The University of Pittsburgh Medical Center (UPMC) and three related entities will pay the U.S. more than $2.5 million to partially settle a False Claims Act lawsuit brought by whistleblowers who alleged the defendants were submitting false and inflated bills to Medicare for their neurology services.
U.S. Attorney David J. Hickton of the Western District of Pennsylvania announced the settlement Wednesday. The University of Pittsburgh Physicians, UPMC Community Medicine, Inc., and Tri-State Neurosurgical Associates-UPMC, Inc. are the other defendants named in the whistleblower suit.
The complaint alleged that certain UPMC neurosurgeons submitted claims for assisting with or supervising surgical procedures performed by other surgeons, residents, fellows, or physician assistants, when the assistance those neurosurgeons provided were not performed to the degree required by the Medicare program.
The settlement also resolves allegations that one particular neurosurgeon who performed multi-level spinal surgeries submitted claims to Medicare for levels of spinal decompression that were not actually performed.
“Today’s settlement demonstrates our commitment to protecting federal health care programs from fraud,” said U.S. Attorney Hickton. “By pursuing false claims act cases like this, we send a clear message that health care providers must follow the rules when they deal with federal health care programs, and that this Office will hold accountable those who do not.”
U.S. Attorney Hickton said the $2,520,429 settlement resolves most of the whistleblowers’ claims, but there were some additional claims that the federal government chose not to pursue. He did not disclose what the additional claims involve but said that the whistleblowers, each of whom are former UPMC employees, will continue to pursue those claims independently.
Source: U.S. Attorney David J. Hickton