These organizations are paying for fraud
The University of Chicago Hospitals and its faculty physician group will be paying $10.9 million to settle Medicare and Medicaid fraud charges that have resulted from an ongoing federal probe into how teaching hospitals and their faculty practice physicians go about billing government insurance programs. Meanwhile, the 392-bed Medical Center at Princeton, NJ, recently agreed to a $2 million fine resulting from Medicare fraud charges related to its outpatient billing from 1992 to 1997. The hospital has stood by its defense that it mistakenly billed some outpatient services as inpatient services as the result of a misunderstanding of billing regulations.
A $4 million fine has been assessed on the American Health Foundation, which was also ordered to pay back the federal government $4.2 million in overdrawn grants, stemming from charges of research grant fraud. Allegedly, the foundation, a not-for-profit organization, which carries out research on cancer and other chronic diseases, spent overdrawn Health and Human Services research grants to pay for private projects and ventures.
DeKalb Regional seeks OK to move headquarters
The DeKalb Regional Healthcare System (DRHS), a Georgia home health care agency originally set up to serve patients in Fulton, Gwinnett, and DeKalb counties, has applied for state approval to move its headquarters from Fulton to DeKalb. The agency, which was purchased two years ago by Decatur Hospital, now receives the majority of its patient referrals from DeKalb County. Accordingly, the agency has petitioned the state to move its headquarters to 6425 Powers Ferry Road in DeKalb County. The move would cost the DRHS nothing and all three counties will continue to be served.
What’s the latest in mergers, changes?
Methodist Healthcare in Memphis, TN, plans to give 80-bed Methodist Healthcare Middle (Lexington) Mississippi Hospital, to the University of Mississippi Medical Center (UMMC) in a deal expected to be completed in April. The transfer of the hospital’s assets and property, valued at about $5 million, will subsidize operations for the next three years. UMMC intends to merge the hospital with a nursing home and a 29-bed hospital in Durant, MS, to form a countywide health care system.
Province Healthcare Co. in Brentwood, TN, has acquired 45-bed City of Ennis (TX) Hospital through a $3 million, 30-year lease agreement. The hospital’s previous owner, Baylor Health Care System in Dallas, eliminated inpatient services at the facility in January. Province plans to restore full services by April 1.
On Feb. 29, Primary Health Systems (PHS) in Wayne, PA, closed 344-bed Mount Sinai Medical Center-University Circle, one of its four acute-care hospitals in the Cleveland-area market. The daily census at the facility had dropped to 70 patients, leading to the decision to close, said Primary Health, which just last year filed for Chapter 11 bankruptcy protection. PHS has not decided what to do with the facility, but will continue to operate the 98-bed Mount Sinai Medical Center East in Richmond Heights, OH.
Organization celebrates 15 years by closing shop
Just as it celebrates its 15th year of operations, the Arizona Healthcare Federation has announced that it is closing its doors. Plans call for closing the organization on May 31.
When it opened, the company provided an alliance for 10 independent Arizona hospital systems, but with the rise in mergers and consolidations only five systems remain as members. They are:
• Phoenix Memorial Hospital;
• University Medical Center;
• Yuma Regional Medical Center;
• Casa Grande Regional Medical Center;
• Catholic Healthcare West’s (CHW) St. Joseph’s Hospital and Medical Center in Phoenix, and Chandler Regional Hospital.
Baptist Hospitals and Health Systems Inc. had been part of the federation for years but dropped out after of selling its hospitals and nursing homes.
A few of the federation’s services — joint contracting and purchasing programs — will be taken over by CHW’s Shared Business Services. Among the programs the federation implemented was a $235 million pooled capital trust tax-exempt financing vehicle, which gave members access to funds for capital equipment and building projects. Most recently, the federation was awarded a grant from the Flinn Foundation to conduct a program in Yuma County for uninsured children.
New name for National Hospice Organization
Effective February, the National Hospice Organization in Alexandria, VA, has a new name — the National Hospice and Palliative Care Organization.
The new name is intended to reflect the group’s evolution in end-of-life care and is designed to foster recognition of the role hospices provide in extending such care. The new name, according to the organization, "reflects the success that hospice programs have already achieved in caring for individuals who have advanced illness."
Palliative care, as defined in 1990 by the World Health Organization, addresses not only physical pain, but emotional, social, and spiritual pain to achieve "the best quality of life for patients and their families." Hospice care is provided to more than 500,000 Americans annually, either in the patients’ homes or in a home-like setting.
The organization, founded in 1978, represents nearly 2,500 hospice care programs and thousands of hospice professional in the United States, making it the largest nonprofit membership organization for hospices and palliative care.
For more information on the organization and the services and educational programs it offers, visit the group’s Web site at www.nhpco.org.
AHA comments on Clinton budget
The American Hospital Association (AHA) in Chicago has released a statement on its concerns about the Clinton administration’s budget plan, which calls for even further Medicare funding cuts for hospitals that care for seniors and their families.
In the proposed budget, Medicare cuts would be used to entirely fund a program designed to give seniors access to affordable prescription medication. While the AHA is in favor of the program, it believes that surplus funds, not Medicare cuts, should be used to fund the program.
Additionally, the AHA says that:
• It agrees with the president’s plan to devote a substantial portion of the surplus to shore up Medicare.
• It supports the president’s commitment to expanding access and coverage to uninsured Americans.
• It commends the administration’s commitment to reducing medical errors and the careful study of this issue.