Hospital To Pay $12M To Settle Charges of Fraud, Unnecessary Surgery

Dec 16, 2016

South Miami Hospital has agreed to pay the federal government $12 million to settle charges that it knowingly allowed and billed for unnecessary medical procedures on thousands of patients.

The whistleblower lawsuit says the needless procedures – including heart surgeries – were performed by Dr. John R. Dylewski.  Now on a leave of absence, Dylewski is still fighting to clear his name, according to one of his attorneys.

“Dr. Dylewski categorically denies all allegations,” said Amber Donner, as the Miami Herald reported this week.

The two physicians who filed the case on behalf of taxpayers under the False Claims Act, Drs. James A. Burks and James D. Davenport, will receive $2.7 million of the settlement, the Justice Department says.

Their suit says that Dylewski’s fraudulent actions lasted for at least seven years. They say they complained repeatedly to officials at South Miami Hospital and the non-profit organization of which it is part, Baptist Health South Florida, “that patients were undergoing excessive, unnecessary, and improper procedures solely for the purpose of billing Medicare” and other federal programs.

Instead of taking action, the suit says, health system officials rewarded Dylewski by giving him a title that came with good pay and few responsibilities, as medical director for the L. Austin Weeks Center for Cardiac Electrophysiology. Dylewski was responsible for getting a $10 million donation from Weeks, a petroleum geologist.

As is usual in settlements, the hospital made no admission of wrongdoing.