Vath has served as interim-president and CEO at the six-hospital health system since March, when then-CEO Mike McBride was fired after a little more than one year on the job.
"Character in the face of adversity is often a true test of leadership," Sister Barbara Arceneaux, Regional Minister, Franciscan Missionaries of Our Lady, said in a media release.
"I will always be grateful for Dr. Vath's willingness to quickly step into an interim role as our health system leader earlier this spring. He is an advocate for Catholic healthcare and the unique opportunities we have to be the face of Christ to each person, especially those most in need," Arceneaux said.
The Franciscans health system fired McBride – without a vote of the board – in March, after 13 months on the job.
"Mr. McBride’s approach to his role as the leader of our system was not in keeping with our values and culture," Arceneaux told The Advocate at that time.
"The Sisters have the authority to take this action and, while unusual, we did so only after much prayer and discernment and continued communication with Mr. McBride about collaboration and the inclusion of others as demonstrating respect and shared responsibility," she said.
A day after McBride was fired Franciscan Health System Board Chairman James Moore Jr. resigned.
The leadership shuffle comes as Franciscan is finalizing a transfer of sponsorship of St. Dominic Health Services from Dominican Sisters. Upon completion of the transfer this summer, St. Dominic's will become part of the Franciscan Missionaries or Our Lady Health System.
Vath joined Franciscan in 2006 after two decades of private practice in pulmonology. He has served as chief medical officer at Our Lady of the Lake Regional Medical Center in Baton Rouge before joining the health system as its chief transformation officer.
Big Blue and subsidiary Cúram Software allegedly made promises about their IT platform capabilities that they couldn't back up.
IBM Corp. and subsidiary Cúram Software Ltd. will pay $14.8 million to settle allegations that the vendors made "misleading statements" about the abilities of an IT platform they sold the Maryland Health Benefit Exchange, the Department of Justice said.
IBM bought Cúram Software on Dec. 19, 2011. On that same day, Cúram submitted its Cúram for Health Care Reform software proposal to Maryland to support its HIX.
On Jan. 5, 2012, with IBM’s knowledge, Cúram pitched its product to Maryland officials, promising that its platform could provide a plethora of services, including interoperability with other software, eligibility determinations for health assistance coverage, calculating applicable tax credits, and changes in life events.
Maryland awarded the contract to Cúram a month later, paying for the services with grants from the Department of Health and Human Services, DOJ said.
Allegedly, the software did not work as advertised.
From 2011 through mid-2014, DOJ said the vendors misrepresented the ability of the snafu-plagued software to meet the state's technical and interoperability requirements.
"After repeated problems following the launch of the HIX website in October 2013, Maryland, acting through MHBE, terminated the contract and replaced the HIX website and IT platform, including the Cúram software," DOJ said.
"Making misleading statements to win contract awards violates fundamental tenets of government contracting and harms the government and taxpayers," Assistant Attorney General Jody Hunt for DOJ's Civil Division, said in a media release.
The settlement is the latest setback for IBM's venture into the healthcare space. The company's Watson Health has been plagued by problems and overpromises that have come back to haunt the subsidiary since its inception.
When IBM bought Curam in 2011, the computer giant said the acquisition "expands IBM's ability to help cities and governments serve citizens better by adopting more intelligent and efficient ways to assess needs, execute social programs, and maximize program results."
The Urban Institute estimates the savings that come with a public option health plan, capping provider payment rates, and financial aid for the middle-class.
The federal government could save $12 billion and add 1.2 million people to the health insurance rolls if it adopted initiatives that include a public health plan option, according to a new analysis from the Urban Institute.
The public option, along with capping provider payment rates, and offering targeted financial assistance to middle class families, would lower premiums and out-of-pocket costs by $9.2 billion.
The initiatives would also cut the cost of individual insurance premiums by $200 a month—2% of the current cost—for people earning more than $49,960 a year (400% of the federal poverty level), according to the study, which was commissioned by the Robert Wood Johnson Foundation.
"Creating a public option or capped provider payment rates along with extending financial assistance to middle-class Americans would make a significant difference in improving healthcare affordability for millions of consumers," Linda Blumberg, Institute Fellow at the Urban Institute, said in a media release.
Medicare for All and public-option health plans are getting a lot of media play as the Democratic candidates for president jockey for position, but it's almost certain that no action would be taken on either sweeping reform before then 2020 election. And even then, Democrats would likely have to control the House, the Senate, and the White House.
