Posted on 03/10/2006 6:52:03 AM PST by Calpernia
http://www.newsday.com/news/local/wire/newjersey/ny-bc-nj--umdnj0308mar08,0,7402337.story?coll=ny-region-apnewjersey
Troubled medical school facing more scrutiny over bills
The embattled University of Medicine and Dentistry of New Jersey is facing scrutiny over new accusations of Medicaid billing problems, according to published reports.
The state medical school may have overbilled the government by as much as $70 million to $75 million, The Record of Bergen County and The Star-Ledger of Newark _ both citing unnamed sources _ reported in Wednesday's newspapers.
(snip)
Stern's first report is due to the U.S. attorney at the end of March.
http://www.nj.com/news/ledger/index.ssf?/base/news-5/11417984673130.xml&coll=1
Clues point to new fraud at UMDNJ
Executive suspended over alleged $70M in Medicaid double billing
(snip)
While auditors are still trying to determine the extent of the problem, the amount involved far exceeds the $4.9million in fraudulent billing outlined in a separate federal criminal complaint against UMDNJ in December.
The university -- charged with knowingly double-billing Medicaid for the same services as its physicians -- avoided prosecution by placing itself under the oversight of a federal monitor. The state institution remains under an ongoing criminal investigation into political influence peddling, no-bid contracts, and sweetheart deals to insiders.
The new billing problems were uncovered last week, as part of an examination of the annual cost reports submitted to the Centers for Medicare & Medicaid Services, according to two officials with direct knowledge of the investigation.
(snip)
UMDNJ/Robert Wood Johnson ping
http://www.freerepublic.com/focus/f-news/1563271/posts?page=23#23
Healthy People 2010
This initiative was stimulated by President Clinton's commitment to eliminate disparities in health for racial and ethnic minority populations by 2010.
http://www.nidcr.nih.gov/NR/rdonlyres/D2C8F49F-400E-467E-ACF2-6255D6E9FDEA/0/Nadrc0900.pdf
DHHS OFFICE OF HEALTH PROMOTION AND DISEASE PREVENTION
AND THE HEALTHY PEOPLE 2010 INITIATIVE
(major snip)
Dr. Randy Wykoff, Deputy Assistant Secretary for Health for Disease Prevention and Health Promotion, DHHS, presented an overview of Healthy People 2010, including the Leading Health Indicators, and possible ways to maximize this initiative. Healthy People 2010 is coordinated by the DHHS Office for Disease Prevention and Health Promotion.
Dr. Wykoff noted that Healthy People 2010 is a comprehensive set of national 10-year objectives that are developed through a collaborative process involving both the public and private sectors. All the objectives are specific and measurable over time based on data. The document, published and distributed by the Federal Government, also is a statistical description of the health status of Americans, including racial and ethnic disparities; a textbook on current public health priorities; and an important part of the national strategic plan for improving health. Healthy People 2010 is the third iteration of an effort that began in 1979 with publication of the Surgeon General's Report on Health Promotion and Disease Prevention. Ever larger and more complex, this iteration has two overarching goals, 28 focus areas, 467 objectives, and 10 leading health indicators.
(major snip)
Grant Review
The Council considered 327 applications requesting $70,492,343 in total costs. The Council recommended
238 applications for a total cost of $31,211,337 (see Attachment II).
UMDNJ is a publicly interest member of this initiative.
Members:
r. Hillary Brode, University of Medicine and Dentistry of New Jersey (UMDNJ)- New Jersey Dental School, Newark
sweet ~sarcasm!
When they start putting people in jail then I'll believe they intend to change.
I totally agree OldFriend.
"The rules of the game in this place have changed, and they haven't been changed by us," he said. "Even though the state is our lifeblood, we cannot, as a matter now of law, engage in some of the kinds of behaviors that have existed in the past. Some of the kinds of things that have (been) reported -- that may have become standard operating procedure in the past -- we cannot do anymore."
In other words, now that we are being watched we have to stop stealing from the state.
now that we are being watched we have to stop stealing from the state [our lifeblood] and they [the rules] haven't been changed by us.
yuppers.
Who do you think that was publicly being addressed to? It is almost like he was telling someone we have a problem here and it isn't our fault.
