The top cardiothoracic surgeon at the University of Pittsburgh Medical Center routinely billed patients and federal healthcare providers for surgeries that were not needed or that he didn’t perform, according to a federal complaint filed Thursday by the U.S. Department of Justice.
The lawsuit names UPMC, its university physicians group, and Dr. James Luketich, the head of UPMC’s Department of Cardiothoracic Surgery, as knowing participants in the alleged fraudulent billing practices, accusing them of submitting hundreds of false claims to Medicare, Medicaid, and other government-backed insurance groups over the last six years.
Prosecutors were first tipped off to the criminal scheme by a former UPMC doctor and whistleblower. It led to a two-year investigation.
Federal attorneys said that Dr. Luketich scheduled multiple complex surgeries at once, forcing patients to undergo hours of unnecessary anesthesia as he traipsed between operating rooms or attended to other hospital business.
The 47-page lawsuit said regulations prohibit doctors at teaching hospitals from conducting and charging for “concurrent surgeries” by federal statutes and regulations, claiming the doctor flagrantly violated patients’ trust while increasing their risk of serious surgical complications.
One patient, the suit said, lost the use of her hand after being left unsupervised with surgical trainees while Luketich juggled four other procedures in four different operating rooms.
The Justice Department also accused the UPMC hospital system of being aware of the problematic scheduling and billing since 2015. In addition, the complaint said the hospital continuously and publicly promoted the surgeon despite receiving multiple complaints, accusing UPMC of endangering patients and wasting millions of taxpayer dollars through false billings.
Both the hospital system and Dr. Luketich’s lawyer have denied the government’s allegations. The latter said the doctor would “vigorously defend against them,” calling him “a person of integrity” and “a doctor who cares.”
In a statement, UPMC called Dr. Luketich a “uniquely skilled and world-renowned” surgeon, saying he frequently delegates portions of complex 12-hour procedures to his team while performing the “most critical portions of every operation.”
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