The U.S. Justice Department has filed a False Claims Act complaint against Pittsburgh-based UPMC, its physician practice group and the chair of its department of cardiothoracic surgery.
The complaint, announced Sept. 2, alleges the defendants submitted hundreds of false claims to Medicare, Medicaid and other government payers over the past six years. The complaint is based on a two-year investigation into allegations brought under the qui tam, or whistleblower provision, of the False Claims Act by a former UPMC physician.
Prosecutors allege James Luketich, MD, the longtime chair of UPMC's department of cardiothoracic surgery, regularly performs as many as three complex surgical procedures at the same time and fails to participate in some of the "key and critical" portions of the surgeries.
Prosecutors argue Dr. Luketich's alleged practices violate statutes and regulations prohibiting teaching physicians from performing and billing the government for concurrent surgeries. They further contend that his alleged practices violate the standard of care and heighten the risk of serious complications.
The claims made against the defendants are allegations, and there has been no determination of liability.