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St. Joseph loses $400,000 every day it can't bill Medicare

Towson hospital awaits certification by federal health program

February 15, 2013|By Andrea K. Walker, The Baltimore Sun

"UMMS expected that there would be some period of time during this transition when we would not be able to bill Medicare for services we were providing to patients at the hospital," said Mary Lynn Carver, its spokeswoman and a senior vice president.

She said the hospital will discuss back-payment options with federal officials once certification is obtained.

The December survey holding up the certification cited several issues at the hospital. Among the issues were surgical assistants in cardiology who were not properly supervised during procedures and pain medications that were not stored and disposed of properly. The survey also cited incomplete medical records, including one instance in which a patient's allergies weren't properly recorded, leaving her in danger of getting the wrong medication.

St. Joseph officials said any issues that posed an imminent threat to patient safety would have been addressed immediately.

"It is critical that patients and the community understand that there were no such urgent deficiencies or issues found," Dr. Mohan Suntha, University of Maryland St. Joseph Medical Center CEO, said in a statement.

Suntha said the second survey conducted this month didn't cite any of the issues found in the December survey, proof that the hospital had addressed the issues. He noted that in the case of the patient's allergies, the survey finding was that they were not documented "consistently" in all areas of the patient's records and that the hospital has corrected the problem.

The University of Maryland bought St. Joseph as the hospital struggled to recover from troubles that started when star cardiologist Mark Midei was accused of putting unnecessary stents in heart patients. Midei has denied any wrongdoing, but his medical license was revoked.

The case has resulted in hundreds of patient lawsuits and challenged the reputation of the hospital, which has lost patients and doctors and reported steep revenue declines.

In most hospital acquisitions, the Medicare certification is transferred to the new owners, but the University of Maryland was likely trying to protect itself from future liability. The university is not responsible for any previous lawsuits under its agreement with previous owner Catholic Health. It could have been responsible for any previous Medicare fraud issues if it had kept the old Medicare certification.

St. Joseph, when owned by Catholic Health, previously paid the federal government $22 million to settle allegations of a kickback scheme involving the cardiology practice where Midei once worked and to repay Medicare payments received for stents he implanted. Last week, Catholic Health agreed to pay the federal government $4.9 million for overbilling the Medicaid and Medicare systems for unnecessary hospital stays from 2007 to 2009.

It is unclear when St. Joseph will receive certification, but hospital officials say that care of Medicare patients has not changed.

"We have received many calls from Medicare patients unsure if they can still come to UM-SJMC for care," Suntha said. "We want to reassure patients that we have been and will continue to provide high-quality medical care to Medicare patients during this transition."



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