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UPMC to pay $8.5 million for fraud
[b][link=https://www.wesa.fm/health-science-tech/2023-02-27/upmc-agrees-to-pay-8-5-million-to-settle-fraud-case-involving-prominent-surgeon] UPMC agrees to pay $8.5 million to settle fraud case …[/link][/b]UPMC has agreed to an $8.5 million settlement to resolve a federal fraud case involving its head of cardiothoracic surgery.
In September 2021, the U.S. Department of Justice [u][link=https://www.wesa.fm/health-science-tech/2021-09-02/federal-prosecutors-say-top-upmc-surgeon-performed-multiple-surgeries-at-once-leaving-patients-under-anesthesia-for-longer-than-necessary]sued[/link][/u] Dr. James Luketich, UPMC and the University of Pittsburgh Physicians for allegedly submitting false claims to Medicare and defrauding the federal government.
While physicians at teaching hospitals are permitted to perform multiple surgeries at the same time, Luketich was accused of not being immediately available during key portions of procedures. Attorneys for the Justice Department said the surgeons patients endured hours of medically unnecessary anesthesia time, putting them at risk of complications. Federal investigators say Luketichs actions during these concurrent surgeries ran afoul of statutes and regulations in regard to billings.
While UPMC continues to believe Dr. Luketichs surgical practice complies with [Centers for Medicare & Medicaid Services] requirements; it has agreed to pay $8.5 million to the government to avoid the distraction and expense of further litigation, said UPMC spokesman Paul Wood.
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7 Replies
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Hard to scale up to make bank.
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Yeah, dont piss of the wrong insider [;)]
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There’s a lucky resident out there with a $3mil whistleblower settlement
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Quote from RoleCall
There’s a lucky resident out there with a $3mil whistleblower settlement
Good. If the allegations are true, he earned it.-
Quote from knightrider
Quote from RoleCall
There’s a lucky resident out there with a $3mil whistleblower settlement
Good. If the allegations are true, he earned it.
The feds obviously had enough evidence that going to trial was too big a risk for the health system.
It’s not the first multi million qui tam case about that issue. You can farm some of your case out to PAs but you have to be present for certain parts and be very clear in your documentation.
These cases should be a cautionary tale for those who think that the feds ‘don’t care’. They don’t care until they do. If they can show that you were driving in your Tesla while your ‘assistant’ was signing reports with your login, you too may be faced with a multi million claim.
The cardiac surgery case has a rats tail of medmal suits. The allegation is that people had extended pump times while the surgeon was off doing other cases.
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Is this also related to the United Healthcare suing Rad Partners?
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Quote from PirateRad
Is this also related to the United Healthcare suing Rad Partners?
No… separate cases
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