Modern Healthcare - - REGIONAL NEWS -

LOS AN­GE­LES— Ro­seville, Calif.-based Ad­ven­tist Health agreed to pay $14.1 mil­lion to re­solve al­le­ga­tions that it im­prop­erly com­pen­sated physi­cians who re­ferred pa­tients to the sys­tem’s White Me­mo­rial Hos­pi­tal in Los An­ge­les. White Me­mo­rial also agreed to en­ter a five-year cor­po­rate in­tegrity agree­ment with HHS’ in­spec­tor gen­eral’s of­fice, the U.S. Jus­tice Depart­ment said in a news re­lease. The hos­pi­tal, the govern­ment al­leged, trans­ferred med­i­cal sup­plies and other goods to physi­cians for less than fair-mar­ket value and paid physi­cians in­flated rates for teach­ing ser­vices in its fam­ily-prac­tice res­i­dency pro­gram. “We are pleased the mat­ter is con­cluded, and we will dili­gently ful­fill the terms of the cor­po­rate in­tegrity agree­ment,” Ad­ven­tist Health said in a writ­ten state­ment. The state­ment noted that the sys­tem co­op­er­ated with the in­ves­ti­ga­tion and that the al­le­ga­tions in­volve fi­nan­cial re­la­tion­ships “with sev­eral doc­tors that were en­tered into more than a decade ago.” The set­tle­ment stems from a whis­tle-blower law­suit filed in 2008 by two doc­tors, ac­cord­ing to a re­lease is­sued by the law firms that rep­re­sented them, Phillips & Co­hen and Hirst Law Group. SACRA­MENTO, Calif.—

A Cal­i­for­nia law that cre­ated an agency to over­see national health­care re­forms granted it sweep­ing au­thor­ity to con­ceal spend­ing on the con­trac­tors that will per­form most of its func­tions, cre­at­ing a bar­rier from pub­lic dis­clo­sure that stands out na­tion­wide. The de­gree of se­crecy af­forded Cov­ered Cal­i­for­nia ap­pears unique among states at­tempt­ing to es­tab­lish their own health in­sur­ance ex­changes un­der Pres­i­dent Barack Obama’s sig­na­ture health law. An As­so­ci­ated Press re­view of the 16 other states that have opted for state-run mar­ket­places shows the Cal­i­for­nia agency was given pow­ers that are the most restric­tive in what in­for­ma­tion is re­quired to be made pub­lic. In Mas­sachusetts, the state that served as the model for Obama’s health­care over­haul, its Health Con­nec­tor pro­gram is specif­i­cally cov­ered by open-records laws, rather than pro­vid­ing ex­emp­tions from them, as is the case for con­tract­ing in Cal­i­for­nia. In Idaho and in New Mex­ico, agen­cies specif­i­cally must com­ply with open-records laws. The Mary­land Leg­is­la­ture sub­jected its ex­change to the state’s pub­lic in­for­ma­tion act, but pro­tected some types of com­mer­cial and fi­nan­cial in­for­ma­tion. In Cal­i­for­nia’s case, the ex­clu­sions may run afoul of the state con­sti­tu­tion, one le­gal ex­pert said. Ex­change spokesman Dana Howard said the agency com­plies with the law but de­clined to dis­cuss in de­tail how it de­ter­mines what is pub­lic and what is not. In set­ting up the Cal­i­for­nia ex­change, law­mak­ers gave it the au­thor­ity to keep all con­tracts pri­vate for a year and the amounts paid se­cret in­def­i­nitely. Ac­cord­ing to agency doc­u­ments, Cov­ered Cal­i­for­nia plans to spend nearly $458 mil­lion on out­side ven­dors by the end of 2014, cov­er­ing lawyers, con­sul­tants, pub­lic re­la­tions ad­vis­ers and other func­tions.

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