this U.S. has sued Pittsburgh UPMC, Its team of doctors and the chairman of its cardiothoracic surgery department violated the “False Declaration Act” and billed it as a concurrent operation—according to the government’s description.
this Litigation claims In the past six years, UPMC and other defendants have deliberately filed hundreds of fraudulent claims against Medicare, Medicaid, and other government programs.
Specifically, the lawsuit alleges that Dr. James Luketich, UPMC’s long-time director of cardiothoracic surgery, performed up to three complex surgical operations at the same time and did not participate in all the “critical and critical” parts of the operation.
The lawsuit states that, therefore, when he moves between operating rooms, the patient will experience hours of anesthesia, which is medically unnecessary. This violates regulations that prohibit teaching physicians like Luktic from performing concurrent surgeries and charge the government for these surgeries, which increase the number of surgeries and thereby increase revenue.
According to UPMC, there are no laws or regulations that prohibit or charge for overlapping surgeries.
UPMC Chief Communications Officer Paul Wood said in an email: “The government’s claim is… based on misuse or misunderstanding of UPMC’s internal policies and CMS guidelines, neither of which can support fraudulent bill claims.” “UPMC and Luketich The Ph.D. program vigorously defends the government’s claims.”
He added that the lawsuit itself admits that many of Luktic’s patients are elderly, frail and seriously ill.
“In treating these patients, Dr. Luktic led a team of highly skilled surgeons and other clinicians through complex procedures that often lasted more than 12 hours,” Wood said.
In addition to suspected fraudulent bills, the government also argued that UPMC deliberately ignored complaints from employees and staff about the surgeon’s “super busy schedule and his refusal to delegate surgery and surgical tasks to other attending doctors…”. [and] Protect him from meaningful sanctions…” thus putting his patients at risk.
“Luketich’s surgery also violated the standard of care, abused the patient’s trust, prolonged the anesthesia time, increased the patient’s risk of complications, and-at least several times during the claim period-caused serious harm to the patient ,” the lawsuit said.
The U.S. lawsuit filed in the U.S. District Court for the Western District of Pennsylvania on Thursday is based on an allegation against former UPMC doctor Dr. Jonathan D’Cunha under the whistleblower clause of the False Declaration Act. Two years of investigation.
In the first half of this year, the enforcement of the False Declaration Act was very strong, and the total amount of resolutions announced by the Ministry of Justice exceeded 393 million US dollars. Gibson Dunn Law Firm Report.
The company predicts that “more aggressive and forward-looking [False Claims Act] Enforcement is likely to be coming soon. “
Photo: Hail, Getty Images
