Whistleblower Suit Snares $1.2M: Anesthesiologists Failed to Supervise

-->April 18, 2013Billing & Compliance Alerts

    Whistleblower Suit Snares $1.2M:
    Anesthesiologists Failed to Supervise

    By Justin Vaughn, M.Div, CPC
    Director of Compliance

    4/18/2013

    An anesthesiologist brought a qui tam action against his fellow physicians for failing to provide proper supervision to both CRNAs and residents.   Commonly referred to as a “whistleblower” lawsuit, the case stems from allegations asserted in 2008 that anesthesiologists in a teaching facility in Irvine, CA. submitted claims involving CRNAs and residents that were, in fact, fraudulent.  Specifically, it was alleged that the anesthesiologists would routinely document their presence and availability on the anesthesia record, when in actuality they were not even in the same building.

    After years of legal wrangling, the California Board of Regents decided to settle the suit for $1.2 million, with the plaintiff anesthesiologist receiving 10% of that sum.  Considering the above facts, the message that should be driven home to every anesthesiologist is this:  Whistleblowers are everywhere.  They may even be a fellow physician within your own group.  When it comes to medically directing CRNAs or supervising residents, make sure you assiduously abide by the following documentation protocols:

     

    1. Never pre-document a record.  That is, don’t indicate your fulfillment of all the medical direction or supervision requirements before the case even begins!  You should wait until the last part of the case to indicate your presence at emergence, for example
    2. An MD who is medically directing a CRNA must document: (a) the pre-anesthesia exam and evaluation, (b) his/her participation in the key portions of the case (eg, induction and emergence), (c) that he/she monitored some portion of the case, and (d) his/her participation in the post-anesthesia care.
    3. An MD who is supervising a resident must document: (a) his/her involvement in the key or critical portions of the case(eg, induction and emergence), AND (b) that he/she remained immediately available throughout the case.
    4. Don’t document what isn’t true.  Remember, someone is always watching.


    The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author’s presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.