Pittsburgh Physician and Medical Center to Pay $8.5 Million to Settle FCA Case

Law360, February 27, 2023 - The University of Pittsburgh Medical Center (UPMC) and one of its surgeons, Dr. James L. Luketich, agreed to pay the federal government $8.5 million to resolve allegations that Dr. Luketich violated Medicare and Medicaid rules by scheduling himself for multiple simultaneous surgeries.

The case was originally filed in 2019 as a whistleblower action by another surgeon who had worked alongside Dr. Luketich previously. The government intervened in late July 2021 and filed its intervenor complaint shortly thereafter in September. As alleged, Dr. Luketich scheduled multiple surgeries at the same time, going back and forth between them. The practice violated federal rules, which require surgeons to be present or immediately available for all critical parts of an operation. The complaint further alleged that not only did UPMC know about the simultaneous surgeries, but in fact had warned Dr. Luketich about the practice but did not stop him.

The settlement resolves these allegations, though UPMC did not admit to liability as part of the settlement. Additionally, a separate provision of the settlement involves a “corrective action plan,” under which Dr. Luketich must submit to a yearlong third-party audit of his Medicare billing. This provision of the settlement is in line with other recent settlements that focused on individual accountability and go-forward corrective actions, including at least one case in which executive compensation was tied to the effective implementation of a compliance program.