- The Washington Times - Thursday, September 7, 2006

Four former anesthesiology nurses have accused George Washington University of overbilling the federal government at least $100 million by charging Medicare physician rates for hospital services performed by nurses and residents in training.

The nurses’ attorneys last week asked a federal judge to impose sanctions against the university for failing to turn over about 10,000 Medicare documents in connection with their False Claims Act lawsuit, which they filed on behalf of the U.S. government more than 10 years ago.

In an amended complaint filed Friday, the nurses said that the university billed the Medicare program for anesthesiology services at physician rates from 1989 to 1995, but doctors left the work for residents or nurses to perform.

In several instances, physicians were playing computer games, sitting in a hospital lounge or studying for exams, the nurses’ court filings say.

The university has disputed the nurses’ claims.

In court records, the university denied any wrongdoing and said hospital doctors acted properly and within the scope of Medicare rules.

An attorney for the university referred questions to George Washington spokeswoman Linda Dent, who said officials have a policy of not commenting on active litigation.

However, “we do believe that George Washington and its physicians acted appropriately in the matter being challenged,” she said yesterday.

The FBI investigated the nurses’ complaint, but the U.S. Department of Justice declined to intervene. The case ultimately was unsealed.

A Justice Department spokeswoman declined to comment.

The nurses suing are Sheila El-Amin, Katherine Linden, Joyce B. Lasley and Robert Roubik, all of whom now are employed elsewhere, said Alan Grayson, an attorney for the nurses.

“The lawsuit is about the fact that the nurses did the work for anesthesiology at the hospital for many years, and the doctors billed for this as if they did it themselves,” Mr. Grayson said.

The nurses said that in some instances, anesthesiologists whose services were charged under Medicare did not get involved in cases until after patients were discharged.

One physician’s services were billed to Medicare as an attending anesthesiologist, while he himself was a patient and in a coma, the lawsuit states.

Attorneys for the university have called the assertions that physicians did not perform services “bald-faced distortions” in court filings.

Nurses and residents did assist physicians in the “seven steps” of anesthesia procedures, but “there is no evidence that GWU’s physicians did anything other than perform the seven steps, utilizing the reasonable — an entirely permissible — assistance of residents and [nurses],” the university argued.

Attorneys for the university denied that physicians ever passed off responsibilities to nurses or residents.

In the latest twist in the long-standing dispute, attorneys for the nurses filed a motion for sanctions against the university, saying officials had failed to turn over about 10,000 Medicare claims.

Attorneys for the nurses say they have reviewed nearly 7 million documents in connection with the lawsuit, but Mr. Grayson said the plaintiffs also need the university’s records to help prove their case.

“The first issue is many records are still missing,” he said. “The second is that when you’re a defendant in a lawsuit, you cannot throw records out.”

The university has denied destroying evidence, saying officials did not keep copies of the records because they were not required to do so. The university also said the nurses’ attorneys have failed to turn over records in the case.

In False Claims Act suits, plaintiffs can receive compensation if they prove the government was cheated, and defendants can be forced to pay up to triple damages.

Under a partnership deal, the university and Universal Health Services Inc., a national hospital management company, have jointly owned and operated George Washington University Hospital since 1997.

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