UC Health to pay $4.1 million in fraud settlement
West Chester Hospital and its parent company, UC Health, agreed to pay $4.1 million to settle allegations that Medicare and Medicaid were billed for medically unnecessary spine surgeries, and the doctor who performed the surgeries may have fled the country, according to the Justice Department.
This settlement resolves allegations that West Chester Hospital submitted claims to Medicare and Medicaid for the spine surgeries performed between 2009 and 2013 by Dr. Abubakar Atiq Durrani, according to a press release.
Officials from UC Health denied the allegations and said Durrani was not an employee of UC Health or the West Chester Hospital but did have privileges at the hospital "for a time."
"We expressly deny the government's allegations and admit no liability, but to avoid delay, uncertainty and the expense of litigation, UC Health and West Chester voluntarily pursued and entered into this settlement," according to a statement from UC Health spokesperson Diana Lara. "We have agreed to refund certain payments under Medicare and Medicaid in connection with procedures performed by a surgeon at West Chester Hospital. The surgeon was not an employee of UC Health or West Chester Hospital but had privileges at West Chester Hospital for a time."
In July 2013, Durrani was arrested and charged with health care fraud violations related to the surgeries.
"Following his arraignment, Durrani allegedly fled the United States and remains a fugitive," the press release stated.
Mason surgeon facing fraud charges flees U.S.
“Any time greed replaces medical necessity as the primary factor in performing invasive procedures and surgeries on Medicare and Medicaid patients, our most vulnerable citizens – the elderly, disabled and economically disadvantaged – are imperiled,” said Lamont Pugh of the Health and Human Services Office.
Ohio and Kentucky will receive approximately $72,000 of the settlement because Medicaid is jointly-funded by states and the federal government, according to the Justice Department.