Coupling electronic prescription drug ordering with computer reporting of adverse events can dramatically reduce medication errors in psychiatric units, Johns Hopkins researchers say.
"Medication errors are a leading cause of adverse events in hospitals," says study leader Geetha Jayaram, MD, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "With the use of electronic ordering, training of personnel and standardized information technology systems, it is possible to eliminate dangerous medication errors."
The findings, published in the March issue of The Journal of Psychiatric Practice, detail how the 88-bed psychiatric unit at The Johns Hopkins Hospital in Baltimore went from a medication error rate of 27.89 per 1,000 patient days in 2003 to 3.43 per 1,000 patient days in 2007. During the study period there were no medication errors that caused death or serious, permanent harm, the study said.
Potentially lethal medication errors can be caused by illegible handwriting, misinterpretation of orders, caregiver fatigue, pharmacy dispensing errors and administration mistakes. "Having something typed eliminates bad writing — and most errors — immediately," Jayaram said. "It's a good reason for going electronic."
The computer program used in the psychiatric department, and hospital-wide at Johns Hopkins, includes integrated decision support for drug dosage selection, drug allergy alerts, drug interactions, patient identifiers and monitoring — data that can be lost with a manual system that relies on layers of human beings, Jayaram said, adding that the more the number of steps involved in the process, the greater the likelihood of mistakes.
At the time that the drug ordering system was installed, Hopkins began using the Patient Safety Net error reporting system, a Web-based reporting tool. When a mistake is made it is to be reported on the PSN. This system allows for follow up, corrective action, and the ability to learn from common mistakes. It also categorizes unsafe conditions and near-miss events.
Jayaram says the HIT programs have helped to create a "culture of safety" in the psychiatry department, along with annual safety training, reporting of all adverse events as they occur, and feedback that focuses not by blaming, but on how to prevent a reoccurrence through education and corrective action.
While medication mistakes involving psychotropic drugs are rarely deadly, Jayaram said psychiatric patients also take other kinds of medication — insulin, blood thinners, and others that can be lethal if given in the wrong doses or in the wrong combination. In a psychiatric department some nonpsychotropic medications are considered high-risk and, as a precaution, two nurses must check them off before they are administered.
Even with computerized backstops, Jayaram said complacency can be a problem and new problems can arise so the system is constantly evolving. "You have to be vigilant for new problems that might come up," she said.
Trauma patients who've been hurt in car or bike crashes, shot, stabbed, or suffered other injuries are more likely to live if they arrive at the hospital on the weekend than during the week, according to a study from the University of Pennsylvania School of Medicine.
The research, published in the current issue of Archives of Surgery, also shows that trauma patients who present to the hospital on weeknights are no more likely to die than those who present during the day, contrasting previous studies showing a so-called "weekend effect" in which patients with emergent illnesses such as heart attacks and strokes fare worse when they're hospitalized at night or on weekends.
The study found that the trauma system's unique organization and staffing appears to serve as a built-in protection for these critically injured patients, and may provide a roadmap for restructuring and coordinating emergency care.
"Whether patients have an emergent illness or a severe injury, the common denominator is time. Patients must rely on the system to quickly get them to the place that's best prepared to save their lives," said Brendan G. Carr, MD, an assistant professor in the departments of Emergency Medicine and Biostatistics and Epidemiology, and a lead author of the study. "Trauma systems have been designed to maximize rapid access to trauma care, and our results show that the system also offers special protection for patients injured during periods that are known to be connected to worse outcomes among patients with time-sensitive illnesses."
The researchers studied 90,461 patients who were treated from 2004 to 2008 at Pennsylvania's 32 accredited trauma centers. About 25% of the patients presented to the hospital on weeknights -- defined as 6 p.m. to 9 a.m. Monday through Friday -- and about 40% arrived on weekends -- 6 p.m. Friday to 9 a.m. on Monday. Neither the weekend or night patient groups experienced delays for crucial brain or abdominal surgeries often required for trauma patients, compared to weekday patients, the study found.
