HCFA grants first PSO waiver. HCFA last week issued its first waiver for a provider-sponsored organization under Medicare+Choice, to be operated by St. Joseph Healthcare in Albuquerque. The PSO, St. Joseph MedicarePlus, plans to begin coverage March 1. The system applied for the waiver last June (June 8, 1998, p. 30). It will serve New Mexico's Bernalillo, Sandoval, Torrance and Valencia counties, which have 89,500 eligible Medicare beneficiaries. The waiver allows the PSO to assume Medicare risk for three years without a state HMO license.
Quorum, Columbia part company. Quorum Health Group and the federal government last week agreed to separate the Brentwood, Tenn.-based hospital chain from a pending whistleblower lawsuit against Quorum and Columbia/HCA Healthcare Corp., which are the subjects of civil fraud charges and a criminal fraud investigation by the government. The whistleblower lawsuit, filed in 1993, is pending in U.S. District Court in Tampa, Fla. The lawsuit accuses Quorum and Nashville-based Columbia, once related companies, of systematically defrauding Medicare by inflating cost reports. The government is expected to file an amended whistleblower complaint against Quorum by early next month. A Quorum spokeswoman said splitting the cases doesn't portend a settlement with the government, and, in fact, no settlement talks are under way between Quorum and federal investigators.
Mo. hospital CEO to go on trial for fraud. The trial of seven defendants facing Medicare kickback and fraud charges begins this week in U.S. District Court in Kansas City, Kan. Federal prosecutors allege two doctors and three former executives at Baptist Medical Center in Kansas City, Mo., and two lawyers for the hospital conspired to pay the Blue Valley Medical Group for patient referrals. Dan Anderson, former president and chief executive officer of Baptist, is the first hospital CEO known to have been charged with violating the federal kickback statutes, which bar any form of remuneration to induce Medicare or Medicaid patient referrals. In pretrial skirmishes the defendants have vigorously asserted their innocence. The jury trial is expected to last several weeks.
Fla. system increases net income. Health Management Associates, a Naples, Fla.-based operator of rural hospitals, last week reported a 25% increase in net income to $31 million, or 12 cents per share, for its first quarter ended Dec. 31, compared with net income of $24.8 million, or 10 cents per share, in the year-ago quarter. Net patient revenues rose 30% to $305.5 million. HMA operates 32 hospitals in 11 states.
CHA in hunt for new lobbyist. The Catholic Health Association has begun a national search for the top lobbyist in its Washington office. The CHA has hired EMA Partners International to find candidates for the position. Officials said they will seek candidates in Catholic organizations as well as state and national lobbying groups. The candidate will take on some of the functions performed by William Cox, who resigned as executive vice president last September after nearly 20 years with the CHA.
Mass. Blues settles Medicare payment case. Blue Cross and Blue Shield of Massachusetts last week agreed to pay about $4.8 million to resolve a dispute involving Medicare overpayments, federal officials said. The settlement by the U.S. Justice Department and the U.S. attorney for Massachusetts involves Medicare payments for healthcare services that should have been paid by group health plans insured or administered by the Massachusetts Blues, federal officials said.