Obviously if this was a conversation amongst themselves, they wouldn't have had to make a public statement like that.
Pay to play will be a thing of the past.
And companies like Prudential will not be asked to hire certain people in exchange for state business.
Why don't we just get rid of legislatures and just have judges, with the Governor/President as Chief Administrative Judge. Far fewer people to payoff that way. :-)
Investigations so far:
* No-Bid Contracts, Often Resulting in No Documented Work -
"It is not just that university officials handed out contracts to politically connected people without any competitive bidding. What is more astonishing is how pervasive the practice was, with more than $700 million in no-bid contracts awarded over five years, and that it appears that some of the contractors did no perceptible work in exchange for their payments."
Example, Newark Star-Ledger noted that the school gave a $75,000 no-bid contract to Ronald White, a former top fund-raiser for former NJ Governor James E. McGeevey, but could provide no evidence he did any work for it: also, the school paid over $1 million over ten years to Chip Stapleton, a Republican consultant, to advise the university, but again the university cannot document that he did any work, either.
* Hiring Lobbyists to Influence the State Government, and Making Political Contributions -
"It is not just that the university hired influential lobbyists and consultants, ostensibly to promote its interests in Trenton - itself a rare step for a public university - but that it hired so many of them. The school, which receives more than $300 million a year from the state, went a step further in strengthening its political ties, giving campaign contributions to many elected officials, a nearly unheard-of practice whose legality has been questioned by some legislators."
Example, the Star-Ledger noted that the school gave a $10,000 campaign contribution to a "breast cancer group" linked to Newark Councilwoman Gayle Chaneyfield-Jenkins.
* Allowing Political Bosses to Make Decisions -
"It is not just that university posts were handed to people with powerful political connections and potential conflicts of interest - though the extent of that practice was impressive. University officials and politicians alike say that political bosses actually dictated to the university who received what jobs, and who was shoved aside."
Example, "Stephen N. Adubato Sr., a Newark power broker and president of the North Ward Educational and Cultural Center, has publicly taken credit for the ouster of Harvey Holzberg as university chairman. Stanley S. Bergen Jr., a former president of the university, and several other people tied to the institution and to state government, say that Mr. Adubato engineered the appointment of Mr. Petillo as chairman and then president - something that Mr. Adubato now vigorously denies. Last November, Mr. Petillo awarded a $95,000 no-bid contract to an organization run by Mr. Adubato."
* Health Care Organizations Seem to Operate with Little Oversight or Accountability -
"But lawmakers, watchdog groups and political scientists say the causes boil down to two basic factors: a relative lack of scrutiny at the university, and the unique political structure and culture of New Jersey."
* The Anechoic Effect -
"If people within government are not watching the doings of state agencies closely enough, the same may be true of those outside government." Furthermore, "But the newspapers in New York City and Philadelphia that are read by so many people in New Jersey have focused on the issue only occasionally, and the out-of-state television stations that dominate the state's airwaves have paid even less attention. And there may lie a reason the university long escaped scrutiny for practices that, in some cases, date back at least a decade."
* University under investigation by the US Federal Bureau of Investigation (FBI)
Newark Star-Ledger described how a burglar made away with a variety of records, but almost no cash, and little of pecuniary value, from a UNDMJ administration building. This burglary occurred days after a memo from a UMDNJ staff lawyer asking employees to secure all documents and destroy none of them. The initial story said that the records included documents subpoenaed by the FBI, and personnel records probably also related to the investigation, according to an additional report. The President of UMDNJ, John Petillo, even said that to him "it looks like it may very well have been an inside job." After the burglary, the FBI stepped up their investigation, interviewing several UMDNJ employees in pre-dawn visits.
* The Black Bag... -
Confusion about what documents were actually taken from UMDNJ, another Star-Ledger article included a statement by UMDNJ officials that "no documents requested of UMDNJ by any outstanding subpoena are missing due to the break-in." Yet, according to the Star Ledger, "stolen personnel records could factor into the federal probe."
