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Dignity Health merges with Catholic hospital giant

Dignity Health, the company that operates the local Mercy, Methodist and Memorial hospitals, announced Thursday that it will be merging its operations with Colorado’s Catholic Health Initiatives, creating a hospital system that will employ roughly 159,000 employees at hospitals and clinics in 20 states.

After the merger, which requires regulatory approval, the new health system will be run by CEOs of both companies: CHI’s Kevin E. Lofton and Dignity’s Lloyd Dean. In a videotaped message to employees, the two men said they will have separate responsibilities but will continue to work toward shared goals of ensuring that the poor and vulnerable have access to quality care.

“It became clear we could best achieve this goal by creating a new organization, one that will have a stronger foundation and be in a better position to advance our collective mission,” Dean said. “This announcement is the culmination of more than a year of thoughtful exploration and collaboration.”

There have been a number of mergers and acquisitions in the health-care industry since implementation of the Affordable Care Act, with companies saying they can achieve new efficiencies because of their economies of scale, but health-care analysts have said that the mergers don’t always lead to big savings.

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Rather, they said, the combined systems increase their bargaining power, allowing them to negotiate higher rates from insurers than they could command as smaller entities. However, Dignity Health officials pointed to a 2016 study by the American Hospital Association that says mergers increase quality while reducing costs.

A new name has not yet been chosen for the combined CHI-Dignity health system, leaders said, but a new name will be announced in the second half of 2018. That is around the same time that approvals are expected to be final from federal, state and church officials. Both companies were founded by the Catholic church.

Dignity Health, now based in San Francisco, severed formal ties to the church in 2012 when it changed its name from Catholic Healthcare West. This merger, however, would create a single Catholic nonprofit health system. The new company will be based in Chicago, officials said, because that city is centrally located and allows good access to all cities where the combined company will have ministries.

“Our people share a passion to serve all people with compassion, and we both celebrate our Catholic heritage,” Lofton said, “and we both advocate for those who are poor and vulnerable, who count on us for access to quality care.”

CHI and Dignity have no overlapping hospital areas, a company statement said, and there are no plans to close any facilities. CHI, now based south of Denver, has hospitals in 17 states.

Including U.S. HealthWorks and other brands, Dignity operates facilities in 22 states, including Mercy General, 4001 J St., in Sacramento; Mercy Hospital of Folsom, 1650 Creekside Drive, in Folsom; Mercy San Juan, 6501 Coyle, in Carmichael; Methodist Hospital of Sacramento, 7500 Hospital Drive, in Sacramento; Sierra Nevada Memorial, 155 Glasson Way, in Grass Valley; and Woodland Memorial Hospital, 1325 Cottonwood St., in Woodland.

“We have an opportunity to bring together two strong systems and create a new industry leader that integrates the best of both CHI and Dignity Health,” Lofton said, “and because our existing service areas do not overlap, we can focus on growing clinical and community services. Despite all the uncertainties in today’s health-care environment, one thing is constant: Standing still is not an option.”

Colorado losing a major headquarters as Catholic Health Initiatives merges with Dignity

Catholic Health Initiatives, which jointly operates Colorado’s largest hospital group, Centura Health, has signed a merger agreement with Dignity Health that will create a new nonprofit Catholic health group based in Chicago.

CHI, based in Arapahoe County near the Interstate 25 and E-470 interchange, employs about 720 people in the metro area, not counting Centura Health workers, and is one of the largest headquarters in Colorado based on revenue. Dignity Health is headquartered in San Francisco.

The two systems will bring together hospitals and clinics across a 28-state region. Chicago was chosen as the base for handling the integration because of its central geographic location and flight access, a CHI spokesman said Thursday.

“We are joining together to create a new Catholic health system, one that is positioned to accelerate the change from sick care to well care across the United States,” Kevin Lofton, chief executive officer of CHI, said in a statement issued Thursday.

CHI spokesman Michael Romano said it’s too early to know what impact the combination will have on specific jobs, departments, or services.

“We expect integration to take place over one to two years after the combination is complete, during which time we will operate in some ways as separate organizations,” he said.

CHI’s existing offices in metro Denver; Erlanger, Ky.; and Fargo, N.D., will remain open and employees at those locations won’t be required to move during the integration, Romano said.

But some streamlining will occur at some point, he added.

CHI was formed in 1996 through the consolidation of four Catholic health systems. That same year, CHI teamed with Adventist Health System to jointly operate Centura Health, which has 17 hospitals in Colorado and is based in Centennial.

CHI operates 100 hospitals and 30 critical care facilities in 17 states. It reported $15.5 billion in revenues and owned assets valued at $21.9 billion in its most recent fiscal year.

Dignity Health got its start in 1986 when two congregations of the Sisters of Mercy combined. It has 400 care centers and a network of more than 9,000 doctors across a 22-state region. The 39 hospitals it operates are located in California, Arizona and Nevada.

Dignity Health generated $12.9 billion in revenues and owns assets valued at $17.4 billion. Both nonprofits provided more than $2 billion each in charity care the past year.

St. Luke’s Catholic Health Initiatives and Dignity Health merging

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Keep going for a look at how Houston hospitals rate.

Keep going for a look at how Houston hospitals rate.

Photo: Houston Chronicle








































Catholic Health Initiatives, the owner of St. Luke’s Health System, and Dignity Health have merged, the two Catholic institutions announced Thursday.

The agreement will create the largest non-profit health system in the country.

“We are joining together to create a new Catholic health system, one that is positioned to accelerate the change from sick-care to well-care across the United States,” Kevin E. Lofton, CEO of Catholic Health Initiatives, said in a statement. “Our new organization will have the talent, depth, breadth, and passion to improve the health of every person and community we serve.”