Unlike most other medical and surgical specialties – in which staffing and resources vary on nights and weekends – trauma centers are required to have round-the-clock resources for emergency medicine, radiology, surgery, and post-operative intensive care immediately available 24 hours a day, seven days a week, 365 days a year.
The report suggests that the greater odds of survival on weekends may be influenced by hospital scheduling. Since elective surgeries are typically not performed on weekends, there is less competition for practitioners' time, operating rooms, blood bank, pharmacy and other hospital resources.
Despite the indication that trauma patients may, overall, be safer during off hours, the findings revealed that both weeknight and weekend presentation was associated with longer ICU stays, and those who came to the hospital on weeknights were more likely to have a longer hospital stay overall than those who were admitted on a weekday. The report said this may be due to hospital factors not entirely related to the patient's condition, including greater bed availability because few elective admissions and surgeries occur on weekends.
"It is unrealistic to think that all hospitals can be fully staffed to provide optimal care for all time-sensitive conditions all of the time, so our challenge is to develop an integrated system of emergency care for unplanned -- but inevitable -- critical illness," Carr said. "The trauma system has a plan of care in place long before we ever need it, and it offers many lessons for the remainder of emergency care."
Physician Hospitals of America is lobbying Congress in a long-shot attempt to repeal a section of the Patient Protection and Affordable Care Act that curtails new construction or expansion of physician-owned hospitals.
Two bills, HR 1159, introduced by Rep. Doc Hastings (R-WA) and HR 1186, introduced by Rep. Sam Johnson (R-TX), would both repeal Section 6001 of PPACA, which now prohibits future physician investment in hospitals, caps existing physician investments, and restricts existing physician-owned hospitals from expanding.
PHA President Michael Russell, MD, said the ban on physician-owned hospitals reduces access to care even as PPACA brings more than 30 million new patients into the public health system.
"Much-needed expansion projects were halted at over 30 existing hospitals and more than 40 hospitals are in a state of uncertainty because they were not certified by Medicare in time to meet the Dec. 31 deadline," Russell said. "Passage of this legislation would undo the harm to communities imposed by the current law, help improve access to quality health care services, preserve the right of patients to choose where they receive their health care, and protect much needed jobs during our down economy."
It's not clear if the bills have any support. The repeal effort may find some backers in the Republican-controlled House, but it is unlikely to gain much traction in the Senate, which is controlled by Democrats. In addition, the American Hospital Association, the Federation of American Hospitals, and other powerful healthcare provider organizations lobbied for the restrictions on physician-owned hospitals in PPACA, and they would more than likely lobby heavily against repealing the ban.
AHA has raised questions about financial conflicts of interests and the safety of physician-owned hospitals. PHA claims that the restrictions are about eliminating competition.
AHA, FAH, and others have complained to Congress that physician-owned hospitals cherrypick healthier, insured patients for higher reimbursement, and that self-referrals threaten community hospitals' ability to provide services such as emergency departments, NICUs, and burn units.
Critics of physician-owned hospitals also point to a Congressional Budget Office report showing that cutbacks to physician-owned hospitals could save more than $2 billion for 10 years. Proponents of the physician-owned hospitals say the numbers are off-base.
There are 275 physician owned hospitals in 33 states that provide general acute care, long-term acute care, emergency medicine, multispecialty, women's, children's, rehabilitation and psychiatric.
The Department of Health and Human Services on Monday unveiled a three-pronged National Quality Strategy that calls for developing patient-centered care, reducing costs, and improving general public health by supporting "proven interventions" that address unhealthy behavioral, social, and environmental issues.
The strategy was called for under the Affordable Care Act and marks the first effort to create national aims and priorities to guide local, state, and national efforts to improve healthcare, the Department of Health and Human Services said.
