A major lawsuit has been filed against former top executives of the University of Virginia Health System, including its former CEO Dr. Craig Kent. The complaint, which spans over 100 pages, alleges a coordinated effort to prioritize profits over patient safety, leading to fraudulent billing, retaliation against dissenting staff, and the deaths of at least two patients.
The legal action was initiated on October 3 in the U.S. District Court for the Western District of Virginia by the widows of two former patients and a group of physicians. They claim the administration, referred to as the "Kent Enterprise," engaged in practices that violate the federal Racketeer Influenced and Corrupt Organizations (RICO) Act.
Key Takeaways
- A federal lawsuit accuses former UVA Health CEO Dr. Craig Kent and his leadership team of orchestrating a "hostile takeover" focused on revenue.
- Allegations include systematic fraudulent billing, altering patient records, and creating a culture of intimidation.
- The complaint directly links the administration's actions to the deaths of two patients, citing incompetent surgical practices.
- Several physicians who are plaintiffs in the case claim they faced severe retaliation after raising concerns about patient safety and unethical conduct.
- This lawsuit follows the mass resignation of top UVA Health officials earlier this year after an internal investigation.
Details of the Allegations
The lawsuit presents a narrative of a systemic overhaul at UVA Health following Dr. Craig Kent's appointment as CEO in February 2020. Plaintiffs allege that Kent and his handpicked executives implemented policies designed to maximize revenue and national rankings, often at the expense of ethical standards and patient well-being. The complaint asserts these actions constituted a criminal enterprise under the RICO Act.
"This case arises out of a hostile takeover of a revered medical system by a cadre of individuals determined to maximize revenues and rankings," the court filing states. The plaintiffs argue that this push for profit led to a series of illegal acts, including widespread fraud and the silencing of medical professionals who objected.
The legal team for the plaintiffs, which includes the Charlottesville-based firm MichieHamlett and Jones Swanson Huddell from New Orleans, is seeking financial compensation for the damages caused. Attorney Gladstone Jones emphasized the gravity of the claims, stating, "What we can do under the law is bring a RICO action when there is an enterprise established to engage in criminal acts that damage and hurt people; and that’s what we’ve alleged here."
Fraudulent Billing and Financial Incentives
A central theme of the lawsuit is the accusation of systematic fraudulent billing practices. The complaint details how the leadership allegedly pressured physicians to increase revenue through unethical means. One key change was shifting physician compensation to rely almost exclusively on "Relative Value Units" (RVUs), a metric that incentivizes a higher volume of services and greater billing intensity.
"The shift created strong incentives for billing abuse," the lawsuit claims.
Specific examples of alleged fraud include:
- Upcoding: Intentionally exaggerating the risk level of surgical procedures to receive higher reimbursement rates from Medicare.
- Double-billing: Charging for two primary surgeons in procedures where only one was necessary or present.
- Falsifying Records: Altering patient medical records to justify inflated charges and to avoid liability in cases of malpractice.
Investigation and Departures
The lawsuit follows a period of significant turmoil at UVA Health. In 2024, 189 physicians and faculty members signed a letter of "no confidence" in the leadership. This prompted the university's Board of Visitors to hire the law firm Williams & Connolly to conduct an internal investigation. The findings of that report have never been made public. Within a five-month span following the investigation, Dr. Kent, medical center CEO Wendy Horton, and School of Medicine Dean Dr. Melina Kibbe all announced their resignations.
Patient Safety and Tragic Outcomes
The lawsuit claims the administration's focus on revenue had fatal consequences. It alleges that leadership hired physicians with known performance issues because they were loyal to the new agenda. The complaint specifically names Dr. Kim de la Cruz, a surgeon hired despite what the lawsuit describes as a history of "dangerous incompetence."
According to the filing, Dr. de la Cruz's former supervisor at Brigham and Women’s Hospital in Massachusetts stated he would have been fired if he had not left. At UVA, he was allegedly required to have a proctor supervise certain surgeries. The lawsuit contends that during a procedure that resulted in a patient's death, the assigned proctor was a junior faculty member who was not present for the entire operation, a violation of UVA Health's own policies.
The complaint further alleges that after the patient's death, Dr. de la Cruz altered the medical records, changing the calculated risk of death from approximately 3% pre-operation to over 20% post-operation. The plaintiffs argue this was done to increase the Medicare reimbursement and to obscure potential malpractice.
A Culture of Fear and Retaliation
Beyond the financial and medical allegations, the lawsuit paints a picture of a workplace where dissent was not tolerated. Several physician plaintiffs claim they were targeted after questioning the new policies. Dr. Kennan Yount, a plaintiff, alleges he was warned that crossing Kent and Kibbe could be "'not pleasant'" due to their powerful connections.
The complaint details various forms of retaliation:
- Physicians who opposed leadership were allegedly threatened with having their clinical privileges revoked.
- Dr. Yount found his job description posted online, and a co-director was hired for his role without his knowledge.
- Dr. Mark Roeser, another plaintiff, claims false reports of bullying and inappropriate behavior were filed against him after he raised concerns. These reports were allegedly placed in his permanent file without a proper investigation.
The 'Kent Enterprise'
The lawsuit alleges that Dr. Kent began assembling his team shortly after his arrival in 2020. During his tenure, approximately 550 faculty members and 16 of the 21 clinical department chairs were either replaced or newly hired. The plaintiffs argue that these new hires were selected outside of traditional governance protocols to ensure loyalty to the administration's profit-driven agenda, effectively creating a "hostile takeover" of the institution.
According to the lawsuit, Dr. Kibbe delivered letters to surgeons who challenged leadership, accusing them of "defiance, insubordination, disrespectful behavior, unprofessional behavior, and a lack of accountability to authority." These letters were reportedly placed in the physicians' human resources files without following standard procedures.
Official Responses and Next Steps
UVA Health has remained tight-lipped regarding the lawsuit. A spokesperson, Eric Swensen, stated that "the University does not generally comment on pending litigation."
Dr. Melina Kibbe, who has since moved to a position at the University of Texas Health Science Center at Houston, described the allegations as "unfounded and baseless" to the Houston Chronicle. She expressed eagerness for "the truth to prevail through the judicial system as there is no legal basis for this lawsuit."
No court date has been set, and not all defendants have been formally served with the lawsuit. Attorneys for the plaintiffs have indicated that the scope of the case and the list of individuals implicated could expand as the discovery process moves forward. Les Bowers, an attorney with MichieHamlett, noted that they had waited months for the health system to take responsibility before filing the suit. "No one wanted to accept responsibility or even take the claim seriously, and so here we are," he said.
