Physician executives concerned their employees may be looking to rat them out for Medicare fraud should know that danger is only a mouse click away.
Under the federal False Claims Act, whistleblowers who alert the government to waste, fraud or abuse are entitled to 15% to 25% of any settlement payments. Some well-publicized cases of multimillion-dollar fraud settlements have made whistleblowing all the more attractive, and a slew of World Wide Web sites is sprouting up to educate amateur sleuths. Healthcare workers who think they've uncovered Medicare billing fraud can simply surf the Internet to learn the ABCs of whistleblowing.
Some Web sites offer advice on how to proceed; others will post the allegation for a fee of $100; some offer legal counsel (again, for a fee); and still others steer whistleblowers to peer-support groups. Check out www.whistleblower.com for an example of what sort of ammunition is out there.
Bucking convention. The nation's largest healthcare technology convention is missing the nation's second-largest healthcare technology company.
Malvern, Pa.-based Shared Medical Systems opted out of this year's Healthcare Information and Management Systems Society conference, which was expected to draw more than 20,000 people to Atlanta from Feb. 21-25.
SMS says showing new products and other information to its user groups and other small meetings would be more effective than attending the conference, which has grown tenfold in attendance since its 1992 founding.
The move had other technology companies scratching their heads.
"People come there to see what you have done in the previous 12 months," says Jack Newman Jr., an executive vice president at Kansas City, Mo.-based Cerner Corp. "It's important to have a presence there.
"We have user groups, but we wouldn't substitute one for the other."
Let's talk about sex. It didn't have anything to do with the president, but theJournal of the American Medical Association found itself explaining another sex-related study.
The AMA admitted it failed to disclose that authors of a study on sexual dysfunction had been paid by Pfizer to review clinical data on impotency drug and cultural icon Viagra before its submission for government approval.
The study, published in the Feb. 10 issue of JAMA, found significant percentages of men and women suffer from some form of sexual dysfunction. Mainstream press reports quoted lead author Edward Laumann, a University of Chicago sociologist, as saying the study "gives us a base for explaining why we had this enormous response to Viagra."
The AMA's admission touched a nerve with critics who have blasted medical journals for failing to disclose corporate financing of research, although that wasn't the case with Laumann's article. JAMA noted the Laumann-Viagra link in its subsequent issue.
Almost a month earlier, editor George Lundberg, M.D. (shown at right), was fired after he published a study about how college students define sex. The article appeared around the time President Clinton's impeachment trial was beginning.
The back page of that issue featured an advertisement for Viagra.
This is only a test. South Carolina Department of Health and Environmental Control attorney Katherine Wells is brushing up on her bankruptcy lingo.
A private bankruptcy attorney before joining the department in 1997, Wells believes the recent trickle of hospital and PPM bankruptcies means a rash of them will be coming soon.
Wells has filed requests for the Chapter 11 bankruptcy documents of Pittsburgh-based hospital system Allegheny Health, Education and Research Foundation and Reston, Va.-based physician manager PHP Healthcare Corp.
"Allegheny and PHP are the tip of the iceberg," Wells says. "We'll see many more."
The South Carolina health department appeared on both companies' creditor lists; each at some point had provided minor services for the department.
Wells says South Carolina got into a paperwork quagmire a few years ago when it was late filing requests for documents in some environmental bankruptcies. Now, she wants the state to be ready in case something big happens.
"I was supposed to take 25% to 30% of my time with bankruptcy," Wells says. "But sometimes now it's more like 50%."
