UPMC to pay $2.5M to settle overbilling allegations

Pittsburgh-based UPMC and three of its affiliates have agreed to pay the federal government $2.5 million to settle false claims allegations, according to the Department of Justice.

A whistle-blower lawsuit claimed certain neurosurgeons employed by UPMC submitted false claims to Medicare. The neurosurgeons allegedly submitted claims for assisting with or supervising procedures when they did not participate in the surgical procedures to the degree required.

The settlement also resolves allegations that a particular neurosurgeon fraudulently submitted claims to Medicare for levels of spinal decompression not actually performed, according to the DOJ.

Several claims included in the whistle-blower suit are not covered by the settlement, and the whistle-blowers will continue to pursue those claims.

UPMC affiliates Tri-State Neurological Associates-UPMC, University of Pittsburgh Physicians and UPMC Community Medicine were named as defendants in the suit, according to the DOJ.

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