The same week that the House of Representatives had scheduled a vote on a managed-care reform bill, House Speaker J. Dennis Hastert (R-Ill.) was feted at an exclusive $1,000-a-plate political fund-raising breakfast hosted by insurance lobbyists.
Hastert defended the breakfast by saying that the bill was already written. "The die is cast already on what the health legislation is going to be. So there's no influence there whatsoever," he said, ignoring the fact that a House-Senate conference committee will have to iron out differences on the bills, assuming a yes vote in the House.
The hosts of the affair included Cigna Corp. lobbyist Art Lifson, Aetna lobbyist Jonathan Topodas, Blue Cross and Blue Shield Association political action committee coordinator Brenda Becker, and Washington healthcare superlobbyist Deborah Steelman, whose client list includes Aetna, drug companies and providers.
Also hosting the breakfast were Thomas Scully, president and chief executive officer of the Federation of American Health Systems, and Michael Bromberg, the federation's former executive director who now works for Steelman and lobbies for Humana.
In a sign of how intense and personal the lobbying battle was last week, the invitation was faxed to Outliers without a cover sheet but with the notation "Follow the money." At the top of the fax was the identification "AMA." The American Medical Association has lobbied strongly in favor of an HMO regulation bill.
Seeing the other side. When Bruce Vladeck was HCFA administrator in the mid-1990s he was seen as tough but fair-minded about provider fraud, lobbying for more money and resources to detect and prevent abuses of Medicare and Medicaid.
That's why there was more than a little irony when his new employer, New York's Mount Sinai School of Medicine, settled Medicare fraud charges with HHS' inspector general's office.
Mount Sinai paid $2.2 million without admitting wrongdoing to resolve False Claims Act allegations that its faculty physicians billed Medicare for work actually performed by resident physicians. It became the sixth hospital to settle in HHS' ongoing Physicians at Teaching Hospitals national investigation.
Vladeck, who now heads the Institute for Medicare Practice at Mount Sinai, couldn't have done much to stop the allegedly fraudulent practices. Federal investigators say they took place between 1992 and 1995 when Vladeck was at HCFA.
Names can hurt. A black Atlanta medical transcriptionist is suing four doctors, their radiology practice, her employer and Atlanta Medical Center, charging that white doctors used racial epithets and spoke disparagingly of poor people on a tape she was hired to transcribe, the Atlanta Journal-Constitution reported.
After complaining to Peachtree Transcription Associates, which hired her, Barbara Jewel Hopson says she was fired. Peachtree denied it had sacked Hopson, saying she was still employed there. One of the doctors later resigned from the medical center and two others volunteered not to work there until the investigation is completed. Atlanta Medical Center Chief Executive Officer James Lathren says the tapes "made him sick." Hopson, says her attorney, "is very stressed out about this whole thing" and is receiving medical treatment.
Justice rewards its own. Want to know how to win kudos at the Justice Department? Prosecute healthcare executives.
Two assistant U.S. attorneys from Kansas, Tanya Treadway and Richard Hathaway, were honored by Attorney General Janet Reno on Oct. 1 in Washington for their prosecutions of complex healthcare and financial fraud crimes.
Treadway has been the lead healthcare prosecutor in Kansas since 1994. She charged two doctors, three hospital executives and two lawyers with conspiring to defraud Medicare by taking and paying kickbacks in exchange for nursing home patients. Robert LaHue, D.O., and Ronald LaHue, D.O., of the Blue Valley Medical Group, and Dan Anderson, former chief executive officer of Baptist Medical Center in Kansas City, Mo., were convicted in April and are awaiting sentencing on Oct. 25.
In 1994 Hathaway and Treadway worked on another prosecution that involved payments for patient referrals. They won convictions against two executives at Park View Hospital, a psychiatric facility in Topeka, Kan., owned by National Medical Enterprises.
Treadway and Hathaway, says Jackie Williams, the U.S. attorney for Kansas, "were among the first in the nation to prosecute savings-and-loan crooks, and now they have pioneered in the prosecution of healthcare fraud."
Bless this accelerator. Cardinal John O'Connor, the archbishop of New York, last week blessed Saint Vincents Comprehensive Cancer Center, a new $33 million outpatient facility that will compete with world-renowned Memorial Sloan-Kettering Cancer Center uptown.
The cardinal knows both hospitals well. He spent almost two weeks at Sloan-Kettering in August and September for diagnosis and treatment of a small brain tumor. And 580-bed Saint Vincents Hospital and Medical Center is the jewel in the crown of Catholic hospitals in New York.
The cardinal is wrapping up a five-week regimen of radiation therapy for the tumor at Sloan-Kettering. But he took special note of the new linear accelerator for radiation therapy at Saint Vincents, telling the New York Times, "This is where I lie every morning for 60 seconds."