Former Vice President Joe Biden, currently leading Democratic presidential candidates in the polls, has rejected single-payer but he supports a public-option plan as a workable alternative. Other candidates, including Sen. Bernie Sanders, I-Vermont, are calling for Medicare for All, although the Democratic Socialist has yet to say how much it will cost, or how he'd pay for it.
Democratic-controlled states have attempted to implement public option plans, but have been hobbled by costs and political pressure. The Connecticut House earlier this month overwhelmingly passed a public-option bill, but a watered-down version stalled in the Senate. Proponents of the legislation said it was kneecapped by powerful insurance companies that threatened to leave the state if the bill was passed.
The Urban Institute's Blumberg said a public plan could reduce premiums in the non-group insurance market by setting payment rates for healthcare providers at Medicare levels.
Or, private insurers selling individual coverage in Affordable Care Act marketplaces could see their payment rates capped at the same levels.
Either approach would best help rural areas with scant competition among health, and low-earning, older adults who are now ineligible for premium assistance. However, the reforms would also require larger prescription drug rebates in the non-group market, the study said.
"These two reforms alone wouldn’t address every gap in America’s health care system," Blumberg said, "but would provide significant savings for people in areas where premiums tend to be higher and for some people ineligible for ACA tax credits today. Importantly, the two reforms combined would not require new sources of federal revenue."
Feds say the new rule will benefit 800,000 employers, and more than 11 million employees and their families, including 800,000 previously uninsured people.
The Trump Administration on Thursday released a final rule that expands access to tax-free health reimbursement arrangements (HRAs) for employer-sponsored health insurance.
The new rule – released jointly by the Treasury Department, Department of Labor and the Department of Health and Human Services – lets employers offer HRAs that workers can use to pay premiums for Medicare Parts A, B, C, D or Medigap policies, or to buy coverage in individual markets.
The rule, which takes effect in January 2020, also creates a "limited excepted benefit" HRA for alternative health plans outside of an employer-sponsored plan, and eliminates an Obama-era Treasure rule that blocked HRAs that were not part of a comprehensive employer-sponsored plan.
The Trump Administration estimates that the new rule will benefit about 800,000 employers, and more than 11 million employees and their families, including 800,000 previously uninsured people.
"The HRA final rule offers millions of American workers more health coverage choices and portability," Labor Secretary Alex Acosta said in a media release. "HRAs create a great opportunity for job creators to support their employees and for those employees to be empowered to make the best healthcare decisions for their families."
Critics contend that the proposalcould allow employers to push higher-risk employees away from company-sponsored coverage and into individual coverage offered through the Affordable Care Act's Marketplaces.
The Trump Administration says there are conditions built into the proposal to "mitigate the risk that health-based discrimination that could increase adverse selection in the individual market." Those conditions include a disclosure provision to ensure employees understand the benefit.
Chad Brooker, associate principal at Avalere Health consultants, says the final rule "underscores the administration's focus on granting employers and individuals enhanced flexibility, including tax-advantaged account-based benefits."
"Long term, this added flexibility may reshape a significant number of employer coverage offerings and result in sizable shifts from employer to individual coverage," he says.
Other observers are less enthusiastic.
Kim Buckey, vice president of client services at DirectPath, says she doesn't believe the HRAs will "see much interest from large employers, as the plans they already offer provide them with a competitive advantage."
"Small to midsize employers seeking to provide some level of support for their employees and to avoid the employer mandate penalty may well be interested if they are not put off by the compliance and administrative aspects of setting up an HRA," Buckey says in an email exchange with HealthLeaders.
Furthermore, the response to the HRAs could be tepid from healthcare consumers, Buckey says, who are already "baffled by health insurance" and rely on their employers to narrow their choices.
"Employers who back out of this 'contract' may face some substantial employee relations issues as well as attraction/retention challenges," Buckey says. "If employers are considering the DC approach to health care, they’d better be willing to commit to a lengthy and robust communications campaign to ensure that their employees understand what it is they are buying, and how to shop effectively (not just on premium cost)."
DOJ said the developers of the 106-bed Lakeway (Texas) Regional Medical Center 'participated in a scheme to improperly obtain the FHA-insured loan.'
Four development companies and their executives will pay the federal government $1.1 million to settle allegations that they improperly obtained and distributed money from a Federal Housing Administration loan for a Texas hospital project, the Department of Justice said.
DOJ said the developers of the 106-bed Lakeway (Texas) Regional Medical Center "participated in a scheme to improperly obtain the FHA-insured loan by delaying refunds to investors who had cancelled their investments to make it appear as if the project satisfied mortgage covenants regarding the cash on hand required to close the loan."
