insurance company, including phone calls, emails, and in-person meetings. 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If you or a loved one suffered a personal injury due to someone else's negligence in connection with a wildfire, you may be entitled to compensation for: Medical Expenses: Past and future medical bills related to your injuries. Lost Wages: Income lost due to your inability to work. Pain and Suffering: Compensation for physical pain, emotional distress, and mental anguish. Loss of Consortium: Compensation to your spouse for the loss of companionship and support. 4. Your Right to Compensation for Lost Income or Business Interruption If a wildfire forced you to miss work or resulted in the closure of your business, you may have legal recourse: Lost Wages: If your employer wrongfully terminated you, failed to pay you, or denied you reasonable accommodations after a wildfire, you may be able to recover lost wages under California employment law. Business Interruption Insurance: If you have business interruption coverage as part of your commercial insurance policy, you may be able to recover lost profits and other expenses incurred due to the wildfire's impact on your business. 5. Your Right to Legal Representation Navigating the legal complexities after a wildfire can be daunting. An experienced attorney can be your advocate and guide, helping you to: Understand Your Rights: Provide clear explanations of your legal options and the applicable laws. Gather Evidence: Collect and preserve the necessary evidence to support your claims. Negotiate with Insurance Companies: Engage in strategic negotiations to secure a fair settlement. File Lawsuits: Take legal action against responsible parties, whether it be insurance companies, utility companies, government entities, or negligent individuals. Represent You in Court: Provide skilled representation in court if litigation becomes necessary. Bradley/Grombacher LLP: Dedicated to Helping Wildfire Victims At Bradley/Grombacher LLP, we understand the impact wildfires have on individuals, families, and communities. With over 50 years of combined experience in personal injury, employment law, and consumer law , we have the knowledge and skills to effectively advocate for your rights and secure the compensation you deserve. We're committed to: Holding negligent parties accountable. Maximizing your financial recovery. Providing compassionate and personalized legal representation. Take the First Step: Contact Us for a Free Consultation If you've been affected by a California wildfire, including the recent Palisades Fire, don't hesitate to contact Bradley/Grombacher LLP for a free, confidential consultation . We'll listen to your story, answer your questions, and provide an honest assessment of your legal options. Call us at (866) 881-0403 or fill out our online contact form. Let us help you navigate the path toward recovery and justice.
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