$956,590 Settlement With UPMC Resolves False Claims Act Allegations

PITTSBURGH, Pa. - The University of Pittsburgh Medical Center (“UPMC”) and a related joint venture, UPMC VNA Home Health (“UPMC Home Health”), have agreed to pay the United States $956,590 to settle False Claims Act allegations, United States Attorney David J. Hickton announced today.

The settlement results from a self disclosure by UPMC to the United States Attorney’s Office concerning referrals for home health services made from UPMC hospitals to UPMC Home Health. Based on information provided by UPMC, the United States alleged that it had civil claims against UPMC and UPMC Home Health resulting from Medicare billings for home health services that were not supported by a documented face-to-face encounter with a physician or authorized non-physician practitioner, as required by Medicare rules and regulations. The settlement resolves the matter without the filing of litigation.

This matter was investigated by the Office of Inspector General of the Department of Health and Human Services and the United States Attorney’s Office for the Western District of Pennsylvania. Assistant United States Attorney David Lew handled this matter on behalf of the United States.