News: UPMC will pay $38 million to settle whistleblower lawsuit

After 12 years, the University of Pittsburgh Medical Center (UPMC) will pay $38 million to settle a whistleblower lawsuit which alleged that some of its surgeons were doing unnecessary or overly complex operations to increase earnings and enrich system hospitals.

Former UPMC neurosurgeon J. William Bookwalter, neurophysiologist Robert Sclabassi, and surgical technologist Anna Mitina had filed suit against UPMC and 13 staff neurosurgeons, who they alleged received bonus pay based on the number of procedures performed at the expense of Medicare. The hospital system did not admit wrongdoing in agreeing to the settlement, Pittsburgh Post-Gazette reported.

In court papers, UPMC responded to the suit with the argument that “its surgeon compensation packages of base pay plus productivity bonuses were standard at medical centers across the United States” and that patient referrals were not part of the formula.

In a statement issued last week, UPMC spokesman Paul Wood said, “UPMC is pleased to have resolved this matter, 12 years after it first started. The settlement, which includes no admission of liability, allows UPMC to keep its focus where it belongs—on providing world-class care to our patients.”

Agreed in the settlement, the three plaintiffs are to receive 29% ($11 million) of the total amount, while the government will claim the rest. The $38 million settlement is believed to be among the biggest false claim recoveries where the Justice Department declined to intervene, plaintiff attorneys told Pittsburgh Post-Gazette.

Editor’s note: To read Pittsburgh Post-Gazette’s coverage of this story, click here.