UPMC surgeon performed, billed for illegal overlapping surgeries, whistleblower suit alleges

The U.S. Justice Department is suing UPMC, its chair of cardiothoracic surgery and University of Pittsburgh Physicians in a whistleblower suit brought by a former UPMC physician.

Over the last six years, prosecutors allege that the defendants illegally submitted hundreds of false claims to Medicare, Medicaid and other government health programs. James Luketich, MD, UPMC's longtime cardiothoracic chair, allegedly performs up to three complex surgeries at the same time, does not participate in "key and critical" portions of his cases and has patients under anesthesia for long periods as he moves between operating rooms, the Justice Department alleged in a Sept. 2 news release.

Federal law prohibits surgeons at teaching hospitals from billing CMS for two concurrent, or overlapping surgeries unless the surgeon is present for all "critical or key portions" of the procedure. Prosecutors also said that breaking this law violates the standard of care, patients' trust and increases the risk of serious complications.

"Doctors take an oath to uphold the highest levels of ethical standards and care," said FBI Pittsburgh Special Agent in Charge Mike Nordwall. "The allegations set forth today violate those ethics, painting a picture of fraud and deception."

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