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U.S. accuses UPMC surgeon, physicians group of false billing
Last edited Fri Sep 3, 2021, 07:58 AM - Edit history (1)
(link) https://www.post-gazette.com/business/healthcare-business/2021/09/02/U-S-accuses-UPMC-surgeon-of-filing-false-claims-to-Medicare-Medicaid-Luketich-billing/stories/202109020160
The chairman of the University of Pittsburgh Medical Center's Department of Cardiothoracic Surgery has for years systematically billed for unnecessary surgeries or surgeries he didn't perform and directly harmed patients, all with UPMC's knowledge, the federal government said in a lawsuit filed Thursday in federal court.
Dr. James Luketich, who practices at UPMC Presbyterian-Shadyside, is the defendant along with UPMC and University of Pittsburgh Physicians.
The U.S. suit, based on a two-year investigation into allegations originally brought by a former UPMC doctor under whistleblower provisions of the False Claims Act, alleges that Dr. Luketich and UPMC have submitted hundreds of false claims for payment to Medicare, Medicaid, and other government health benefit programs over the past six years.
The suit says Dr. Luketich regularly performed as many as three complex surgical procedures at the same time, failed to participate in all of the “key and critical” portions of his surgeries and forced his patients to endure hours of medically unnecessary anesthesia time as he moved between operating rooms and attended to other patients or hospital matters.
Those practices violate the statutes and regulations governing doctors and hospitals, including those that prohibit "teaching physicians" such as Dr. Luketich from performing and billing for “concurrent surgeries,” the suit says.
Dr. James Luketich, who practices at UPMC Presbyterian-Shadyside, is the defendant along with UPMC and University of Pittsburgh Physicians.
The U.S. suit, based on a two-year investigation into allegations originally brought by a former UPMC doctor under whistleblower provisions of the False Claims Act, alleges that Dr. Luketich and UPMC have submitted hundreds of false claims for payment to Medicare, Medicaid, and other government health benefit programs over the past six years.
The suit says Dr. Luketich regularly performed as many as three complex surgical procedures at the same time, failed to participate in all of the “key and critical” portions of his surgeries and forced his patients to endure hours of medically unnecessary anesthesia time as he moved between operating rooms and attended to other patients or hospital matters.
Those practices violate the statutes and regulations governing doctors and hospitals, including those that prohibit "teaching physicians" such as Dr. Luketich from performing and billing for “concurrent surgeries,” the suit says.
- more at link -
This is big news in Pittsburgh. UPMC (University of Pittsburgh Medical Center) is not only a nationally-known teaching hospital, but the system of hospitals is one of the major medical providers in western Pennsylvania.
1 replies
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Not a mystery why my health insurance has doubled in 3 years. 