St. Joseph’s/Candler agreed to repay the state of Georgia $2.7 million to settle allegations that the two-campus hospital received excessive Medicaid payments for patients also covered by Medicare. The claims at issue— referred to as crossover claims— understated the amounts already paid by Medicare and led the state to calculate erroneously high Medicaid reimbursement, according to a news release from Attorney General Sam Olens. St. Joseph’s/Candler cooperated with an investigation after the attorney general’s Medicaid Fraud Control Unit detected an abnormal pattern of Medicaid claims by hospitals throughout the state, according to a written statement from St. Joseph’s/Candler. The inquiry uncovered a glitch in the state’s computer system that deleted information from claims and led to the overpayments, St. Joseph’s/Candler said in the statement. “While we are in total agreement that the funds should be repaid, the error in payment was outside of our control, and is the same issue that has been experienced by other hospitals throughout the state.” Five-hospital WellStar Health System, Marietta, agreed to pay $2.7 million in August to resolve the same issue, and the state’s investigation of other hospitals’ crossover claims is ongoing, the attorney general’s office said.
Physician investors have teamed up with Texas Health Arlington Memorial Hospital to open a physician-led, 48-bed specialty heart hospital. Texas Health Heart & Vascular Hospital Arlington is a physician-led hospital run by AMH Cath Labs, which is a joint venture between 332-bed Arlington Memorial and the cardiologists on its medical staff, according to a news release. The new facility is housed in the Tom Vandergriff building on the Arlington Memorial campus. Arlington Memorial is part of Texas Health Resources, a 13-hospital system based in Arlington. Megan Brooks, a spokeswoman for Texas Health, said the heart hospital has 25 staffed beds and will add more as the patient census grows. The “hospital within a hospital” is leasing its space from Arlington Memorial, and more than $4 million in improvements were made to the building, Brooks said. Patients seeking care for heart and vascular problems in the Arlington Memorial emergency department will be transferred to the new facility for specialized care. Cardiothoracic surgeon Baron Hamman is the president of the new hospital.
Hampton Regional Medical Center reported a wider loss on operations and overall for fiscal 2010 compared to its losses in fiscal 2009, according to its annual audited financial statements. On operations, 32-bed Hampton Regional lost nearly $1.6 million, more than double fiscal 2009’s loss of $622,000. Net patient service revenue increased 1.8%, to $22.4 million, but overall revenue declined 0.8%, to $22.8 million. After including investment and unrestricted non-operating income, Hampton Regional posted a loss of $1.4 million in fiscal 2010, versus a loss of $392,000 in fiscal 2009.