Lawsuit alleges overbilling by some at UPMC

Neurosurgeon J. William Bookwalter was examining a colleague’s patient who had back troubles when he made an unusual discovery: The operation that his colleague billed Medicare for was far more extensive than the one actually done, according to allegations contained in a lawsuit.

A review of two more back operations performed by UPMC neurosurgeon Ghassan Bejjani on another patient yielded the same result, including once when an insurer was billed twice for removal of the same back vertebrae. Another neurosurgeon who examined one of Dr. Bejjani’s patients two months later found the same billing discrepancy that Dr. Bookwalter uncovered, which resulted in higher reimbursement for UPMC for work that was not done, the lawsuit said.

“I certainly don’t review all of Dr. Bejjani’s cases, but occasionally see someone as a second opinion,” an unnamed UPMC neurosurgeon complained in a letter to UPMC Shadyside Hospital officials, a 2012 whistleblower lawsuit unsealed July 25 said. “If only a fraction of those had a post-operative myelogram to definitely

and so is effectively communicating with doctors.

“Doctors have a strong appetite for knowing what the hospital has done to address this effectively,” she said. “People trust their physicians more than anyone else, so the health system needs to tell patients it’s still safe to come there and the situation has been fixed.”