PITTSBURGH _ The Justice Department said Wednesday that the University of Pittsburgh Medical Center and three affiliates have agreed to pay $2.5 million to settle claims that they submitted false bills for payment to Medicare.
The settlement includes University of Pittsburgh Physicians, UPMC Community Medicine and Tri-State Neurosurgical Associates UPMC and resolves several allegations in a suit brought in federal court in Pittsburgh in 2012.
The U.S. attorney's office said neurosurgeons employed by UPMC submitted claims for assisting or supervising surgeries by other doctors, residents, fellows or physician assistants when the neurosurgeons didn't participate to the degree required.
The Justice Department said the settlement also resolves allegations that one neurosurgeon who did spine surgeries, identified in the lawsuit as Dr. Ghassan Bejjani, submitted claims to Medicare for levels of spinal decompression that weren't performed.
The settlement does not resolve other claims originally brought by the whistleblowers, all former UPMC employees who will continue to pursue those complaints on their own, the U.S. attorney's office said.
The case was investigated by the Department of Health and Human Services and the FBI.
UPMC said that under the settlement, the hospital network admits no liability. UPMC said that it learned of the false bills by its affiliates, contacted the U.S. attorney's office and conducted an internal review. The hospital network also said the doctors themselves did not submit the false bills.
UPMC said that the government declined to take up the vast majority of the allegations raised in the original suit brought by the whistleblowers, three former UPMC employees.
Should those plaintiffs continue to pursue their claims on their own, UPMC said it will "defend the matter vigorously."