"The Affordable Care Act sets America on a path toward a higher quality healthcare system so we stop doing things that don't work for patients and start doing more of the things that do work," said HHS Secretary Kathleen Sebelius. "American hospitals, doctors, nurses and other healthcare providers are among the best in the world. With this ground-breaking strategy, we are working with local communities and health care providers to help patients and improve the health of all Americans."
While promoting quality care that is focused on patients, their families, and communities, the strategy also will reduce administrative burdens and facilitate care collaboration for doctors and other providers, HHS said.
To deliver on its goals of improving care, reducing costs, and improving public health, the strategy identified several "priorities." They are:
Making care safer by reducing medical errors.
Ensuring that patients and their families are engaged as partners in the care.
Promoting the most effective prevention and treatment for leading causes of mortality, starting with cardiovascular disease.
Working with communities to promote best practices for healthy living.
Making healthcare affordable by developing new delivery models.
HHS said the strategy was developed both through evidence-based results and in collaboration with stakeholders, including federal and state agencies, local communities, provider organizations, clinicians, patients, businesses, employers, and payers.
The National Quality Strategy will be an evolving guide, and HHS said it will continue to work with stakeholders to create specific quantitative goals and measures for each priority. Different communities have different needs and assets, and the strategy will them to take different paths to achieving these goals, HHS said.
Academic faculty physicians in primary and specialty care reported slight increases in compensation between 2009 and 2010. However their compensation continues to trail that of physicians in private practice, according to a new report from the Medical Group Management Association.
MGMA’s Academic Practice Compensation and Production Survey for Faculty and Management: 2011 Report Based on 2010 Data found that median compensation for primary care faculty physicians was $163,704 -- an increase of 3.47% since 2009 -- and median compensation for specialty care faculty was $241,959 -- an increase of 2.7% since 2009.
“Overall, academic practices provide a different environment for their faculty than private practices,” said Jonathan Tamir, associate chairman, Finance & Administration, Department of Internal Medicine, Yale University School of Medicine. “Even the very best academic clinicians will not be as clinically productive as their private-practice counterparts since at least some of their time is devoted to research and teaching efforts—which are never as well compensated as clinical care.”
This year’s report contains data on 18,776 faculty physicians and non-physician providers categorized by specialty and 1,993 managers. Englewood, CO-based MGMA said.
Annual compensation for internal medicine primary care faculty physicians increased by 6.84% between 2009 and 2010, and increased 4.46% between 2008 and 2009. Pediatric faculty reported annual compensation of $145,000, a 2.21% increase since 2009.
Tamir said the salary bumps are required to hire internal medicine faculty. “It is the law of supply and demand. More applicants are interested in part-time appointments or reduced on-call roles. The demand for more highly paid hospitalists is increasing, further reducing the applicant pool, and senior physicians are retiring earlier than in the past,” Tamir said. “While causes such as increasing paperwork, decreasing reimbursement, the change in the doctor-patient relationship and increasing regulations are certainly a factor, the bottom line is that there aren’t enough internal medicine applicants available.”
Among specialists, compensation for pulmonary medicine faculty rose 7.38%, and noninvasive cardiologists’ compensation increased 6.7%. Ophthalmologists noted moderate decreases.
MGMA’s survey also reported that seniority plays a big role in determining compensation. Department chairs and chiefs received the greatest compensation, $292,243 for primary care faculty and $482,293 for specialty care faculty. Primary care professors received $190,815 in compensation and specialty care professors received $268,786.
Lingering uncertainty over the sweeping healthcare reforms, federal and state budget cuts for social services, and trimming tax breaks for charitable giving as part of a deficit reduction strategy could severely impact nonprofit healthcare providers, a new survey from the Association for Healthcare Philanthropy shows.
"Combined with growing state and federal cuts in funding for social services and uncertainty over implementation of the Patient Protection Act, these draconian tax proposals—if enacted—add up to a triple threat to America's not-for-profit healthcare providers," said AHP President/CEO William C. McGinly. "This is not the path to take as we recover from the recession."
