Friday, May 25, 2018

Senator calls for probe of billing schemes at rural hospitals

At yesterday's Senate Finance Committee hearing on rural health, U.S. Sen. Claire McCaskill, D-Mo., called for a federal investigation of a rural Missouri hospital after reports surfaced of possibly fraudulent billing practices. "McCaskill has requested the top watchdog at the Department of Health and Human Services examine billings that occurred when a management company, Hospital Partners Inc., used Putnam County Memorial Hospital in Unionville as a pass-through for millions of claims for out-of-state laboratory services," Jenny Gray reports for the Fulton Sun.

Florida resident Jorge Perez controls HPI, which bought Putnam in September 2016. Perez also owns a Florida-based laboratory services business. Soon after Putnam's purchase, Perez began issuing billing for laboratory services from all over the country from Putnam, since hospitals receive higher reimbursement rates for services than do urban ones, Dan Margolies reports for KCUR-FM in Missouri.

The issue came to light after Missouri State Auditor Nicole Galloway audited Putnam in 2016 and found $90 million in questionable laboratory billings, Margolies reports. "An investigation by KCUR, KBIA and Side Effects Public Media found that businesses linked to Perez had bought or acquired management rights to about 20 struggling rural hospitals across the country and pursued the same controversial lab billing arrangements to salvage them." McCaskill said there may need to be limits on such billings.

Without any supporting evidence, McCaskill said "the same group" apparently was involved in a similar purchase and billing scheme at Chestatee Regional Hospital in Dahlonega, Ga., the first such case reported by David Axelrod of CBS News/

No comments: