Medical whistleblowers

The Miami Herald reports on a new law that will effect the health care industry beginning January 1st.

South Florida hospitals are gearing up to obey a new federal law that takes effect next week requiring that they give their employees lessons on detecting healthcare fraud -- and how to be whistle-blowers if they spot it.

The move, originated by Sen. Chuck Grassley, R-Iowa, is intended to lower Medicare and Medicaid fraud, which federal officials estimate runs up to $1 billion a year in South Florida alone.

''We are in compliance,'' said Anne Streeter, spokeswoman for Baptist Health South Florida, which operates Baptist, South Miami, Doctors and Homestead hospitals. The system is sending out letters to employees and vendors and is revising its code of ethics brochure.

''We're in the midst of it right now,'' said Spencer Levine, chief ethics officer at the North Broward Hospital District.

All hospitals contacted by The Miami Herald, including the large HCA and Tenet chains, said they were working to obey the law.

Whistle-blowers, who discover fraud that costs taxpayers money, can get a percentage of the funds recovered. That amount can be substantial.

The four owners of a tiny Key West pharmacy have received at least $70 million for their revelations about how pharmaceutical companies cheated Medicaid, the state-federal healthcare program for the poor.

The whistle-blower law, officially called the False Claims Act, also has provisions that employers can't fire workers who report fraud.

Some national law firms, such as Goodwin Procter, warn that the new provisions will make more people aware of the potentially lucrative law and could result in a rash of new lawsuits.

''I don't fear scrutiny,'' said Levine at North Broward, a public entity that runs Broward General and other hospitals.

'You're dealing with taxpayers' money and the health of our citizenry, so yeah, there is a concern.''

Miami-Dade's public hospitals recently paid $14 million to settle claims they overcharged Medicare and Medicaid.

That's small potatoes compared to these two con artists.

Tenet Healthcare who settled with the federal govt for $900 Million because of Medicare Billing.

and

The University of Medicine and Denistry of New Jersey, the biggest medical school in the country, that had to accept a federal monitor or face shutdown because of Medicare and Medicaid Fraud.

Two giants of the healthcare industry caught overbilling the government. That and my own personal experiences tell me there is serious fraud in the medical system today. How many patients get cheated out of money by these hucksters?

Two more comments=

1= The $1 billion a year in savings due to the new legislation seems optimistic to me. It will take very brave people to report their employers and many won't for the financial hardships they'll face if they get fired for whistleblowing.

2- Of all the people the Miami Herald quoted, why Spencer Levine? Was Miami Herald Reporter John Dorschner totally ignorant of this story? I would think there is better South Florida healthcare exec to use for a quote than one that took over an agency losing 209 Million a year and wasn't willing to criticize past management. Levine is wishy washy at best when it comes to being an expert on the proper management of healtchare.

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