The U.S. Attorney’s Office Western District of Pennsylvania announced on September 2, 2021 that the United States has filed a complaint under the False Claims Act against the University of Pittsburgh Medical Center (UPMC), University of Pittsburgh Physicians, and James Luketich, M.D. based on a two-year investigation into allegations originally brought by a former UPMC physician under the False Claims Act’s whistleblower provisions, alleging that the defendants knowingly submitted hundreds of materially false claims for payment to Medicare, Medicaid, and other government health benefit programs over the past six years.
The complaint alleges that Dr. Luketich, who is long-time chair of UPMC’s Department of Cardiothoracic Surgery, regularly performs as many as three, complex surgical procedures at the same time, fails to participate in all of the “key and critical” portions of his surgeries, and forces his patients to endure hours of medically unnecessary anesthesia time, as he moves between operating rooms and attends to other patients or matters. According to the United States’ complaint, these practices violate the statutes and regulations governing the defendants, including those that prohibit “teaching physicians” (like Dr. Luketich) from performing and billing the United States for “concurrent surgeries.” The United States’ complaint alleges that Dr. Luketich’s practices violate the standard of care and the patients’ trust, and heighten the risk of serious complications.
The Acting U.S. Attorney stated in announcing the complaint, “The laws prohibiting ‘concurrent surgeries’ are in place for a reason: to protect patients and ensure they receive appropriate and focused medical care. Our office will take decisive action against any medical providers who violate those laws, and risk harm to Medicare and Medicaid beneficiaries.”
The Special Agent in Charge of the HHS-OIG Philadelphia Regional Office stated, ‘When physicians and other healthcare providers put financial gain above patient well-being and honest billing of government healthcare programs, they violate the basic trust the public extends to medical professionals. Our agency, working closely with our law enforcement partners, will continue to thoroughly investigate such healthcare fraud allegations to protect the health of patients and the integrity of taxpayer-supported programs serving them.”
False Claims Act
The False Claims Act’s whistleblower (“qui tam”) provisions authorize private parties to sue on behalf of the United States for false claims and share in any recovery, and permit the United States to intervene and take over the lawsuit, either in its entirety, or in part.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
Visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.
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