A Pharmacist Owns a Hospital?!?

We have all read about hospitals with billing errors and/or improper coding. It happens all the time. Sometimes it is due to negligence, sometimes it’s just clerical mistakes. But an Illinois for-profit hospital has been accused of intentionally performing unnecessary and invasive surgeries in order to create and justify fraudulent billings, e.g. a $160,000 tracheotomy.

This small hospital is located in a very poor neighborhood and almost all of its patients are Medicare/Medicaid recipients. Nevertheless, according to a report from Charles Babcock for Bloomberg News, this hospital’s profits jumped from just $1.3 million to $9.4 million in one year. Hmm?

The owner of this hospital is a pharmacist who, according to Bloomberg News, also owns a home health agency, a kidney dialysis center, an adult daycare center and WAIT FOR IT… a malpractice insurance company. At the racetrack we call this hedging your bets.

We’re all for free enterprise, but sometimes in healthcare, this can run amok. People who know how to work the system can sometimes profit at the expense of others. One of our jobs in Utilization Management is to make sure that patients get only what they need and don’t become cash cows for those who would exploit them.

Call Us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz