St. Louis-area practices adopt medical home model, and other news
Five area primary-care practices are participating in a pilot project to improve care by adopting the patient-centered medical home model. The five practices are members of the St. Anthony’s Physician Organization, which is affiliated with 602-bed St. Anthony’s Medical Center in St. Louis. They will receive funding for a nurse to act as a care manager. Other personnel, such as a diabetes educator, will be available as well, and patients will have access to a secure online portal for communication with the practices, according to an e-mailed news release. The Missouri Foundation for Health Philanthropy has provided around $575,000 to CSI Solutions, Bethesda, Md., for the administration of 18-month learning collaboratives that offer information on transforming practices into medical homes. The practices are staffed by 18 doctors, two physician assistants and two nurse practitioners. “The primary-care specialty becomes all- encompassing, as the physician looks to treat the physical, emotional, mental, psychological, sociological, economic and spiritual needs of the patient,” said practice administrator Ron Finnan in the release. “Can the physician, alone, provide all of this? Absolutely not. But the physician can be the quarterback for the rest of the healthcare team. It’s a partnership among physician, care manager, staff, patient and family.” ROSEMONT, Ill.—
Lifewatch Services reached an $18.5 million settlement with the government over allegations that the ambulatory health monitoring company filed false Medicare claims, the U.S. Justice Department announced. The company did not admit liability or wrongdoing in the settlement, which resolves two lawsuits filed under the whistle-blower provisions of the False Claims Act. Both complaints say Lifewatch filed fraudulent claims to Medicare for ambulatory cardiac telemetry services. Lifewatch allegedly knew those services weren’t eligible for Medicare reimbursements for patients with mild or moderate heart palpitations. The company used a false diagnostic code to have claims paid and also made claims for services in the form of fulltime employees to several hospitals and medical practices without charge, arrangements that amounted to kickbacks, according to the Justice Department. “The chief executive officer at Lifewatch as well as other corporate executives will be required to personally certify compliance with our five-year (corporate integrity agreement), which includes provisions to monitor Lifewatch’s claim submission process, sales force activities and relationships with some types of business referrals,” HHS Inspector General Daniel Levinson said in a prepared statement. Two former Lifewatch sales representatives filed the suits: One in 2009 in Washington, D.C., and another in 2011 in Ohio. Together they will receive $3.4 million with interest as their share of the settlement, according to the news release.