![]() ![]() CMS must respond to the letter, if it materializes, as soon as possible or by a date that CMS and UPMC agree on. ![]() It includes a unique provision allowing UPMC-on its own or with other health systems or teaching hospitals-to send a letter to CMS asking for guidance and/or an advisory opinion on the teaching physician regulation, the parts of the Medicare Claims Processing Manual related to the teaching physician regulation and/or “the application of those provisions to the types of surgeries at issue in this Civil Action,” according to the settlement. Something helpful for all teaching hospitals and physicians may come out of the settlement. ![]() UPMC, UPP and Luketich deny the allegations. The defendants declined to enter into a corporate integrity agreement (CIA) as part of the FCA settlement, however, and therefore were added to the HHS Office of Inspector General’s (OIG) high-risk category, which subjects them to “heightened scrutiny,” according to OIG’s Fraud Risk Indicator. Luketich, a cardiothoracic surgeon employed by UPMC, allegedly performed up to three surgeries at the same time without always being present for the “critical or key” portions and left some patients under anesthesia for hours while he attended “to other matters,” according to the False Claims Act (FCA) complaint filed by the Department of Justice (DOJ). Attorney’s Office for the Western District of Pennsylvania said Feb. Luketich, M.D., agreed to pay $8.5 million over allegations they billed for overlapping surgeries in a way that violated Medicare regulations, the U.S. In a false claims settlement that includes an unusual audit requirement, University of Pittsburgh Medical Center (UPMC), University of Pittsburgh Physicians (UPP) and James L. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |