Becker's Hospital Review

10 CFO / FINANCE Tenet must pay whistleblowing cardiologists $10M, return staff privileges, court rules By Ayla Ellison D allas-based Tenet Healthcare must pay two cardiologists who filed a False Claims Act lawsuit $10 million and reinstate their medical staff privileges for one year, a Michigan federal court ruled Feb. 1, ac- cording to Bloomberg Law. In December, Amir Kaki, MD, and Mahir El- der, MD, who were fired from their leadership positions at Tenet's Detroit Medical Center in October 2018, were awarded $10.6 million. e arbitration award also included reinstatement of their medical staff privileges. e physicians, who originally filed suit in 2019 alleging violations of the False Claims Act, claimed they were ousted from their leader- ship positions for reporting problems affecting patient care. e court ordered the parties to arbitrate the federal claims, and the arbitrator found that Tenet acted with malice when the physicians were fired from their leadership positions and later had their staff privileges re- voked, according to the Detroit Free Press. Tenet, Detroit Medical Center and the other named defendants tried to get the arbitrator's award vacated in federal court. e defendants brought three main challenges to the award, and the court stated that only one — whether the arbitrator exceeded her powers — was a legitimate potential ground for vacat- ing the award. Arthur Tarnow, a district judge for the Eastern District of Michigan, ultimately concluded that the defendants' arguments were without merit. e defendants are appealing the court's or- der to the U.S. Court of Appeals for the Sixth Circuit. n Heights Hospital in Houston closes over unpaid rent By Ayla Ellison P hysicians and patients were locked out of Heights Hospital in Houston Jan. 18 after its management failed to pay rent, according to a notice posted on the door of the building. "Please be advised that the door locks to the leased premises have been changed and tenant shall be excluded therefrom due to non-payment of rent," the note read, according to TV station KHOU. In 2017, AMD Global, a Houston-based real estate developer, purchased Heights Hospital and created two companies to manage the medical cen- ter: 1917 Ashland Venture and 1917 Heights Hospital, according to the Houston Chronicle. The letter informing physicians and patients of the lock- out was addressed to both entities. New keys will be given when past-due rent and fees are paid, the notice said, according to ABC 13. Physicians weren't notified of the lockout in advance and tried to treat pa- tients in the parking lot Jan. 18. "I tried to contact the owners," Felicity Mack, MD, a physician at the hospital, told ABC 13. "They aren't responding. The title company is not responding. We are really not getting any answers, but at the end of the day, my primary concern, like I said, is my patients." Heights Hospital was once an acute care hospital but now largely provides outpatient and specialty care, according to the Houston Chronicle. n Inspector general urges CMS to take action against 100 'error-prone' providers By Ayla Ellison C MS should take action against 100 healthcare providers who had high rates of improper Medicare payments, the HHS Office of Inspector General said in a report released Jan. 19. Using comprehensive error rate testing program data, the inspector gener- al identified 100 "error-prone" providers from 2014 through 2017. Of $5.8 million reviewed, $3.5 million was incorrect, an improper payment rate of 60.7 percent. From 2014 through 2017, Medicare made $19.1 billion in payments to the 100 "error-prone" providers, according to the OIG. Based on its findings, the inspector general recommended that CMS review the list of 100 providers and "take specific action" such as prior authoriza- tion, prepayment and postpayment reviews. The report also recommend- ed that CMS use annual comprehensive error rate testing data to identify providers that have an increased risk of receiving improper payments and apply more program integrity tools to them. In written comments on the draft report, CMS disagreed with the inspector general's recommendations. CMS also disagreed with the inspector gen- eral's methodology for identifying error-prone providers. CMS said it has tried to use comprehensive error rate testing data to identify error-prone providers but found that the data was ineffective for this purpose. After reviewing CMS' comments, the inspector general maintained its find- ings and recommendations. n

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