The U.S. Department of Justice (DOJ) has alleged that the University of Pittsburgh Medical Center in Pennsylvania (UPMC) and the head of cardiothoracic surgery, James Luketich, “fraudulently bill[ed] Medicare and Medicaid for complex surgeries,” according to court documents. The complaint was filed this month in federal court in Pittsburgh, Pennsylvania, after an investigation began following a 2019 whistleblower lawsuit submitted by former UPMC physician, Jonathan D’Cunha. The government intervened under the False Claims Act, which allows it to step in and hold liable persons and companies who defraud governmental programs.
The Department of Justice (DOJ) said, “PMC has regularly allowed James Luketich to book as many as three complex surgeries at the same time, going back and forth between patients and not participating in key parts of the surgeries, while keeping patients under unnecessary anesthesia.” Furthermore, “Luketich and UPMC violated laws and regulations that they say prevent physicians like Luketich, who perform teaching duties within a medical school or residency program, from billing federal health insurance programs for such surgeries.”
Juggling multiple surgeries at once is extremely dangerous to patients. Acting U.S. Attorney Kaufman added, “The laws prohibiting ‘concurrent surgeries’ are in place for a reason: to protect patients and ensure they receive appropriate and focused medical care. Our office will take decisive action against any medical providers who violate those laws, and risk harm to Medicare and Medicaid beneficiaries.”