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May 2, 2011

Takes from Twitter: Intriguing hospital tidbits

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Here’s some hospital updates from the ever-flowing well of Twitterchat.  I’m not endorsing the tweeters in question, but I was intrigued by these tidbits:

@EFS_Consultants Medical Wonder: Meet The CEO Who Rebuilt A Crumbling California Hospital

@Stanford: HP pledges $25 million to help Lucile Packard Children’s Hospital carry out a major expansion and conduct new research:

@nicolebrown25  Lawmakers weigh report on New Orleans hospital: The state has committed $300 million in construction money

@anesthesiology2 10 Recent Stark, False Claims and Kickback Lawsuits Involving Hospitals

@TheAuditGroup Four Hospital Action Items for 2011

@Voicemed: 12 Best Practices for Making Hospitals Great Places to Work

@HospitalLayoffs #Hospital #Jobs Hospital Mass Layoffs Dropped Slightly in First Quarter


Gotmore info to share?  Tweet me at @katherinerourke and I’ll take a look.


April 19, 2011

Tenet/Community Health battle brings host of troubles

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My oh my.  Don’t we have a pretty enough dustup going on here without the need for more schaudenfreude? Apparently not.

As most of you know, Community Health Systems (CYH) made a $3.3 billion hostile takeover bid for Tenet Healthcare Corp (THC) late last year.

Since then, things have gotten rather ugly, with Tenet suing CHS this month over allegations that its suitor was, shall we say, not playing by the rules of the game.

More specifically, it accused CHS of gaming Medicare by admitting patients who weren’t sick enough to merit a costly inpatient stay.  Tenet argued that by building such system-gaming into its offer, CHS was over-valuing the stock it was using to pay for the takeover and overstating the savings it could accomplish.

Since then, CHS converted its takeover big from part-stock, part-cash to all cash. And today, April 20, CHS moved to have the Tenet suit dismissed, contending that with the stock out of the picture, Tenet had no basis to whinge about the deal. (For brownie points, here’s CHS’s press release on the request for dismissal.)

Still, even if Tenet’s Trevor Fetter and CHS’s Wayne Smith let bygones be bygones and throw a joint Passover Seder — complete with charoset! —  the host of troubles springing from this deal is pretty ong:

*  CHS has gotten a subpoena from the HHS OIG over possible Medicare and Medicaid billing fraud, matters which, one imagines, might not have come to the feds’ attention for quite some time if CHS execs had held their fire. (Look how far Columbia/HCA was able to go, and for how long, before the s–t hit the fan. Just ask our friend Rick Scott — oops, I mean Governor Scott.)

* Law firms like this one are sniffing the entrails to see if they can gin up a shareholder suit out of this somehow. And why not? Hey, shareholder suits are to the moneyed class what slip-and-falls are for the down-and-out — they file for the money, but being righteously justified is a nice payoff too.

* Suits and counter suits, federal subpoenas and shareholder angst aren’t good medicine for either players’ stock, which has been skidding in the wake of all of these skirmishes.

Hey, what ever happened to good old-fashioned tear-their-throat-out competition within markets?  Seems to me the play these days is to tighten up local health system networks rather than try for an outmoded “economies of scale” merger, anyway. But that’s just me. You?


August 13, 2010

Oops, he did it again; Rick Scott's history repeats itself

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For those who have followed the rise and fall of Rick Scott, former CEO of hospital chain Columbia/HCA, you may find the following to be  amusing.

If you’re  a Scott fan, you may see the allegations below as a setup. But if you thought the Columbia/HCA scandal was his misdoing, however, you may wonder how the man keeps this stuff up.

Not long ago, Scott bought a lot of media attention by running an anti-health reform organization, “Conservatives for Patients Rights,”  spending $5 million of his personal fortune to promote his message.  Now, it seems, he’s hoping to parley his renewed high profile into a role as governor of Florida.

The problem is, there’s the teeny little  issue of what’s going on at the company he runs today.  Just two weeks before the Florida primary,  his urgent care company Solantic has been accused a string of improper practices, including Medicare fraud and misuse of physician licenses.

