University Of Pennsylvania Health System Agrees To Settle Voluntary Disclosure Of Improper Medicare Billing For Unnecessary Stent Procedures

The United States announces that it has settled allegations under the False Claims Act with the University of Pennsylvania Health System (“UPHS”) for improperly billing Medicare for stent procedures two interventional cardiologists performed at Pennsylvania Hospital between 2008 and 2012. UPHS voluntarily disclosed the allegations to the U.S. Attorney’s Office and has agreed to pay $845,000 to resolve the matter. The cardiologists no longer work at Pennsylvania Hospital.

The government launched an investigation based on the UPHS voluntary disclosure. The investigation determined that UPHS submitted bills to Medicare for services provided by the cardiologists that the United States alleges were medically unnecessary, resulting in overpayments to UPHS. After it discovered the problem, UPHS cooperated with the government’s investigation, and implemented a new quality assurance plan for procedures performed in the Pennsylvania Hospital cardiac catheterization lab. In addition, UPHS notified potentially affected patients of its internal review of stent procedures and offered free evaluations by UPHS’ cardiologists. UPHS also voluntarily disclosed the allegations to state regulators.

This matter was investigated by the Office of the Inspector General of the Department of Health and Human Services, and by Auditor Dawn Wiggins and Healthcare Fraud Analyst Ray Uhlhorn of the U.S. Attorney’s Office. The case was handled by Assistant U.S. Attorney Susan R. Becker.