Wednesday, July 30, 2008

The Grift of the Magi?

The (unfortunate) headline reads like a convoluted novel:
The good news, such as it is, is that this is not a hit piece on organized religion. Rather, it's a report on the (alleged) shenanigans of some local health care providers. It's an insight, as well, on how "the system" works:
"The suit seeks damages from Christ Hospital, the Health Alliance of Greater Cincinnati, Ohio Heart and Vascular Center and the now defunct Medical Diagnostic Associates for an alleged kickback scheme in which Ohio Heart and Christ Hospital traded referrals for patients whose services were billed to Medicare and other federal programs."
What's interesting (frightening?) about this is that there's no indication of actual monetary damage. No allegation that Medicare was billed for fictitious services, or that patients were treated for non-existent maladies. It seems that the appearance of impropriety is enough to warrant legal action.
In some ways, this is not unexpected.
About a year ago, we reported that Christ Hospital had actually parted ways with the Cincinnati-based Health Alliance. The news account mentions that the (alleged) violations occurred over a seven year period, ending in 2004; this would certainly jive with the date of the "break up." During that time, the feds say, physicians were "rewarded" for throwing business to the alliance and its hospitals.
We've talked before about the inherent conflict of interest when physicians have ownership in various other medical-related industries. Doctors are human, after all, and subject to the same temptations as the rest of us mortals. It appears that the Health Alliance took advantage of this fact (and I didn't see anything in the story indicating that they had to force the doc's to participate), and ended up profiting from it (as did the doc's, apparently). The good news is that at least one physician, a Dr Harry Fry [ed: how ironic is it that a cardiologist is named Fry?], warned the Alliance that the practice was illegal, but was apparently ignored.
I suspect that, ultimately, the real issue will turn out to be "who was harmed?" There's a lot of finger-pointing going on right now; we'll let you know how it ends up.
[Hat Tip: Holly Robinson]
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