The developers named in the settlement are San Diego-based Pacific Medical Buildings LLC, PMB Lakeway LLC, RD Development Partners LLC, Lakeway Management LLC, J&L Rush Family Partnership LP, Jeff Rush, and Brad Daniel.
The settlement also resolves allegations that the developers took "impermissible distributions of project funds," DOJ said.
The FHA backs loans to build hospitals in underserved areas.
"It is deeply disconcerting when industry professionals, who have fiduciary responsibilities and are expected to act as honest brokers, exploit federal programs created to aid legitimate medical facilities," said Robert Kwalwasser, with the Housing and Urban Development Office of Inspector General.
PMB issued a statement saying it is "extremely proud of the work it was contracted to complete on the Lakeway Regional Medical Center."
"With respect to the settlement, it was the most cost‐effective way to resolve allegations which PMB, Jeff Rush and Brad Daniel deny," the statement read. "Indeed, the settlement signifies no finding of wrongdoing on the part of the parties, and specifically no finding that their behavior in anyway undermined federal insurance programs."
Lakeway Regional Medical Center suffered financial difficulties soon after it opened in 2012, and defaulted on a $164 million HUD loan in August 2013, In September 2016, HUD sold the defaulted for $50 million according to The Austin American Statesman.
The health system issued a statement noting that "these allegations have nothing to do with Baylor Scott & White Health or the hospital it operates as Baylor Scott & White Medical Center – Lakeway. These allegations relate to matters that occurred long before we acquired the operations of this hospital."
A cardiologist with a history of False Claims Act settlements says the federal government is abusing the whistleblower process.
Wichita, Kansas cardiologist Joseph P. Galichia, MD, has a beef with the Department of Justice.
Galichia – who last week paid $5.8 million after negotiating his third False Claims Act settlement in 20 years – says the federal government is abusing the whistleblower process, and using it to take back money that was rightfully earned by physicians and hospitals.
"Unfortunately, the federal government has chosen to solve its financial problems with Medicare by pursuing physicians, hospitals, and other healthcare providers to seek reimbursement of money paid for legitimate patient care," Galichia says in a media release this week.
He's asking Congress to investigate "the DOJ's flawed probe, according to board certified experts based on a whistleblower's civil action, and the effect that questionable legal precedents are having on cardiologists nationwide."
"This national trend of accusing providers seriously interferes with the patient-physician relationship and leaves many patients without the care they need because physicians and other providers are intimidated by the risk of a fraud allegation by the federal government," he says.
DOJ said in a media release last week that Galichia improperly billing federal healthcare programs for medically unnecessary balloon angioplasties from 2008 through 2014.
The settlement stems from a whistleblower lawsuit filed by Aly Gadalla, MD, that the federal government joined in 2014. Gadalla will get $1.16 million from the settlement, DOJ said.
"Performing medically unnecessary procedures puts patients at risk and defrauds federal health care programs," said Stephen McAllister, U.S. Attorney for the District of Kansas.
Despite the settlement, Galichia "firmly denies" the allegations, and referred to Gadalla as "a disgruntled former employee who started the entire action and is not even a cardiologist."
Galichia claims he settled "only because, after seven years of cooperating with the investigation, the action was taking up far too much time and energy."
"Further, it simply became too costly to keep defending against these false accusations," he said. "The federal government decides, after the fact, what care the patient should have received, second-guessing the physician and the patient regardless of the health or satisfaction of the patient."
Galichia says his patients weren't in danger because they got the correct care, a claim that he says is supported by "expert interventional cardiologists" who reviewed the government's 100 cases against him and "unanimously agreed that our treatment was appropriate."
The former two-term president of the International Society of Cardiovascular Interventionists settled claims alleging improper documentation in 2000, and again in 2009, agreeing to pay the federal government $1.5 million and $1.3 million, respectively, to resolve the allegations.
Galichia's attorney, Gary Ayers, said "disgruntled whistleblowers and their lawyers" are incentivized to make "false allegations" with the hope of cashing in on a big settlement.
"The government pays a physician 'expert' to second-guess another physician's medical judgment, then alleges this supposed disagreement over treatment is fraud," Ayers said. "In Dr. Galichia's case, the government's 'expert opinion' was absolutely wrong according to four independent, board-certified interventional cardiologists who reviewed the same cases."
Ayers said that "hundreds if not thousands of providers across the country have experienced this same phenomenon."
"Congress needs to reign in the federal government's overreaching and abusive behavior, because it puts patients at risk of not receiving the medical care they need and deserve," Ayers said.
A new study challenges the rationale used to reject the use of vital organs harvested from deceased opioid users.
