Anesthesiologists Overbilled Pittsburgh VA Hospital, Says Inspector General Report
Contract anesthesiologists at the Veterans Affairs Pittsburgh Health System (VAPHS) billed for services they did not perform and oversaw the anesthesia service though they were contractors, according to an Aug. 7 report by the U.S. Department of Veterans Affairs Office of Inspector General (OIG). The OIG reported that wrongdoing was found within contracts valued at $5.4 million involving 4.575 contract anesthesiologists – about $1.2 million of contract value per anesthesiologist – over 32 months ending in August 2013. For CRNAs, the OIG report underscores the importance of ethical behavior in documenting patient care and an example of the types of wrongdoing that the OIG is investigating in the Veterans Health Administration (VHA).
According to the OIG report, a review of 20 random entries for invoiced anesthesiologist services found that “for two of the 20 entries there were more than seven unsupported hours for each entry. These are hours that exceeded the hours in the OR records after including an additional two hours for pre- and post-surgery time that the physician may have been in the VA.” The report also stated that the Pittsburgh VA “serves as Chief of Anesthesiology and Director of Pain Services at VAPHS, but is not a VAPHS employee. We note that VA does have anesthesiologists on staff but a UPP (University of Pittsburgh Physicians, Inc.) physician serves as VA’s Chief of Anesthesiology.”
The report also said that a CRNA helped shine the light on misappropriation in the anesthesiology department. “During our site visit, a VA Certified Registered Nurse Anesthetist (CRNA) stated that he had concerns with UPP anesthesiologists signing in hours prior to their being needed in surgery,” the report said. “He stated that these were transplant surgeries and that many times the exact start time of the surgery was unknown because they were dependent on the organ harvest preparation time. However, physicians were not required to wait at VAPHS, but were given the choice to go home and would be notified when they were needed. He also stated that UPP anesthesiologists remained signed in because it was inconvenient for them to go home and return. The 20 entries that we examined included instances where a physician had signed in many hours before the surgery began.”