President Obama's proposed 2012 budget caps charitable deductions at 28%, while a Bowles-Simpson Deficit Reduction Commission proposal would reduce the tax incentive for charitable giving to a 12% tax credit for donations that exceed 2% of a taxpayer's adjusted gross income.
Nine out of 10 AHP respondents surveyed in February said the Bowles-Simpson proposal would cause significant reductions in overall giving to their organization, with 64% saying the adverse impact on major gift-giving would be considerable. About 40% said giving would fall between 10% and 30% if significant changes are made to the current tax incentives for charitable donations—which conservatively could amount to more than a $1.07 billion drop in total annual giving to nonprofit hospitals, AHP said, based on its own FY2009 statistics.
AHP Chair Mary Anne Chern said any reductions in the tax incentives for charitable giving could be "devastating for healthcare in the U.S."
"More than 60% of fundraisers believe that tax code changes will reduce donations, and most predict that reduced funding will impede buying much-needed hospital equipment and paying for hospital improvements and expansions, during a time when our communities' healthcare needs are increasing and the demands on nonprofit hospitals continue to grow," said Chern, who is also president of White Memorial Medical Center Charitable Foundation in Los Angeles. "These concerns are being expressed by fundraisers who work on behalf of a wide range of healthcare institutions, including local community hospitals, medical centers, medical schools, children's hospitals, nursing homes and assisted living facilities."
Survey respondents talked about the domino effect on charitable fundraising that could come with tax code changes, the lingering impacts of the recession, and concerns over the implementation of the Affordable Care Act. One respondent wrote: "We have already experienced decreased giving from the effects of the economy and uncertainty over health care reform. This (tax code changes) would be another disincentive for people to give."
McGinly said most donors don't give because of a tax break, but that adverse tax consequences affect the amount of the gift. "This is especially true of major gifts and planned giving, where donors consider the impact on their tax liability," he said. "These tax code changes would compound the current fiscal problems that most nonprofit hospitals face, particularly for healthcare providers serving in-need communities, where in some cases nearly 50% of the patients rely on charity care or some form of assistance beyond what federal and state programs provide."
AHP is a not-for-profit organization whose more than 4,700 members direct philanthropic programs in 2,000 of North America's not-for-profit healthcare providers. The survey may be downloaded here.
The HR/PR fiasco at the University of Iowa Hospitals and Clinics provides a good example of what can happen when a dumb idea goes viral.
If you haven’t heard the story, Google “baby monitor” and “University of Iowa Hospitals and Clinics” and “employees” and “spying.” Condensed version: An office supervisor at a UI urology clinic apparently planted a baby monitor behind a bag of cotton balls on a shelf near the desks of some office workers to listen in on their conversations.
Tysen Kendig, UI’s vice president for Strategic Communications, said the health system had: “completed its internal investigation into the monitoring of staff interactions at UIHC.
Appropriate disciplinary action has been taken against two UIHC staff members involved in the incident. Details of that disciplinary action are considered confidential personnel information. The investigation also determined that no violations of HIPAA laws, which govern privacy of patient records, occurred as a result of this incident.”
The Associated Press reported that the office supervisor in the Urology Department, who’d been with UI for 19 years -- “abruptly left employment Thursday.”
Will the dismissal mark the end of the great baby monitor caper? It’s hard to say. John Stellmach, a mailman for the health system and AFSCME Local 12 president, told HealthLeaders Media that the incident has rattled employees. The alleged bugging – which is a misdemeanor crime in Iowa – was an isolated incident by a direct supervisor who used poor judgment, Stellmach says, but he’s more troubled by the initial response from hospital leaders, who he said tried to “sweep it under the rug” before the news media found out.
