University Health turns itself in to Feds for possible complianc - KTBS.com - Shreveport, LA News, Weather and Sports

University Health turns itself in to Feds for possible compliance issues

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University Health Self-Reports Compliance Issues University Health Self-Reports Compliance Issues
KTBS 3 News Investigates reports of a possible double standard of care, favoring insured and paying customers over the poor and uninsured.

The findings involve some outpatient clinics formerly run by LSU Medical Center that now fall under University Health. According to University Health, compliance issues were found in their clinics by three consulting firms that UH hired after they took over. University Health self-reported these potential compliance issues to Federal agencies.

University Health CEO, Rod Huebbers said, "We have a legal responsibility to report these issues to the office of Inspector General and the CMS, which we have." CMS is the Centers for Medicare and Medicaid Services, part of the federal Department of Health and Human Services (DHH.) CMS is the agency responsible for making sure Medicare and Medicaid reimbursements are made to healthcare providers and that providers that bill them are in compliance with Federal Regulations. UH has also stopped billing Medicare and Medicaid until a determination about compliance occurs.

After reporting possible compliance issues under University Health's watch, Huebbers sent notice to LSU Shreveport School of Medicine's chancellor Dr. Robert Barish. In that letter, Huebbers wrote that consultants found "… an apparent dual system of care between insured and uninsured patients." Huebbers said insured patients were more likely to get treated quickly in a clinic staffed by more experienced medical school teachers. But, uninsured patients were more likely to be treated in clinics staffed by less experienced residents and more likely to have long wait times. Huebbers said patients waited up to "95 days" for an appointment "... if seen at all." University Health also claims to have discovered a "backlog of referrals numbered in the thousands dating back months, if not years, that had yet to be entered into the appointment scheduling system."

When discussing the backlog, State Senator Greg Tarver said, "We're talking about 16,000 people." Tarver, a big supporter of the University Health takeover, believes discrimination of patients has been going on for up to seven years prior. He said, "a lot of them fell through the cracks. We don't know what happened to them. We don't know if they died or if they're still living."

Huebbers' letter goes on to say "the consideration of payor source was a long-standing practice by LSU when determining which clinic a patient would be treated and how quickly the patient would be seen." LSU Med School officials said they have no evidence of improper care.

The Vice Chancellor for Clinical Affairs at LSU Shreveport School of Medicine, Dr. Hugh Mighty, said, "our faculty at LSU have always taken care of all patients regardless of where they come from, what brings them here. We've taken care of them equally." Joe Miciotto, now Executive Director for Campus Operations at the Med School explains that LSU has long had a fraud and complaint hotline and said "I know of no infraction. There's never been any complaints. No CMS investigation." According to these LSU officials, they have not seen all of the data University Health is referring to, nor have they seen the actual letter sent to CMS. Regardless, Mighty said, "LSU will be committed to investigating it fully and getting to the bottom of anything like that."

LSUHSC spokeswoman, Sally Croom, said that the compliance issues had to do with the provider number being used. Provider numbers are used to identify a healthcare provider when submitting claims. On October 1, 2013, the provider number transferred from LSU to University Health. However, the employees performing key functions for the clinics were not University Health employees, they are LSUHSC employees. Croom described the problem as “a need to centralize functions and scheduling.”

Senator Tarver doesn't buy it. "The people in charge are at fault. They can't hide behind it. They're the ones that have been discriminating based on how much money do you have," said Tarver. Huebbers vows that UH will bring all clinics into compliance, saying "there will be equal access to quality care for all."

Huebbers said in his letter to LSU's chancellor that ensuring equal care will mean, in part, the "dismantling of all faculty clinics and creating a centralized scheduling system."

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