Pittsburgh Hospital Settles Medicare False Claims Lawsuit for $2.5 Million

The University of Pittsburgh Medical Center (UMPC) and three of its associated providers have settled a case in which they were accused of submitting false claims to the federal Medicare program. The defendants admitted no fault as part of the settlement, which was for $2.5 million.

According to court documents, surgeons at UMPC and its partners — UMPC Community Medicine, University of Pittsburgh Physicians and Tri-State Neurosurgical Associates UMPC — were accused of falsely claiming that they assisted with procedures performed by other surgeons, fellows, residents or physicians’ assistants. In reality, the complaint said, the surgeons in question were not involved with the procedures in any way.

Additionally, the settlement resolves claims that one neurosurgeon in particular falsely stated that he performed certain levels of spinal decompression during multilevel spinal procedures.

In a statement after the settlement was announced, U.S. Attorney David Hickson said that the result was a testament to the federal government’s commitment to protecting healthcare programs from corruption.

Whistleblower claims left unaddressed

What was not resolved in the settlement were several other claims from whistleblowers. Their attorney said that the individuals who made the allegations would continue to pursue legal action against UPMC. It’s not yet clear what the next steps will be in that process.

If you have been made aware of wrongdoing within your business or organization, you have options to expose it—either to your superiors or to a government oversight agency. To learn more about what might be the best option for your circumstances, meet with a knowledgeable Dallas attorney at Whistleblower Law for Managers.