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Yale-New Haven fined $4.5M for union interference

Wed, 24 Oct 2007 06:59:56 -0400

An arbitrator has slapped Yale-New Haven Hospital with a $4.5 million fine after concluding that the hospital interfered in a union election. In a 47-page decision, arbitrator Margaret Kern held that the hospital had engaged in a "methodical dismantling" of an election agreement struck between the hospitals, union and the city of New Haven.

The Service Employees International Union, which had planned to hold the election in December, had called it off in December, alleging that the hospital had intimidated union supporters and spread incorrect information. The arbitrator is now requiring Yale-New Haven to pay the union $2.3 million for its organizing expenses. She's also demanding that the hospital pay $2.2 million to the 1,700 employees who would have been eligible to vote--a sum equal to the amount it spent on anti-union consultants.

To learn more about the dispute:
- read this New Haven Independent piece

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FL hospital sued over sale of $1.9B in bad debt

Mon, 15 Oct 2007 06:59:57 -0400

On the surface, the deal looked like a win-win. Giant Jackson Memorial Hospital would be able to sell--and make some money on--eight years worth of outstanding bills. Collector International Portfolio Inc.(IPI), meanwhile, would make more than $108.6 million on its $5.7 million investment. The thing is, it didn't work out that way, according to IPI, which has sued the 1,757-bed public hospital in an attempt to resolve its problems with Jackson.

IPI is alleging that the $1.9 billion in accounts receivable sold by Jackson wasn't as collectible as it was supposed to be. Its attorneys say that the accounts didn't meet the terms of the sale, including patients who were dead, bankrupt, on Medicare or Medicaid or simply didn't owe what the records suggested. When Jackson got the news, it gave IPI another batch of receivables, but the accounts were only worth $682 million, with many lacking adequate collections information, IPI says.

Since then, the dispute has raged on. Jackson has told many patients with unpaid accounts that they have a zero balance, and has apologized for IPI's collection efforts. Now, it looks like a judge will have to sort things out. In the future, perhaps Jackson will sell accounts for a contingency fee, as is more typically the case when hospitals pursue bad debt collections.

To find out more about the suit:
- read this South Florida Business Journal piece

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FDA warns Mayfield Clinic MD over study problems

Fri, 21 Sep 2007 06:59:55 -0400

A Mayfield Clinic neurosurgeon has gotten an FDA warning letter alleging that problems with record-keeping, reporting of adverse events and enrollment of patients in a study he was conducting. The FDA asserts that Dr. William Tobler and his team didn't document adequately that subjects were screened for study eligibility, kept inaccurate records and post-dated reports years after the fact. It also contends that Tobler did too little to respond to an earlier FDA critique of how the research was managed.

The study, which took place between May 2003 and August 2006, was part of a multi-center trial comparing a device used in spinal fusions for disk degeneration to other approaches. During the study, seven patients received the device, and all fared well, the clinic said in a press statement.

To learn more about the warning:
- read this Business Courier of Cincinnati piece

ALSO NOTED: Case draws attention to organ donation system; Questions over Lipitor; and much more...

Fri, 14 Sep 2007 06:59:50 -0400

> A case alleging that a physician hastened a patient's death to harvest his organs has thrown a spotlight on the organ donor system. Article

> When does good news feel almost bad? When a blockbuster drug is deemed the juiciest on the market--but the wolves are circling. If this sounds like Lipitor to you, you're right. FiercePharma

> Johns Hopkins is investigating a patient data breach resulting from the theft of a desktop computer. FierceHealthIT

> A new study suggests that Regional Health Information Organizations are growing slowly, and reliant on grants to stay alive. FierceHealthIT

And Finally... When this woman's son was diagnosed with autism, she went into entrepreneur mode. Article

Cardiologist investigated for allegedly striking patient

Wed, 12 Sep 2007 06:59:55 -0400

A high-profile San Diego cardiologist is under CMS investigation for allegedly hitting a patient several times during a cardiac catheterization. The physician, Dr. Maurice Buchbinder, is a controversial figure who's been up against federal authorities before, last time for using an unapproved device developed by a company in which he had a financial interest. Buchbinder practices within the Scripps hospital system, which performs more heart procedures than any other in the U.S.

Dr. Buchbinder was targeted after lab technicians filed complaints with state licensing officials alleging that he had struck an unruly patient several times during a cath procedure done on August 31st. The complaints triggered the CMS investigation. Scripps has since announced that Buchbinder has been suspended indefinitely from practicing at any Scripps facility nationwide.

