Hospital and doctor charged with Medicare Fraud for performing unneeded tracheotomies reaping upto $160,000 per case

A Chicago hospital, its owner, the CFO and five physicians have been charged with Medicare fraud saying that they gave or received kickbacks in return for patient referrals and some with providing unneeded tracheotomies. This surgery is typically used to open air passages directly into the windpipe for patients who can’t breathe otherwise. Based on FBI secret tape recordings, the court filings say that a Sacred Heart pulmonologist kept patients too sedated to breathe on their own, then ordered unneeded tracheotomies for them, enabling the for-profit hospital to earn as much as $160,000 per case. An FBI affidavit also includes a quote from the hospital’s owner asking the pulmonologist to provide two more tracheotomy cases for the hospital soon, before inspectors, who had visited the hospital before March, returned. A Sacred HEart surgeon performed tracheotomies on 28 Medicare patients between early 2010 and January, according to the affidavit. Five died within two weeks, a death rate three times the statewide rate in Illinois. The affidavit says that tracheotomy patients were lucrative for the doctors as well as they could bill $160 each time they visited a tracheotomy patient at the hospital. Sacred Heart is located on Chicago’s west side in a neighborhood with half the median household income and twice the poverty rate of the city overall. It has been filling less than half its 119 beds in recent years and almost all patients are Medicare or Medicaid recipients. Despite this, the hospital reported a jump in profit to $9.4 million for the year ending June 30, 2012 up $1.3 million from the prior year. Jeffrey Newman represents whistleblowers.