(June 29, 2010) Chicago--The University of Chicago Medical Center has agreed to settle a lawsuit alleging that it sought reimbursement from Illinois Medicaid from 1997-2005 for care provided to patients treated in the neonatal intensive care unit (NICU) in the Medical Center's Wyler Children's Hospital on days when there were more infants in the unit than it was designed to handle--a technical violation of the Illinois licensing regulations on bed spacing and capacity.
Three-quarters of the funds paid as part of the settlement will go to improve prenatal and maternal health care on the South Side of Chicago.
The Medical Center has been open and cooperative throughout the investigation, working closely with the State Attorney General's office to resolve this issue. The Medical Center remains convinced that the physicians and nurses in the NICU acted in the patients' best interests and that no patients were harmed as a result of periods of high census.
"The physicians and staff of the neonatal intensive care unit provided extraordinary care to many infants who urgently needed their attention," said Michael Schreiber, MD, professor and vice chair of pediatrics at the University of Chicago.
The expanded neonatal intensive care unit in the Comer Children's Hospital at the University of Chicago, which opened in February 2005, was a direct response to the growing demand for the Medical Center's specialized NICU services and the constraints on the smaller Wyler NICU.
In the $7 million settlement, the Medical Center will pay $5.135 million into a segregated account under the direction of Office of the Illinois Attorney General, which will disburse the funds to support the delivery of preconception, prenatal, and general maternal health care services to indigent female patients of reproductive age at non-profit hospitals and health care clinics on the South Side of Chicago.
Recipients will be Chicago Family Health Center, Christian Community Health Center, Holy Cross Hospital, Jackson Park Hospital Foundation, Mercy Hospital Foundation, Mile Square Health Center, Roseland Community Hospital and St. Bernard Hospital.
"We are pleased that much of the settlement will be used to improve health care on the South Side--a priority we share with the Attorney General's office," said Schreiber.
Another $1.365 million will go to the individuals, two former NICU nurses who filed the lawsuit. The final $500,000 will go to the federal Centers for Medicare and Medicaid.
Opening Comer Children's Hospital increased NICU capacity from 58 to 65 patients, including 47 Level III beds--the highest level of neonatal intensive care. The square footage of the new unit is more than two times that of the Wyler NICU, with 40 square feet more space per bed than the minimum recommendations under the Illinois hospital licensing regulations.
The Comer neonatal intensive care unit is one of the premiere NICUs in the country. It has been ranked among the top 20 in the nation by U.S.News & World Report. It cares for the sickest newborns, most of them from the South Side of Chicago. Since the University of Chicago Medical Center serves as the hub of a regional perinatal network of 10 area hospitals, premature and critically ill newborns are transported to the Medical Center from community hospitals all over the region.
For many critically ill babies during the period in question, there was no comparable care available in the region. The Medical Center believed that regulations regarding bed spacing and capacity directly conflicted with the obligation to care for all patients, including infants, in emergency situations. Many felt that it would have been inappropriate to turn away infants in need when--because of the NICU caregivers' special expertise--they were in a unique position to help, even if that meant exceeding the unit's intended capacity.
The Medical Center no longer accepts patients into its NICU when capacity in the NICU approaches the licensed limit.