Department Of Justice Fraud Investigation Next For Health Management Associates
|By Stacy Brown, The Sentinel, Carlisle, Pa.|
HMA officials did admit that the chain was under a pending DOJ investigation.
He did note that in general when it comes to these types of investigations, there is a duty to taxpayers.
"At the core of any fraud investigation is taxpayer money," Frederiksen said.
On the show, two former CRMC doctors alleged that the hospital's management asked emergency room doctors to admit patients who didn't require admission.
They said HMA had a quota in which physicians were expected to admit at least 20 percent of patients in the emergency room.
Another former HMA doctor,
HMA officials and several CRMC heads, including CEO
The investigation has raised concerns in the medical community, which has come under scrutiny of late because some care facilities have used unscrupulous billing practices, according to "60 Minutes."
Those practices could be the undesired result of what a recent
The paper said an array of new economic realities, from reduced
In one manifestation of the trend, hospitals, private equity firms and even health insurance companies are acquiring physician practices at a rapid rate, according to the newspaper.
Today, about 39 percent of doctors nationwide are independent, down from 57 percent in 2000, according to estimates by
By one estimate, under its current reimbursement system,
"A great deal of national media attention has been focused in the past few days on allegations that some physicians are being pressured, particularly emergency physicians, to make medical decisions that are financially beneficial to the hospital but may not be necessary for the care of the patient," Dr.
"As the state physician association, we can say that the best medical decisions are made when physicians, leading a team of health care providers, work closely with their patients without the presence of financial pressures," said Schott, who is also a practicing cardiologist from the
The medical society estimates that approximately 70 percent of physicians are now employed by a large group, hospital or health system and Schott said physician employees must put the needs of patients far ahead of their or their employers' economic needs.
"This is true even though financial pressures are mounting throughout the health care system," he said, adding that physicians need to lead and shape health care delivery to assure that the evolving system provides quality and value to patients and the community. "To make this vision a reality, we are working closely with CEOs of large physician groups, deans of
HMA could face stiff consequences if any of the allegations are found to be true.
"Every hospital should have a compliance plan in place first," said
Likely, audits by non-government payers such as
Meyer said he reached that conclusion two years ago after hearing complaints from emergency room doctors and others who said they were being pressured to fill beds with people who did not need to be admitted to the hospital. Meyer told the show that he audited four hospitals and concluded that HMA had intentionally billed
HMA officials said they hired an outside law firm to investigate Meyer's fraud allegations and found nothing to support them.
The company said it is fully cooperating with investigators.
(ASTERISK)Editor's Note: The lead of the story was changed to better reflect that the
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