UPMC, surgeon deemed 'high risk' to Medicare after rejecting oversight

Pittsburgh, PA (March 23, 2023) - The government office that fights Medicare fraud has put UPMC and one of its star surgeons on a “high-risk” list after determining that they pose a “significant risk to federal health care programs and beneficiaries.”

U.S. officials took the action after Pittsburgh’s multi-billion-dollar health system settled a sweeping Medicare fraud case last month — but rejected signing an agreement that would put it or its renowned doctor under extra government oversight.

“This is a huge deal,” Reuben Guttman, a Washington, D.C. lawyer who has litigated similar Medicare fraud cases, said Thursday. “Citizens of Pittsburgh should be outraged.”

The settlement, reached after a two-year investigation led to a federal lawsuit, resolved fraud allegations against UPMC, its physicians practice, and Dr. James Luketich. Luketic is head of its cardiothoracic surgery department and one of its highest-paid and most prolific surgeons.

As part of the settlement, the government asked the defendants to sign paperwork — known as a corporate integrity agreement — that would place them under additional oversight. They refused.

By: Jonathan Silver, Pittsburgh Tribune Review