“These numbers are pretty significant, and they are going to keep driving up. I like to see it,” said Lynn Gordon, a Chicago partner in the healthcare practice at Ungaretti & Harris. “Most healthcare in this country is pretty compliant. We have quality providers and they truly care about delivery. But if you have even a very nominal percentage who don't, the abuses can be terrible.”
More than 5,500 doctors and nurses joined the list after convictions for patient abuse or neglect, while another 14,200 people were excluded after their local licensing boards disbarred them for unstated reasons. Most exclusions last five years, but some are longer and a few are lifetime bans.
Conrad Murray, the personal physician who attended to pop star Michael Jackson in his final hours, is on the list. So is nurse and convicted serial killer Charles Cullen. Baltimore-area cardiologist Mark Midei was added after his licensing board concluded he had performed scores of unneeded surgeries. Former Synthes North America President Michael Huggins was excluded after a conviction for failing to stop a “rogue clinical trial” of a bone cement on unsuspecting patients in 2003-04.
After years of murky standards, HHS' inspector general announced this month that every healthcare employer in the nation that cares for Medicare patients should perform monthly checks of their entire payroll rosters—including temporary nurses, doctors and subcontractors—to see if they're employing people they shouldn't.
As a compliance director in South Florida, Ken Resmini is on the front lines of this battle. He said the new standards are going to make it expensive or excessively time-consuming for larger employers to comply with the new screening requirements.
Resmini is the chief compliance and internal audit officer of the publicly supported Memorial Healthcare System in southern Broward County, an area awash with excluded providers by virtue of its being one of the hottest hot spots in the nation for healthcare fraud and the accompanying flood of exclusions.
“Virtually every type of healthcare fraud in the industry starts here and emanates out to the rest of the country,” Resmini said.
Memorial implemented monthly checks of all employees against the exclusion list last year, he said, at the same time that the system hired an outside contractor to do the work at a cost of about $1,500 a month.
In the past, when the system checked its employees against the list only once a year, the process lasted several weeks and consumed several hundred hours of employee time, which is why he outsourced the job. Yet then, as now, the checks don't tend to turn up many people trying to sneak back into the system.