Consumer Fraud

Unnecessary surgeries were performed for profit and promotion, whistleblower lawsuit alleges

osha whistle Unnecessary surgeries were performed for profit and promotion, whistleblower lawsuit allegesA whistleblower lawsuit filed against The University of Pittsburgh Medical Center’s (UPMC) Hamot campus under the False Claims Act accuses the hospital and five cardiologists of defrauding Medicare and a number of patients by participating in a kickback scheme from 2001 to 2005 that involved performing unneeded heart operations.

According to Pennsylvania’s Erie Times-News, “The suit claims the doctors, part of Medicor Associates Inc., performed unnecessary surgical procedures to make more money for themselves and Hamot and to promote the development of a cardiovascular surgery program at Hamot.” The lawsuit also contends that “Hamot overbilled Medicare in exchange for referrals from the doctors,” the Times-News reports.

At the time of the alleged wrongdoing, UPMC was known as the Hamot Medical Center. It became part of the University of Pittsburgh Medical Center system in 2011.

According to the lawsuit, the defendants performed an unnecessary eight surgeries, most of which were angioplasties, a procedure in which key arteries are fitted with mesh tubes called stents that help keep the artery open and improve blood flow. The lawsuit blames the allegedly unnecessary procedures on the deaths of two patients.

Tullio Emanuele, M.D., a former member of Medicor Associates Inc. who was affiliated with Hamot from 2001 to 2005, brought the lawsuit under the federal False Claims Act, which lets private citizens sue on behalf of the federal government when they believe fraud and other misuses of federal money has occurred. The act offers a measure of protection to whistleblowers and allows them to keep up to 30 percent of the funds recovered. Dr. Emanuele currently practices in Kentucky.

Lawyers for the defense have filed motions to have the case dismissed, claiming the lawsuit presents “eye-catching but factually devoid allegations.”

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The Erie Times-News