To learn more about the investigation:
- read this San Diego Union-Tribune article

Pediatrix faces shareholder suit

Wed, 05 Sep 2007 06:59:57 -0400

Maternal-fetal and pediatric subspecialty practice Pediatrix Medical Group has been named as a defendant in a shareholder suit alleging that the company broke federal services laws. Pediatrix disclosed the suit in its quarterly SEC filing.

Unlike some shareholder suits, which pertain largely to technical issues, this lawsuit contains a daunting list of meaningful charges. It maintains that officers in the the publicly-traded firm violated their financial duties to the company, broke federal securities laws, managed the company poorly and committed fraud in its awards of stock options for more than 10 years. Earlier this year, Pediatrix had disclosed on its own that it had found 56 backdated grants from the period between April 1997 and August 2000, which resulted in the restating of more than one quarterly report.

To learn more about the suit:
- read this South Florida Business Journal piece

PLUS: Pediatrix just bought a Fairfax, VA based anesthesiology practice which will bring nearly 120 nurse practitioners and anesthesiologist into its fold. Article

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Arizona health system wins 'unreasonable' charges suit

Thu, 16 Aug 2007 06:59:57 -0400

An Arizona health system has won an appeal of a case that claimed it imposed "unreasonable" charges for care. The patients' health plan, a CDHP known as Medical Savings Insurance Co., sued Banner Health in Phoenix, alleging Banner charged them more than 400 percent of its cost for providing care. But this week, an Arizona appeals court disagreed that Banner's prices weren't fair.

In the suit, the health plan and seven individual plaintiffs said Banner was required to include "a reasonable price term" as implied by the contracts. They noted Banner ordinarily only receives 34 percent of its billed charges from patients who received care, suggesting the charges in this case were out of line. Banner, in turn, sued the seven patients for breach of contract, contending forms the patients signed protect the plan.

To find out more about the suit:
- read this Modern Healthcare article (reg. req.)

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Universal Health must turn over $1.1M in back pay

Tue, 17 Jul 2007 06:59:57 -0400

King of Prussia, PA-based Universal Health Services must pay about $1.1 million in back wages, along with nearly $50,000 in fines, to settle a lawsuit alleging it routinely underpaid employees at its Connecticut psychiatric facility. The settlement follows a lawsuit filed in March by the Labor Department against the chain's Stonington Institute of North Stonington, Conn. The settlement extends to 143 employees who worked with substance-abuse patients there between July 1, 2004 and July 1, 2006, a small fraction of the roughly 38,000 people the chain employs. Not surprisingly, Universal has denied any wrongdoing.

To find out more about the settlement:
- read this Modern Healthcare article

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St. Barnabas racketeering suit dismissed

Wed, 27 Jun 2007 20:01:37 -0400

Despite its having engaged in a massive Medicare scam costing the federal government at least $630 million, St. Barnabas Health Care System did not prevent other hospitals from getting fair reimbursement.

That's the conclusion of a federal judge, who ruled that despite the fraud, St. Barnabas had not engaged in racketeering. Two small hospitals in Maine and Colorado filed the suit, alleging St. Barnabas' over billing was so extreme it distorted CMS's Medicare reimbursement formulas nationwide. (St. Barnabas had been involved in a scheme to inflate reported costs for its most expensive procedures and thereby increase billings.) The hospitals contended St. Barnabas' actions led to thousands of facilities losing more than $500 million in federal money. The judge, however, ruled the government was the only victim of the health system's actions. When St. Barnabas agreed to repay $265 million, even that damage was mitigated.

To find out more about the case:
- read this article in The New York Times (reg. req.)

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UnitedHealth faces California legal challenges

Sun, 03 Jun 2007 20:01:38 -0400

UnitedHealth Group is facing a host of legal troubles in California, where both regulators and a large group of independent physicians are accusing the plan of financial and operational misconduct. Two of the state's agencies have begun investigating whether the health plan has been making late and inaccurate payments, as well as restricting patient access to care. The agencies are responding to a high volume of complaints alleging that the plan held up physician payments and paid claims inaccurately, which resulted in physicians limiting acceptance of the plan.

Meanwhile, a Sacramento radiology group is suing United Health over similar charges, namely that the plan isn't paying them what it should. The group says UnitedHealth isn't honoring the terms of its contract with PacifiCare Health Systems, which merged with UnitedHealth two years ago. The group, Radiological Associates of Sacramento Medical Group, is the largest private radiology and radiation oncology practice in Northern California, with 23 centers through the area.

To find out more about UnitedHealth's problems:
- read this Sacramento Business Journal article

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