From our offices in the Detroit area, Akeel & Valentine, PLC serves clients nationwide.

From our offices in the Detroit area, Akeel & Valentine, PLC serves clients nationwide.

UPMC settles whistleblower lawsuit for $38 million

On Behalf of | May 13, 2024 | Whistleblower

The University of Pittsburgh Medical Center recently agreed to pay $38 million to settle a whistleblower lawsuit.

Three individuals filed this lawsuit, including a former UPMC neurosurgeon. They claimed that UPMC surgeons received bonuses based on the number of procedures performed, potentially at the expense of Medicare.

The whistleblowers

The following individuals blew the whistle on UPMC:

  • Former UPMC neurosurgeon J. William Bookwalter
  • Neurophysiologist Robert Sclabassi
  • Surgical technologist Anna Mitina

They originally filed the lawsuit against UPMC and 13 staff neurosurgeons in 2012. They claimed that their actions put patients at risk and increased healthcare costs.

Allegations

The whistleblowers alleged that UPMC surgeons performed unnecessary or overly complicated procedures. They also claimed that some were performing multiple complex surgeries simultaneously. This practice, known as concurrent surgeries, allowed the surgeons to increase their earnings by performing more procedures in a shorter amount of time.

Violation of the Stark law

The Stark law, known as the Physician Self-Referral Law, is a set of federal laws that prohibit physicians from referring Medicare or Medicaid patients to entities with which they have a financial relationship. Violations can result in significant penalties, including fines, exclusion from Medicare and Medicaid programs and potential civil lawsuits.

Settlement details

UPMC did not admit wrongdoing but agreed to pay $38 million. The three plaintiffs received $11 million, or 29% of the total settlement amount. The rest of the settlement will go to the government. In 2016, UPMC previously settled some of the allegations by paying $2.5 million to the government.

The conclusion of this case highlights the importance of transparency and accountability in healthcare practices. It also underscores the role of whistleblowers in uncovering wrongdoing and holding companies accountable for their actions.