The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay $8.5 million to settle a qui tam suit brought by a former UPMC cardiothoracic surgeon. The suit, brought under the False Claims Act, alleged that Luketich regularly performed up to three complex surgeries simultaneously, did not participate in all “key and critical” portions of the surgeries, and kept patients under anesthesia for long periods to give him time to go from one to another.
According to the complaint, Luketich’s practices violated the statutes and regulations which prohibit surgeons at teaching hospitals from billing Medicare, Medicaid and other government programs for concurrent surgeries, resulting in hundreds of “false claims” over six years. Federal programs can be billed for concurrent surgeries only if the surgeon is present for all “key and critical portions” of the procedures. The whistleblower, Jonathan D’Cunha, M.D., Ph.D., also alleged that the concurrent surgeries increased the risk of surgical complications for patients. It was reported separately that several of Luketich’s patients suffered serious complications, including amputations, after having been left under general anesthesia for a long time in mid-procedure.
As part of the Settlement Agreement, the defendants agreed to create a corrective action plan and submit to a third-party audit of Luketich’s billings to Medicare. UPMC claims to welcome the opportunity to request guidance from the Centers for Medicare & Medicaid Services regarding certain Medicare regulations pertaining to concurrent surgeries.
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