UIC Medical Center Pays $2 Million to United States and State of Illinois to Settle Liver Transplant Fraud Suit

In November 2003, the University of Illinois paid the United States and the State of Illinois $2 million to settle a "whistleblower" lawsuit brought by Dr. Raymond Polak, a liver transplant surgeon and professor at the University of Illinois College of Medicine, that alleged that the University's Medical Center at Chicago improperly diagnosed and hospitalized certain patients and exaggerated the seriousness of their medical conditions to liver Status 1 - confined to intensive care and likely to die within 7 days, and liver Status 2A - chronic liver disease with sudden deterioration, in intensive care, and likely to die within 7 days, to allow them to become eligible sooner for liver transplants.  The suit was brought under the False Claims Act and the Whistleblower Reward and Protection Act.  Similar allegations were settled around the same time with the University of Chicago and Northwestern Memorial Hospitals.  Dr. Pollack received 25%, the maximum allowed by the law, of the total settlement proceeds, which added up to be over $500,000.  UIC also payed $300,000 for Dr. Pollak's attorney fees, expenses, and costs.

The suit alleges that the improper hospitalization and diagnoses enabled UIC to transplant enough patients to meet the minimum number of liver transplants necessary to be certified under the Medicare and Medicaid programs, thus enabling it to receive federal and state reimbursement for the procedures.  Illinois Attorney General Lisa Madigan said, "A hospital's desire to receive additional state and federal health care dollars should play no role in whether or not a patient is eligible for an organ transplant...Not only did the defendant defraud the state and federal governments, it endangered individuals. These actions are legally and morally wrong."

This case reminds me that, although hospitals should be examples of high integrity, places where people are born and lives are saved, they are just like any other place of business, motivated by money.  Are these hospitals any better than the organ black market?  Aren't they both run by a thirst for monetary reward rather than by a regard for life?  Neither in this case have respect for federal laws and systems in place, such as the Organ Procurement and Transplant Network and the United Network for Organ Sharing, which are designed promote the most ethically fair and logical processes of organ donation.  What separates other rogue operations from those that on the surface appear to be on the patients' side, but which choose not to abide by rules that promote life?

Although the settlement contained certain "integrity requirements" in addition to payment, I wonder how much integrity a hospital can regain after such gross indiscretion.  How long will it take to regain the public's respect and trust, when the place in whose hands a person puts his or her life turns out to have such disregard for them?  A hospital's walls are filled with people who have taken an oath to promote and protect human life, and it saddens me tremendously that those lives were manipulated just to make the cut and to make a buck.

The case is United States of America and State of Illinois ex re. Raymond Pollak, M.D., v. Board of Trustees of the University of Illinois and the University of Chicago, 99 C 710 (N.D. Il.).

http://www.usdoj.gov/usao/iln/pr/chicago/2003/pr111703_01.pdf

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