UPMC, Top Physician To Pay $8.5 Million To Settle Federal Fraud Case

PITTSBURGH, PA — UPMC, one of its physicians and a UPMC physicians group have agreed to pay $8.5 million to settle a federal lawsuit alleging the doctor submitted hundreds of false claims to Medicare, Medicaid and other government health benefit programs over the past six years.

The complaint filed by federal authorities alleged that Dr. James Luketich, longtime chair of UPMC's Department of Cardiothoracic Surgery, regularly performed as many as three complex surgical procedures at the same time and didn't participate in all key and critical portions of his surgeries.

Additionally, Luketich forced patients to endure hours of medically unnecessary anesthesia time so he could move between operating rooms or attend to other matters.

The defendants also agreed to implement a corrective action plan for Luketich, and to submit to a year-long, third-party audit of Luketich’s physician fee services billings to Medicare. The settlement also allows UPMC to request guidance from the Centers for Medicare and Medicaid Services of the Department of Health and Human Services regarding Medicare regulations at issue in the case.

“This is an important settlement and a just conclusion to the United States’ investigation into Dr. Luketich’s surgical and billing practices, and UPMC and University of Pittsburgh Physicans' acceptance of those practices,” Acting U.S. Attorney Troy Rivetti said. "No medical provider – however renowned – is excepted from scrutiny or above the law.”

UMPC spokesman Paul Wood said the medical conglomerate agreed to pay the $8.5 million "to avoid the distraction and expense of further litigation."