None of the Medicare fraud allegations have been proven, and a series of physician suits against the company have been quietly settled, but these problems have cast a cloud over Scott’s gubernatorial bid nonetheless. And in reality, they should probably raise deeper questions as to Scott’s personal culpability — though to date the state hasn’t gotten involved.

The rise and fall of the Columbia empire

As many readers will know, Scott was kicked out of office CEO of Columbia/HCA hospital chain, an organization he’d helped to build with the backing of Texas billionaire and GW Bush financier Richard Rainwater. (Rainwater’s wife Darla was the one who fired him.)

Looked at one way, Scott and lieutenant David Vandewater (now CEO of Ardent Health) did a spectacular job. With  hustle, muscle and an eye for undervalued properties, they built Columbia up from two dinky hospitals in El Paso to the world’s largest health care organization. At its peak, Columbia/HCA had $20 billion in annual revenues, and more than 340 hospitals, 130 surgery centers and 550 home health locations in 38 states and two foreign countries.

The  problem is that the whole sprawling empire seems to have been rife with billing fraud.

It’s important to note that throughout the Columbia/HCA mess, Scott was never charged with a crime or deposed. Still, the meltdown happened on his watch, and after his departure the company paid out a stunning $1.7 billion fine to the feds.

By the way, Solantic CEO Karen Bowling headed up advertising at Columbia Healthcare Corporation, the company Scott built and merged with HCA. By no means do I want to suggest that she did anything wrong, either, but it is a bit curious that someone goes from marketing to a complex healthcare administration role.  (Not sure what that means — just putting it out there.)

The Solantic chapter

Anyway, regardless of who actually pulled the trigger on the Medicare and Medicaid shenanigans at Columbia/HCA, what’s up this time around? If nothing else, I don’t buy Scott’s “bad things just happen around me” line, do you?

As with Columbia/HCA, Solantic been accused of systematic, deliberate Medicare  billing fraud, a charge which was also leveled at him as leaders  of the Columbia/HCA empire.  For example, Solantic has purportedly  been in the habit of billing Medicare 100 percent of scheduled fees for unsupervised nurse practitioner visits, when rules require that it bill 85 percent.

Solantic is also accused of adding its doctors’ names to state filings and billing forms, seemingly in an effort to falsify how much physician coverage if had in place.

For example, former Solantic physician Dr. Randy Prokes, who worked there from 2004 to  2009, says he found his name on billing forms and medical records at company clinics he’d never visited and for patients he’d never treated, according to The Florida Independent.

Another plaintiff, Dr. P. Mark Glencross, filed a lawsuit in 2008 asserting that Solantic used his name to license six clinics without his knowledge.  Glencross began work  at Solantic in 2003 as chief medical officer, but left in 2004 after he allegedly discovered the misuse of his name and medical license, the Independent reports.  Solantic settled with Glencross this year, under a confidentiality agreement which keeps Glencross from chatting up the press any further.

No “Governor Scott”?

What makes all of this explosive, of course, isn’t the allegations themselves. As readers know, many healthcare organizations make it through accusations  that forms weren’t filled out properly or that Medicare was billed incorrectly.

But given Scott’s fight for the Republican gubernatorial nomination — he’s (yuck) the Tea Party’s candidate — the Solantic accusations are nasty, corrosive and who knows, might even derail his bid.  His primary opponent, State Attorney General Bill McCollum, has pulled ahead  in the polls since the allegations went public.

McCollum has been pounding on Scott to voluntarily disclose the video of the deposition he gave in the case filed against him by Dr. Glencross (one of the two MDs claiming Solantic misused their licenses and names).  Scott, to date, has refused to do so.

At this point, with so much questionable behavior at issue, one has to ask:  Would you want Rick Scott to run your healthcare organization, much less your state?    Seriously folks, would you?

P.S.  I can’t vouch for the accuracy of the content, but you might want a look at this post, which purports to offer a detailed map of Scott’s relationships over the last decade or so.  Intense stuff.