“It reflects lack of transparency that’s prevalent in the culture here that currently exists. It probably would have been a lot easier to stomach if they had just come out and said ‘we screwed up,’” Stellmach says. “Being a mailman, I’ve had tons of doctors and nurses and research staff and all of us regular employees say ‘wink, wink, nod, nod. We know what happened and what they are doing.’”
Stellmach says he was told that the supervisor had planted the monitor after another employee had complained that her colleagues were “talking too much.” The union rep says he was told the office manager was concerned that the workers were talking about patients, and that their comments could have run afoul of HIPAA. It turns out that was not the case, he says.
The baby monitor fiasco marks the second time in 10 months that UI’s HR department has been involved in a public relations debacle, which is particularly unusual in the staid and conservative world of healthcare HR.
In May 2010, Chad D. Simmons abruptly quit as the top HR officer at the health system after just 16 months on the job. The Associated Press reported that Simmons -- a former Kraft Foods executive -- was recruited in January 2009 after a national search, despite his lack of experience in healthcare or academia HR administration. No explanation for Simmons departure was given, but he took with him a $450,000 severance package – this after the university paid consulting firm Witt/Kieffer more than $109,000 to recruit him, AP said.
UI apparently learned from that debacle, and formed a 16-member search committee of executives, physicians, union representatives, and staff to find a replacement, Jana R. Wessels, who took over as associate vice president for UI Health Care Human Resources on March 1. In fairness to Wessels, she can’t be blamed for either the Simmons hiring or the baby monitoring fiasco. But, she’s in charge now – this happened on her watch -- and she is the one who will have to deal with the fallout.
Ironically, Stellmach was on the search committee. “The charge to the committee was we want to find someone who is going to help change the culture here. And this is the very first action that comes out from the new HR position. It’s disheartening because it looks to us like its business as usual,” he says.
Wessels and Jean Robillard, MD, the vice president for medical affairs, issued an apology – sort of – in an Intranet memo to health system employees that reads:
Local media have reported that a supervisor at UI Hospitals and Clinics placed a baby monitor in a work area. Upon discovery of the monitoring device, it was promptly removed. A thorough investigation is presently underway. As part of this investigation, it has been determined that no conversations were transmitted. In addition, there is no evidence of any HIPAA violation. UI Health Care regrets this extremely unfortunate situation, which is not in keeping with our organization’s values or sound supervisory practice.
It’s a start -- sort of -- but it may be time for UI leadership to do a little soul searching and ask itself tough questions. For starters, they should ask themselves how a manager at the health system could ever conceive that spying on employees was appropriate. It does appear to be an isolated incident of bad judgment, but does it also reflect some deeper issues with trust and engagement at UI?
“We are just regular working folks, but we aren’t dumb and we weren’t born last night,” Stellmach says. “We know what happened and it’s a shame that they didn’t just fess up and say ‘this happened and we are sorry.’”
The baby monitor scandal may not reflect the reality at UI, but it reflects the perception.
The growth in Medicaid enrollment under healthcare reform will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients in much of the country – particularly the South and Mountain West, a national study shows.
The study, released this week by the nonpartisan Center for Studying Health System Change, also found that temporary increases in Medicaid reimbursement to entice primary care physicians to accept Medicaid patients are unlikely to make a difference in the states with the biggest enrollment jumps.
"The study's bottom line is that growth in Medicaid enrollment in much of the country will greatly outpace growth in the number of primary care physicians willing to treat new Medicaid patients resulting from increased reimbursement," said HSC Senior Fellow Peter J. Cunningham, the study's author.
Under federal health reform, Medicaid eligibility will expand to cover as many as 16 million more poor and low-income adults by 2019. Nationally, 42% of primary care physicians in 2008 were accepting all or most new Medicaid patients, compared with 61% of primary care physicians accepting all or most new Medicare patients, and 84% accepting all or most privately insured patients.
