The case can now move to the discovery phase in the U.S. District Court for the Western District of Pennsylvania.
The lawsuit alleged that “unnecessary and overly complex surgeries” were performed to boost physician salaries and hospital revenue, beginning in 2006.
In 2012, three former UPMC employees — neurosurgeons J. William Bookwalter, MD, and Robert Sclabassi, MD, and operating room technician Anna Mitina — claimed the surgeries were performed due to UPMC’s physician compensation deal, which provided bonuses to those performing the procedures.
The False Claims Act and the Ethics in Patient Referrals Act, or the Stark Law, prohibited UPMC’s compensation arrangement, the plaintiffs alleged. Under the legislation, hospitals cannot bill Medicare for some services when they have financial ties to the physician involved.
The lawsuit was dismissed twice by a U.S. district judge before being reinstated by the 3rd Circuit Court of Appeals in 2019.
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