A Star-Ledger editorial noted, "at least two definitions come to mind when considering the term 'black bag.' First, there's a doctor's medical bag. Then there's the slang meaning a secret, illegal break-in, usually by a government agency. Now, thanks to the latest jaw-dropping incident at New Jersey's University of Medicine and Dentistry, there's no need to make the distinction between the two."
What a frugal idea!
:)
Just trying to save the citizens some money. :-)
Thanks for the ping!
bump for weekend reading.
>>>>"The rules of the game in this place have changed, and they haven't been changed by us," he said. "Even though the state is our lifeblood, we cannot, as a matter now of law, engage in some of the kinds of behaviors that have existed in the past. Some of the kinds of things that have (been) reported -- that may have become standard operating procedure in the past -- we cannot do anymore."<<<
At UMDNJ "The Rules of the Game Have Changed"
As auditors continue to investigate the finances of the University of Medicine and Dentistry of New Jersey (UMDNJ), new problems continue to surface.
We have posted extensively at the troubles at UMDNJ, which now is operating under a federal deferred prosecution agreement with the supervision of a federal monitor (most recently here).
The indefatigable reporters at the Newark Star-Ledger have revealed yet another problem, possiblly massive over-billing by UMDNJ of Medicare. " While auditors are still trying to determine the extent of the problem, the amount involved far exceeds the $4.9million in fraudulent billing outlined in a separate federal criminal complaint against UMDNJ in December." " The new billing problems were uncovered last week, as part of an examination of the annual cost reports submitted to the Centers for Medicare & Medicaid Services, according to two officials with direct knowledge of the investigation." "At issue were costs associated with the university's mental health division, University Behavioral HealthCare, and whether UMDNJ-University Hospital padded those costs with its own administrative expenses. If the federal cost reports were inflated, the hospital would be reimbursed at a higher rate than it is legally entitled to receive. The sources said the hospital may have submitted reports that funneled an additional $50million to $70million in unwarranted reimbursements."
Meanwhile, the Dean of one of UMDNJ's two medical schools, Dr Harold Paz, has resigned. His new job will be Senior Vice President for Health Affairs, Dean of the Medical School, and CEO of Hershey Medical Center at Pennsylvania State University. Thus both of UMDNJ's medical schools for the moment will be operating with acting deans.
Furthermore, UMDNJ's new interim president, Bruce C. Vladek, has come on board while putting all his constituents on notice that it will no longer be business as usual at UMDNJ:
People are all on notice that there is no tenure in the management structure of this organization. I feel empowered to restructure the administrative staff of this organization, subject to consultation and approval of the board, however I feel is necessary.
The rules of the game in this place have changed, and they haven't been changed by us. Even though the state is our lifeblood, we cannot, as a matter now of law, engage in some of the kinds of behaviors that have existed in the past. Some of the kinds of things that have (been) reported -- that may have become standard operating procedure in the past -- we cannot do anymore.
It sounds like he has the right idea, but will have a lot of work to do.
But he also noted,
As far as I know, the very, very real problems here are largely isolated from the educational, clinical and research activities of the university.
I do beg to differ somewhat with this. I am sure that UMDNJ has many dedicated professionals and faculty who have been working hard to keep the clinical and academic missions on track. Yet I am not sure how "isolated" they have been from the problems. It must have been demoralizing to work under the previous UMDNJ administration, which has now been revealed as scandal-ridden. I can only hope that their morale is improving now. Hopefully, the new leaders of UMDNJ will be worthy of their trust.
The case of UMDNJ should be a wake-up call for those who thought that business as usual was just a fine way to run the health care system. However, although this case, like that of UCI, has gotten plenty of local attention, it seems not to have been noticed outside of its region, nor in medical, health care, and health policy journals. As far as I can tell, the only place to see these cases juxtaposed is here on Health Care Renewal.
http://hcrenewal.blogspot.com/
http://www.courierpostonline.com/apps/pbcs.dll/article?AID=/20060425/NEWS01/604250372/1006
Judge's findings hit UMDNJ dean
KEY POINTS
The federal monitor concluded R. Michael Gallagher, outgoing dean of UMDNJ's School of Osteopathic Medicine:
Directed subordinates to "doctor' a clinic's financial records so that he could qualify for $15,000 bonuses.
