Issue link: https://beckershealthcare.uberflip.com/i/1365724
76 HEALTHCARE NEWS Michigan healthcare CEO gets 15 years in prison for $150M fraud By Ayla Ellison T he CEO of a group of Texas-based hospice and home health companies was sentenced Feb. 3 to 15 years in prison for his role in a $150 million healthcare fraud and money laundering scheme, according to the Department of Justice. Henry McInnis was sentenced more than a year after he was con- victed of conspiracy to commit healthcare fraud, conspiracy to commit money laundering, obstruction of justice and healthcare fraud. From 2009 to 2018, Mr. McInnis and others submitted more than $150 million in false and fraudulent claims for healthcare services. The claims were submitted through Merida Group, a hospice company with dozens of locations in Texas. Mr. McInnis was CEO of Merida. He had no medical training but acted as the director of nursing for the company. He also en- forced a companywide practice of falsifying medical records to conceal the scheme and ordered employees to change medical records to make it appear patients were terminally ill. Mr. McInnis also paid bribes to physicians to certify unqualified patients for home health and hospice. Mr. McInnis was sentenced less than two months after the owner of Merida Group, Rodney Mesquias, was sentenced to 20 years in prison and ordered to pay $120 million in restitution. n New York hospital takes $34M hit from nearly 2,700 canceled surgeries By Ayla Ellison E rie County Medical Center in Buffalo, N.Y., is working to recover revenue lost due to can- celed surgeries and lower patient volumes tied to the COVID-19 pandemic. The 573-bed hospital reported a 6 percent year- over-year decline in emergency department visits in 2020, leading to a revenue drop of $1.5 million, according to Buffalo Business First. Canceled elective surgeries took a bigger financial toll on the hospital. The suspension of elective pro- cedures last year led to nearly 2,700 canceled sur- geries and $34 million in lost revenue, according to the report. "It is a financial hit for us to have less visits, but the more severe financial hit was lack of surgeries, that is the heart financially of the organization," Erie County Medical Center President CEO Thomas Quatroche Jr., PhD, told Buffalo Business First. n Surgeon's libel claim poses threat to public welfare, Iowa hospital says By Ayla Ellison T he Iowa Supreme Court is slated to decide whether hospitals can be sued for libel aer reporting suspected phy- sician misconduct to state licensing boards, according to the Iowa Capital Dispatch. Mark Andrew, MD, sued Van Diest Medical Center in Webster City, Iowa, for breach of contract, defamation and libel aer he was fired, and a district court ruled in late 2019 that he could have his lawsuit heard by a jury. e hospital appealed to the state supreme court, arguing physicians, hospitals and oth- ers are immune from lawsuits that arise from confidential complaints to the Iowa Board of Medicine, according to the report. If the Iowa Supreme Court allows Dr. An- drew's case to be heard by a jury, it will have a "chilling effect" on the complaint process and public welfare will be put at risk, the hospital argues, according to the Iowa Capital Dis- patch. e dispute between Dr. Andrew and Van Diest Medical Center dates back to 2016, when the hospital investigated the physi- cian's prescribing practices aer a pharma- cist expressed concerns about the amount of hydrocodone Dr. Andrew was prescribing. e hospital's then-administrator fired Dr. Andrew within a week of completing the in- vestigation. Dr. Andrew was informed in writing that he was being fired "due to significant concerns about prescribing practices and patient care issues," according to the report. In his lawsuit, Dr. Andrew alleges that the hospital made false and malicious claims about him in a complaint filed with state li- censing officials. e state high court is being asked to decide whether the hospital is im- mune from lawsuit. Under Iowa law, a person isn't civilly liable as a result of filing a complaint with a licensing board. However, the immunity doesn't apply if the complaint is made with malice, accord- ing to the report. e Iowa Board of Medicine closed Dr. An- drew's file in April 2018 aer concluding the hospital's complaint didn't warrant disci- plinary action. e Iowa Supreme Court hasn't scheduled oral arguments in the case. n