One morbid benefit of the long and deadly opioid epidemic that claims tens of thousands of lives every year in the United States is an increase in available human organs for transplant.
Now, a new study in The Annals of Thoracic Surgery shows that the hearts removed from overdose death donors (ODD), who often tend to be younger and healthier, provide "favorable heart donor quality" and as-good-or-better outcomes than organs harvested from donors who died from other causes.
"One of the roles of the transplant community is to at least partially mitigate the tragedy of this exponentially growing problem by maximizing the utilization of organs from ODD," said study lead author Nader Moazami, MD, of NYU Langone Health in New York, in accompanying remarks.
Using data from the Scientific Registry of Transplant Recipients for the years 2000 to 2017, Moazami's researchers looked at trends in organ donation and transplants among drug overdose deaths.
Of the nearly 16,000 heart transplants from adult donors during this period, opioid overdoses (10.8%) were the fourth most common cause of death, behind blunt injury (30.5%), hemorrhage/stroke (22.1%), and gunshot wound (18.3%).
The statistics from the opioid epidemic are staggering. More than 700,000 people died from drug overdoses between 1999 and 2017, including about 400,000 people who overdosed on an opioid. More than two-thirds (68%) of the nation's 70,200 drug overdose deaths in 2017 involved an opioid. On average, 130 people die every day in the United States from an opioid overdose, according to statistics cited by the Centers for Disease Control & Prevention.
In 2017, according to Moazami's research, overdoses accounted for more than 20% of donor deaths in 11 states. In 2000, the highest state's rate was 5.6% and 33 states had less than 1% of donor deaths attributed to overdoses.
A record 36,500 organ transplants were performed in 2018, and 3,400 of those were heart transplants. Even with the influx of new donors, however, the demand for vital organs far outstrips the supply. On average, 18 people died every day waiting for an organ transplant in 2017, according to the United Network for Organ Sharing.
The researchers also saw a hike in the percentage of transplants that utilized ODD hearts: 1.1% in 2000; 6% in 2012; and 14.2% in 2017. The current rate of ODD utilized for heart transplantation is 16.9%, a 14-fold increase from 2000.
"The dramatic increase in the rate of ODD utilization was striking, and it has increased concordantly with the rate of overdose deaths," Moazami said. "The significant impact of the opioid epidemic on transplantation is one of the major reasons that organ transplant numbers have increased over the last several years."
Donors who died from opioid overdoses were often younger than age 40 and had higher rates of substance abuse. They also had lower rates of diabetes and hypertension. Because of that, Moazami said that ODD organs had "favorable heart donor quality" and as-good or better outcomes than non-overdose organs.
"We do not believe that overdose status alone is a valid reason to discard an otherwise viable donor heart, and this study supports that ODD organs should not be rejected due to inappropriate bias," he said.
"With no significant difference in survival between ODD and non-ODD recipients, further expansion of this donor pool may be appropriate, with more hearts potentially used for transplantation," he said.
The opioid epidemic has also increased the numbers of other vital organs available for donation, Moazami said. ODD provided 7% of the transplanted lungs from 2010-2017, up from 2% in 2000-2007. And as with the findings on the heart donors, the research suggests that ODD lungs are not an extra safety concern for recipients.
The recent surge in hepatitis C contamination and its correlation with drug use has raised concerns about the safety of using organs from overdose death donors. Moazami said that medical advances and sophisticated testing have minimized the risks of transplanting an infected organ.
Robert S.D. Higgins, MD, surgeon-in-chief of The Johns Hopkins Hospital in Baltimore, who was not involved in the study, said Moazami's findings "highlights the need for additional research in this area to further define the 'risk' as well as the reward of expanding the donor pool to save more lives."
The flagship J.C. Blair Memorial Hospital becomes the fifth hospital in the Penn Highlands system and has been renamed as Penn Highlands Huntingdon.
Nine months after entering acquisition talks, Huntingdon, Pennsylvania-based J.C. Blair Health System has cleared regulatory review and this week has joined Penn Highlands Healthcare, the health system announced.
The flagship J.C. Blair Memorial Hospital, a 71-bed, non-profit community hospital located about 120 miles east of Pittsburgh, becomes the fifth hospital in the DuBois, Pennsylvania-based Penn Highlands system and has been renamed as Penn Highlands Huntingdon.
"This affiliation represents an exciting new chapter in our growth," Penn Highlands Healthcare CEO Steven M. Fontaine said in a media release.