Submitted bills featuring more than $200,000 worth of questionable expenses, including expensive meals and a $750 stay at a New York hotel.
http://hcrenewal.blogspot.com/
More About UMDNJ Leaders Feathering Their Own Nests
Has it really been almost three weeks since we posted about the University of Medicine and Dentistry of New Jersey (UMDNJ)? UMDNJ now is operating under a federal deferred prosecution agreement with the supervision of a federal monitor (see most recent posts here and here.) We had previously discussed allegations that UMDNJ had offered no-bid contracts, at times requiring no work, to the politically connected; had paid for lobbyists and made political contributions, even though UMDNJ is a state institution; and seemed to be run by political bosses rather than health care professionals. (See post here, with links to previous posts.)
There are yet more revelations about how UMDNJ leaders feathered their own nests.
Some concern one New Jersey State Senator Wayne R Bryant (Democrat - Camden County). According to the Philadelphia Inquirer, "in 2003, the college's School of Osteopathic Medicine in Stratford created a program-support coordinator job for Bryant. Investigators are looking into allegations that Bryant improperly used his position as Chairman of the Senate's budget committee to direct millions in state funds to the school." Furthermore, "legislative sources say that as the state budget was finalized last June, Bryant steered a last-minute $2.7 million to the Stratford school for debt service. In addition, Bryant also paved the way to increase a state allocation to UMDNJ's Robert Wood Johnson Medical School in Camden, for a total of $7.8 million, as well as a $5 million appropriation for the Newark campus' Neurosciences Institute...."
Others arise out of more findings by the federal monitor who is now overseeing UMDNJ. According to the indefatigable Newark Star-Ledger, the monitor's latest report has more about Dr R Michael Gallagher, the former Dean of the School of Osteopathic Medicine (mentioned above). "Investigators concluded that the osteopathic school near Camden systematically falsified profit and loss statements - at Gallagher's direction - to show the headache center [which Gallagher ran] was making money, thus making Gallagher, whose salary is $381,854, eligible for the annual bonus." Also, the investigators reported that Gallagher "submitted travel expenses to the university for reimbursement that had already been picked up by drug companies." The report also included a variety of lavish expenses for which Gallagher was reimbursed by UMDNJ, such as an expensive leather computer case for his wife, a night at the Waldorf for Gallagher and his wife, and the now familiar meals at exepnsive restaurants and country clubs.
Also according to the Star-Ledger, the monitor alleged UMDNJ Trustee Donald Bradley, who is also Newark City Council President, pushed UMDNJ to "further his political activities." He persuaded UMDNJ to underwrite a gala affair entitled "Keep the Dream Alive." It cost over $22,000, including $2550 for a martini bar and ice sculptures. "The event apparently violated state policy, which prohibits publicly funded institutions from holding receptions honoring any state employee - which would have included the UMDNJ staffers who were celebrated at the event - or expenses for alcoholic beverages...." Bradly also applied pressure to secure jobs for favored people at UMDNJ. "Bradley would often personally accompany people he recommended for jobs on interviews. Among those were his daughter-in-law, who was hired and subsequently fired." Finally, the monitor questioned "whether Bradley forced UMDNJ to sublet medical office space it leases at 194 Clinton Avenue in Newark to Chandrakant Patel, a physician and contributor to Bradley who operated Universal Industrial Clinic until he lost his medical license." "Top [UMDNJ] administrators were told they should provide physicians and medical imaging equipment to enable Patel to establish a federally qualified health clinic at the site. According to the report, the city council president told one that if she assisted in the effort, he could make 'go away' a separate city lawsuit against UMDNJ...." "UMDNJ has never tried to collect $75,000 in real estate taxes Patel was obligated to pay under the token lease...." The University was never even paid its symbolic lease payment. "It is owed $3 by Patel."
UMDNJ has unfortunately become a prime example of how the leadership can bring a once respected health care organization low by putting their own interests ahead of the institution's mission. At least we can hope that the ongoing clean-up will provide a model for how to clean up other errant health care organizations. Once again, my sympathy is with the dedicated UMDNJ staff who have tried to soldier on through all of this, and of course with the patients who still need to go to UMDNJ for their health care.
umdnj updated
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