UPMC, others to pay government $2.5 million in Medicare billing case
The settlement comes in a whistleblower lawsuit by
The settled claims contend that UPMC billed
"Today's settlement demonstrates our commitment to protecting federal health care programs from fraud," he said.
The lawsuit includes UPMC, the
UPMC discovered the overbilling and disclosed it to the government, said UPMC spokeswoman
"UPMC took steps to strengthen the processes and practices in the billing systems that had allowed incorrect billing," she said. "Under the settlement, UPMC admits no liability."
The government elected not to pursue the other claims in the lawsuit. If the three former UPMC employees pursue those claims, "UPMC will defend the matter vigorously," she said.
After the whistleblowers filed the lawsuit, it was kept under seal while the FBI and the inspector general for the
The government decided to intervene only on the claims that were settled, according to court documents.
The unsettled claims include allegations that UPMC promoted medically unnecessary surgeries and paid physicians more than they would typically receive for a surgery to encourage them to refer more surgeries to UPMC facilities.
The release says that the whistleblowers plan to further pursue those claims. Attorneys for the whistleblowers couldn't immediately be reached for comment.
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