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Thursday, August 24, 2017

Mo. audit of rural hospitals uncovers $90 million billing scheme at one that outsourced operations

Missouri State Auditor Nicole Galloway is auditing the finances of the state's rural, county-owned hospitals, Samantha Liss reports for The St. Louis Post-Dispatch. It's the first time an initiative from the state's auditor has focused solely on rural hospitals, but Galloway says it's important to make sure they are efficient and honest. "These are major employers in these rural counties," Galloway told Liss. "Additionally, they might be the only resource to health care that people have. And if these facilities close because they’re financially in bad shape they might have to drive an hour or more to get access to health care."

Rural hospitals all over the country are struggling, since rural residents tend to be older, poorer, and need more medical care, straining hospital resources. They're more likely to depend on Medicaid and Medicare, and Medicaid isn't very profitable for hospitals — especially in states like Missouri, which did not expand Medicaid under the Patient Protection and Affordable Care Act.

The audit is already seeing results. One review uncovered a $90 million billing scheme at Putnam County Memorial Hospital. The five-person hospital board had agreed to hire independent contractor Hospital Partners for the hospital's day-to-day operations but didn't run the contract by legal counsel. There were no stipulations in the contract to limit the salary of Hospital Partners' CEO, who has since increased his own salary from $160,000 to $200,000, Liss reports. Auditors found out-of-state employees on the payroll who were supposedly working for the hospital's lab, and "the vast majority of the laboratory’s billings are for out-of-state lab work for patients who never went to Putnam for care," Liss reports. State and federal officials have been notified about the audit's findings at Putnam.

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