The study found that states with the smallest number of primary care physicians per capita overall—generally in the South and Mountain West—potentially will see the largest percentage increases in Medicaid enrollment. In contrast, states with the largest number of primary care physicians per capita—primarily in the Northeast—will see more modest increases in Medicaid enrollment.
The reform law also increases Medicaid reimbursements for some services provided by primary care physicians to 100% of Medicare rates in 2013 and 2014. The increases will have less impact in states with a smaller number of primary care physicians accepting Medicaid patients now because many of these states already reimburse primary care at rates close to or exceeding 100% of Medicare, the study found.
The study also determined that geographic differences in primary care physician acceptance of new Medicaid patients reflect differences in physician supply, not geographic differences in the primary care physicians' willingness to treat Medicaid patients.
Funded by Robert Wood Johnson Foundation, the survey includes responses from more than 4,700 physicians. Physicians who identified their primary specialty as general internal medicine, family practice, or general pediatrics numbered 1,748.
The study classified states into three groups—low-, medium-, and high-primary care physician states—based on the ratio of physicians to the nonelderly U.S. population in 2008, using the Health Resources and Services Administration Area Resource File. Low-, medium-, and high-primary care physician states were determined based on the distribution of the U.S. population into these groups—25% of the U.S. population is in low-primary care physician states, 50% in medium-primary care physician states and 25% in high-primary care physician states.
Primary care physician supply varies considerably by region of the country. States with the highest numbers of primary care physicians—relative to the population—are concentrated almost entirely in the Mid-Atlantic and Northeast, while states with the lowest supply are concentrated largely in the South and Mountain West.
Low- and high-primary care physician states also vary by state Medicaid program characteristics. Medicaid reimbursement rates for primary care—as a percentage of Medicare rates—are much higher on average in low-primary care physician states (81.6%) compared to high-primary care physician states (54.8%) Low-primary care physician states also tend to have more restrictive Medicaid eligibility, as exemplified by the fact that only one—Arizona—currently allows Medicaid eligibility for at least some parents or childless adults with incomes above 100% of poverty, the study noted.
Accounting for differences in physician practice, patient and healthcare market characteristics, the study found that higher Medicaid reimbursement rates are associated with a greater probability of primary care physicians accepting all or most new Medicaid patients, although the effects are relatively modest. For primary care physicians, a 10% increase in the Medicaid/Medicare fee ratio for primary care was associated with only a 2.1% increase in primary care physicians Medicaid patient acceptance. Excluding pediatricians, the effects of reimbursement on Medicaid acceptance is slightly higher.
In other words, if primary care physicians in low-supply states were similar to primary care physicians in high-supply states on all measured factors other than level of reimbursement, Medicaid acceptance would be 5.7% higher in low-primary care physician states compared to high-primary care physician states, the study said.
One limitation of the study is that it treats the temporary Medicaid reimbursement increase as permanent, so estimates of the impact of the increases on primary care physicians' willingness to accept new Medicaid patients are likely overstated.
Based on information from HSC's nationally representative 2008 Health Tracking Physician Survey, the study's findings are detailed in a new HSC Research Brief—State Variation in Primary Care Physician Supply: Implications for Health Reform Medicaid Expansions—available online at www.hschange.org.
The average per capita cost of healthcare services covered by commercial health plans and Medicare programs rose 6.29% over the last 12 months ending in January, the first time the rate has accelerated since May 2010, according to Standard & Poor's Healthcare Economic Indices.
A further S&P breakdown shows that Medicare's growth in per capita cost grew at 3.4% in the 12-month period ending in January, which was less than half the rate of cost growth for commercial plans, which saw an increase of 8.03% for the 12-month period.
Healthcare cost increases continue well above the rate of inflation in the larger economy, which grew 2.1% for the 12-month period ending in February as measured by the Consumer Price Index. Most of that growth was fueled by rising food and energy costs, the Bureau of Labor Statistics reported.
