Modern Healthcare - - Regional News -


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.

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