(Reuters) - The University of Pittsburgh Medical Center and the head of its cardiothoracic surgery department have agreed to pay $8.5 million to settle claims that they fraudulently billed Medicare and Medicaid for complex surgeries.
The settlement resolves a 2019 whistleblower lawsuit by a former UPMC doctor, claiming that UPMC regularly allowed James Luketich to book as many as three complex surgeries at the same time, going back and forth between patients, not participating in key parts of the surgeries, and sometimes keeping patients under unnecessary anesthesia.
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Acting U.S. Attorney Troy Rivetti in Pittsburgh called the settlement "a just conclusion" to prosecutors' investigation. Jeffrey Dickstein of Phillips & Cohen, a lawyer for whistleblower Jonathan D'Cunha, said it "finally brings meaningful oversight of Dr. Luketich and UPMC."
UPMC spokesperson Paul Wood said in a statement that it continues to believe that Luketich's practice complied with federal requirements but settled the case "to avoid the distraction and expense of further litigation."
Efrem Grail, Luketich's attorney, said he hoped the settlement would lead to clearer guidance on billing "so that universally respected surgeons like Dr....
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