David Blitzer, managing director and chairman of the Index Committee at S&P noted that January marked the first acceleration of the rate of growth in per capita healthcare services since May 2010. "The first month of the New Year shows a departure from this trend, but it's too soon to predict if this is an anomaly or a sign of what 2011 has in store for us," Blitzer said.
Blitzer said the rate of growth in expenditures for commercial health plans continues to outpace that of Medicare – as it has for most of the six year history of the measurement – and the gap has widened by three percentage points in the past year.
In 2010, the average per capita cost of healthcare services covered by commercial health plans and Medicare programs rose 6.06%, matching the lowest growth rates in four years. A further S&P breakdown for 2010 shows that – even with its older, sicker population and higher utilization, Medicare's growth in per capita costs – at 3.27% in 2010 – was less than half the rate of cost growth for commercial plans, which saw an increase of 7.75% for the year.
The S&P indices estimate the per capita change in revenues accrued each month by hospital and professional services facilities for services provided to patients covered under traditional Medicare and commercial health insurance programs. The annual growth rates are determined by calculating a percent change of the 12-month moving averages of the monthly index levels versus the same month of the prior year.
The Standard & Poor's Healthcare Economic Indices for January may be viewed here.
Investments in Medicare fraud detection and enforcement are paying for themselves many times over with record-high recoveries of ill-gotten tax dollars, the Obama administration says.
Federal officials say that fraud prosecutions in fiscal year 2010 resulted in more than $4 billion returned to the Medicare Health Insurance Trust Fund, an increase of $1.4 billion – or 56% -- over FY2009. The $4 billion recovered in FY 2010 includes a record $2.5 billion in settlements and judgments obtained by the Department of Justice for False Claims Act violations connected to healthcare fraud -- a 53% increase over $1.63 billion collected in FY 2009, DOJ and the Department of Health and Human Services said in a joint announcement.
Speaking at healthcare fraud prevention summit in Detroit on Tuesday, HHS Secretary Kathleen Sebelius said the administration is making progress in its crackdown on healthcare fraud and waste. "Thanks to provisions in the Affordable Care Act, the prospects for a criminal thinking about targeting our healthcare system have gotten a lot gloomier," Sebelius said in a joint statement with U.S. Attorney Eric Holder. "Here in Detroit, we are honoring our commitment to America's seniors, meeting our obligation to taxpayers, and standing up to criminals who, in the past, have gotten away with far too much."
Detroit has been targeted by the federal government as a hotspot for Medicare fraud. Holder said the joint efforts of DOJ/HHS in the Motor City have been noteworthy. Since May 2009, charges have been brought against 120 people in 18 separate criminal cases for fraud schemes totaling $120 million.
So far, eight people have been convicted at trial and 63 have pleaded guilty.
"Here in Detroit and communities across this region, many of you have witnessed the devastating effects of healthcare fraud," Holder said. "Through a collaborative DOJ-HHS effort, we are working in partnership with government, law enforcement and industry leaders to protect taxpayer dollars, control healthcare costs and ensure the strength and integrity of our most essential healthcare programs. The results are clear: thanks to our efforts, healthcare fraud schemes throughout this region and across the country are being aggressively and permanently shut down."
DOJ/HHS-led Medicare Fraud Strike Force operations have expanded from South Florida and Los Angeles into nine healthcare fraud hot spots including Houston; Detroit; Brooklyn; Baton Rouge, LA; Tampa, FL; Chicago and Dallas. Since their inception in 2007, Strike Force operations have charged more than 1,000 defendants for Medicare fraud involving more than $2.3 billion in claims, DOJ/HHS said.
The Affordable Care Act earmarks $350 million to combat healthcare fraud over the next 10 years through the Health Care Fraud and Abuse Control Account. The law toughens sentencing, enhances screenings and enrollment requirements, encourages increased data sharing across government, expands overpayment recovery efforts, and provides greater oversight of private insurance abuses, DOJ/HHS said.
