Thursday, May 24, 2018
Health

Whistle-blower lawsuit alleges All Children's overpaid doctors in violation of federal law

ST. PETERSBURG — A former employee of All Children's Hospital has filed a whistle-blower lawsuit in federal court accusing the hospital of overpaying its physicians in violation of anti-kickback laws.

Barbara Schubert, a 60-year old Bradenton resident, worked at the hospital for more than a decade as director of operations for its doctors' practice. She contends that All Children's was so eager to hire doctors — ensuring a steady stream of patient referrals — that it paid them salaries far higher than was merited for their specialities.

For example, her suit alleges that All Children's hired a pediatric surgeon at a base salary of $600,000, when the fair market value for a doctor with his experience was closer to $350,000.

In all, the lawsuit, filed in Tampa in July 2011 and unsealed last month, says that All Children's overpaid its doctors by about $5 million in 2010. In so doing, Schubert claims it ran afoul of federal and state laws designed to prevent doctors from ordering costly, unnecessary procedures because they stand to benefit financially.

Florida Attorney General Pam Bondi's is conducting an investigation involving All Children's, her office said Tuesday, but declined to give specifics or comment on an open case. State and federal officials have not said whether they intend to get involved in the lawsuit, said Christopher Casper, Schubert's Tampa-based attorney. He said she was not available Tuesday to discuss her allegations.

All Children's officials declined to comment.

"We believe (the suit) to be factually inaccurate and flawed from a legal perspective," spokeswoman Ann Miller said. "We intend to defend ourselves vigorously."

• • •

Instead of the longtime model of doctors in private practice having staff privileges at hospitals, the new national trend is for hospitals to hire more of their own doctors as employees. In the past, All Children's officials have described their physician hiring efforts as necessary to better coordinate patient care at a time when the health care system is expanding its focus from caring for the sick to wellness and prevention.

But it can be a slippery slope, experts say, as the financial relationship between hospitals and doctors is closely regulated. Of key importance is the federal Stark law, which prohibits compensation that brings some type of benefit for doctors referring patients using Medicare and Medicaid, the government's health insurance programs for the elderly and the poor.

The vast majority of All Children's patients pay for their care through Medicaid, so taxpayers would potentially foot the bill for any medical services resulting from the overpayment of All Children's doctors, as the lawsuit alleges.

"They want to make sure there's kind of an arms-length relationship between the referring physician and the hospital," said Jeff Milburn, a consultant with the national Medical Group Management Association who specializes in developing and assessing physician compensation plans. But he noted that hospitals can use many payment approaches — and often are justified in making exceptions to their official plans.

• • •

Back in 2007, Schubert was the administrator tasked with navigating these regulations in developing pay scales for physicians as All Children's ramped up its recruiting of private practice doctors to be hospital employees.

After consulting physician salary surveys, she designed a plan setting the base salaries between the 25th and 75th percentile of national norms. Experience was to determine where the physicians placed within that range, approved by the board overseeing the All Children's practice.

But quickly, All Children's began to offer salary packages exceeding Schubert's fair market range, she says in the lawsuit. Within three years, the hospital had hired at least 75 physicians — and nearly one-third of all doctors at the hospital were drawing base salaries higher than the 75th percentile for their field.

"What she saw again and again was the hospital ignoring these regulations," said Casper, with the James, Hoyer law firm. "They were paying whatever it took to get these doctors onboard.

"She felt strongly that it was important to come forward and risk the negative consequences to bring this to light," he added.

She may not have been the only concerned party. The lawsuit says that when Johns Hopkins Medicine merged with All Children's in 2011, it brought in an outside consulting group to review the compensation contracts.

Casper wasn't sure what resulted from the study. Schubert left All Children's in 2011. She initially went on medical leave and then decided not to return, he said. She is now employed in a similar role at a medical facility in Sarasota that he declined to name.

As a whistle-blower, Schubert could receive as much as 30 percent of any money recovered by the lawsuit.

Times researcher Natalie Watson contributed to this report. Letitia Stein can be reached at [email protected] or (727) 893-8330.

Comments
Estimated 7,000 bodies may be buried at former asylum

Estimated 7,000 bodies may be buried at former asylum

STARKVILLE, Miss. — Some of the boxes stacked inside anthropologist Molly Zuckerman’s laboratory contain full bones — a skull, a jaw, or a leg. Others contain only plastic bags of bone fragments that Zuckerman describes as "grit." These humble remain...
Published: 05/23/18
FDA warns teething medicines are unsafe for babies

FDA warns teething medicines are unsafe for babies

WASHINGTON — Federal health officials warned parents Wednesday about the dangers of teething remedies that contain a popular numbing ingredient and asked manufacturers to stop selling their products intended for babies and toddlers. The Food and Drug...
Published: 05/23/18
A chronic lack of sleep could lead to decreased brain function, study finds

A chronic lack of sleep could lead to decreased brain function, study finds

A sleep study revealed that less than six hours of sleep a day can limit the brain’s ability to function properly.The study, published on Monday in the journal Proceedings of the National Academy of Sciences, found that people experiencing less than...
Published: 05/23/18
Many cancer patients juggle care along with financial pain

Many cancer patients juggle care along with financial pain

Josephine Rizo survived chemotherapy, surgery and radiation, but breast cancer treatment wrecked her finances.Money was already tight when doctors told the Phoenix resident she had an aggressive form of the disease. Then she took a pay cut after goin...
Published: 05/22/18

Hernando County officials gather to remedy ‘dearth of services’ for youth with mental illness

BROOKSVILLE — Educators, court officials, law enforcement officers and health care professionals met Friday to identify the best ways to keep local youth with mental illnesses out of the court system and provide treatment for those already in the sys...
Published: 05/22/18
Give your arms a workout, too

Give your arms a workout, too

In addition to appearance, it is very important to maintain strength in those arms, as they are needed for practically every upper body movement we perform. We often take our 23 arm muscles for granted, until we reach a point where it suddenly become...
Published: 05/22/18
Intermittent fasting seems to be a good thing, new report suggests

Intermittent fasting seems to be a good thing, new report suggests

Going long hours without eating isn’t good for us, we are often told. Our bodies need fuel regularly. Otherwise, we may become lethargic, tired and hungry. Our thinking can become mushy, our ability to work, and even play, hampered.Not so fast.A new ...
Published: 05/22/18
U.S. approves first drug developed to prevent chronic migraines

U.S. approves first drug developed to prevent chronic migraines

TRENTON, N.J. — U.S. regulators Thursday approved the first drug designed to prevent chronic migraines. The Food and Drug Administration’s action clears the monthly shot Aimovig (AIM’-oh-vig) for sale. It’s the first in a new class of long-acting dru...
Published: 05/18/18
Know your blood pressure numbers? Today (May 17) is World Hypertension Day

Know your blood pressure numbers? Today (May 17) is World Hypertension Day

Today (May 17) is World Hypertension Day, and the American Medical Association is encouraging people to monitor their blood pressure levels and get high blood pressure, or hypertension, under control. High blood pressure, sometimes referred to as the...
Published: 05/17/18
Study: Depression in men may lower chances for pregnancy

Study: Depression in men may lower chances for pregnancy

Women having trouble getting pregnant sometimes try yoga, meditation or mindfulness, and some research suggests that psychological stress may affect infertility. But what about men: Does their mental state affect a couple’s ability to conceive?The la...
Published: 05/17/18