A doctor who completed his medical residency at an Advocate Health Care facility has sued the health system for refusing to use residents in surgeries, then billing Medicare and Medicaid for their assistance.
In a federal lawsuit unsealed this week, Luay Ailabouni alleged that the Chicago-area health system said they didn't have qualified assistant surgeons available for operations, even though nursing records showed that qualified residents were in the room.
Medicare and Medicaid reimburse teaching hospitals for some expenses, as they're expected to have higher patient costs due to seeing more severe cases and other costs like inexperienced residents ordering extra tests.
According to the complaint, Advocate Health has known about the improper billings for at least a decade, noting that the past president of Advocate Christ Hospital and Medical Center - where Ailabouni did his residency - had been informed of the practices more than a decade ago.
The False Claims Act suit also calls out specific surgeons for excluding their assigned residents from their surgeries in favor of physician assistants. One in particular repeatedly used his physician assistant daughter in his surgeries rather than his assigned residents, the suit alleged.
Advocate Health also received improper graduate medical education payments from Medicare and Medicaid, according to the suit. The federal government and Illinois declined to intervene in the lawsuit, which was initially filed in March 2013.