"Just like our other hospitals, J.C. Blair is deeply rooted in its community and is known for providing high-quality care to patients close to home," Fontaine said. "Now, through our partnership, we will not only continue to provide the services residents of Huntingdon County and surrounding communities have come to depend on, but we also will bring access to the advanced care and treatments available through Penn Highlands Healthcare."
The boards of directors of both Penn Highlands Healthcare and J.C. Blair signed a letter of intent in October.
"This affiliation will provide a great opportunity for J.C. Blair to build upon its strength as a leader in healthcare services while also maintaining our role as a major employer in the county," J.C. Blair President and CEO Joe Myers said. "An affiliation with Penn Highlands will create a sustainable model for our local hospital as well as bring additional resources and expertise to Huntingdon County."
Penn Highlands Board Chairman Dick Pfingstler said the acquisition of J.C. Blair will expand Penn Highlands's footprint strengthen its ability to recruit providers and grow its specialty services.
"Creating even more healthcare access and delivery throughout our region aligns perfectly with our longstanding mission to serve our communities," Pfingstler said.
J.C. Blair Memorial Hospital has 40 physicians on staff, and more than 400 employees, serving 45,000 residents of Huntingdon County. medical staff of nearly 40 physicians, over 400 employees, and more than 40 active volunteers, J.C. Blair is the only hospital in rural Huntingdon County, serving over 45,000 permanent county residents.
Penn Highlands Healthcare was formed in 2011. Its four other hospitals are Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. The health system has 474 inpatient beds, and employs nearly 3,600 workers in more than 100 venues throughout 12 counties in North Central/Western Pennsylvania.
Nearly 1 in 5 people have experienced an unethical or unprofessional interaction with a physician but only a fraction of them go on to report the event.
Physician misconduct is underreported, perhaps because most people don't know how or where to file a complaint, according to a new survey commissioned by the Federation of State Medical Boards.
The Harris Poll online survey of 2,018 people found that nearly 1 in 5 of respondents (18%) have experienced what they said was an unethical or unprofessional interaction with a physician. However, only one-third of those who had a negative interaction filed a complaint, and only one-third of those filed a complaint with a state medical board, which oversees physician licensure and discipline.
"The results of The Harris Poll survey show that physician misconduct is being underreported, and a majority of Americans do not know where to file a complaint against a physician," FSMB President and CEO Humayun Chaudhry, DO, said in a media release.
"This is an opportunity to further educate consumers about the valuable role state medical boards play in these cases and ensure that if and when a patient is mistreated or harmed by a physician, they know to report that incident to their medical board," Chaudhry said.
Among the findings:
Eighteen percent of respondents said they had been treated by a physician who they believe was acting unethically, unprofessionally, or providing substandard care.
Women are twice as likely as men to have experienced physician misconduct (24% vs. 12%).
Of those who have experienced physician misconduct, only one third (33%) filed a complaint.
Men (41%) are more likely to report misconduct than women (30%),
Only one third (34%) of those who filed a complaint notified the state medical board.
Only 27% of respondents said they know how to find out if a physician has received a disciplinary action.
More than half of the respondents (51&) don't know that state medical boards are responsible for the licensing and regulating of physicians.
FSMB has mounted a public awareness campaign that relies on the search tool DocInfo.org, which explains how and where to file complaints, along with background history, including disciplinary action, on every licensed physician in the United States.
"The FSMB believes it is essential to create a safe environment for reporting, so patients feel comfortable coming forward to boards, while also empowering every member of a health care team to exercise their duty to report misconduct as well," Chaudhry said.
Coffey Health System denies any wrongdoing, but said it settled to avoid additional legal fees and 'the risk of an unfavorable outcome.'
A rural hospital in Kansas will pay $250,000 to settle whistleblower allegations that it falsified the status of its meaningful use program, the Department of Justiceannounced.
Coffey Health System, a 25-bed critical access hospital in Burlington, Kansas, allegedly submitted false claims to Medicare and Medicaid under the Electronic Health Records Incentive Program for some of the $2.2 million it collected in 2012 and 2013.
Specifically, DOJ said, Coffey Health falsely claimed that it had met program reporting requirements for ensuring EHR security.
The settlement resolves allegations in a 2016 whistleblower lawsuit filed by two former hospital employees, who will receive $50,000.
Coffey Health issued a statement denying any wrongdoing and maintains that it "properly implemented its electronic health record system, and correctly documented it."
"Nevertheless, the hospital decided to settle the lawsuit rather than continue the litigation with the government because of the additional attorney’s fees and the risk of an unfavorable outcome, which is always possible in litigation," the statement read. "Also, the hospital was concerned that the litigation with the government would distract its staff from their primary mission, which is outstanding patient care."