Many businesses are looking to expand with monumental deals and acquisitions.


Media: Houston Chronicle


Lloyd Dean, president and CEO of Dignity, added that “by combining our ministries and building upon our shared mission, we will expand our commitment to meeting the needs of all people with compassion, regardless of income, ethnicity, or language. “We foresee an incredible opportunity to expand each organization’s best practices to respond to the evolving health care environment and deliver high-quality, cost-effective care.”


The new entity will comprise 139 hospitals and employ 159,000 people. Its combined revenue will be $28. 4 billion.

It is still unclear exactly what the merger will mean for CHI’s Texas division, which includes St. Luke’s in Houston. Catholic Health Initiatives acquired the venerable Houston hospital system in 2013.

St. Anthony Catholic High School Celebrates New Computer Lab

St. Anthony Catholic High School has a new computer lab.

The new Caruso Library Learning Lab creates a space for the school to offer introduction to engineering class as well as other mathematics-based computer classes.

The news is an exciting addition to Long Beach’s STEM (Science, Technology, Engineering and Mathematics) programs, according to First District Councilwoman Lena Gonzalez.

“It’s absolutely amazing that we are able to offer classes in STEM-related fields,” she said. “This is more than a computer lab. For me, it’s an opportunity to educate downtown Long Beach.”


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First District Councilwoman Lena Gonzalez has nothing but applause for the new computer lab.


—Gazette photo by Stephanie Stutzman

The school’s computer lab is fitted with new HP brand computers, ergonomic student chairs and a center desk for group discussions.

The room itself was renovated with new tile, paint and an industrial ceiling.

“This program is an important piece to shrinking the digital divide,” Gonzalez added. “It’s important that we continue to do our part to minimize that.”

The digital divide exists where people have limited or no access to digital resources. In cities like Long Beach, the divide usually exists where people and families do not have the financial ability to acquire them.


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Students in a previous class learned how to model fasteners using a professional 3-D modeling program called Inventor.


—Gazette photo by Stephanie Stutzman

School programs — like St. Anthony’s STEM classes — give students the opportunity to work with and learn about computers and software, keeping them up-to-date alongside their peers, regardless of their financial status.

One student, Laura Hu, expressed her excitement for the new classes.

“I want to be a mechanical engineer,” Hu, a junior at St. Anthony, said. “I’ve only used this program for two days and I’m getting the hang of it.”

Hu said that she’s excited that the school is offering STEM classes and she hopes to pursue a degree in mechanical engineering after graduating high school. She added that no one in her family has graduated from college, and she hopes St. Anthony’s STEM program will give her an advantage come time for college applications.

“This is a field I’m exploring by myself,” she said. “I really like making things — I’ve been taking art all my life — I think I can design something great as a mechanical engineer.”


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Laura Hu, student at St. Anthony’s, is excited for the opportunities the class has to offer.


—Gazette photo by Stephanie Stutzman

Hu isn’t alone in wanting to make the most of the high school’s programs. The staff is expressing high hopes as well.

“We added this program to give our students a competitive advantage in the digital workforce,” Gina McGuire, St. Anthony High School president, said. “We thank God for giving us this space and pray that our students follow their dreams and exceed in everything they do.”

In addition to a classroom that emphasizes STEM learning, McGuire added that the students will have opportunities to approach projects as a group and collaborate with their peers. 

In the future, classes will incorporate 3-D printing and model presentations.

“It’s one thing to have a beautiful space,” McGuire said. “But it’s what we do with it that matters.”

For more information on St. Anthony Catholic High School, go to longbeachsaints.org.

Stephanie Stutzman can be reached at sstutzman@gazettes.com.

Nurse ‘whistleblowers’ launched probe of Catholic Health overbilling

Catholic Health will pay $6 million to settle a whistleblower lawsuit over allegations that its nursing home subsidiary overbilled Medicare and Medicaid for rehabilitation therapy services – including providing unnecessary therapy to some patients.

The claims involved patients referred from hospitals for short-term rehabilitation as well as long-term care residents.

“A healthcare system that is infected with dishonesty is susceptible to one of the worst afflictions known to mankind – human greed,” Acting U.S. Attorney James P. Kennedy Jr. said Friday. “Today’s settlement demonstrates our unwavering commitment to eradicating this cancer from our federal health care programs.”

The subsidiary, now known as Home Community-Based Care, filed claims for the highest, most expensive levels of therapy that were not reasonable, necessary for patients, and unsupported by records, according to the U.S. Attorney’s Office.

Catholic Health to pay $6 million for alleged false claims

The complaint in the case also alleged false claims from using software that automatically selected payments for services for more days than were provided, and using billing procedures that improperly boosted payments for services.

“When health care companies charge federal government health programs for medically unnecessary services just to boost profits, taxpayers are victimized and the health care industry’s reputation takes a hit,” Scott J. Lampert, special agent-in-charge in the Inspector General Office of Investigations, said in a statement.

Catholic Health, in a statement, said the organization admitted no liability or wrongdoing in the settlement, and that the government’s case was based on a small sample of cases.

Decisions about the necessity of care, after the fact, are subjective, Catholic Health officials said in the statement. Catholic Health disagrees with the government’s position, Catholic Health officials stated.

The system holds the position that the care was provided in ways that were approved by doctors and watched over, Catholic Health officials stated. The hospital system’s patients also returned home faster that patients elsewhere, according to Catholic Health.

Catholic Health said litigation of the case would have gone on for years, consuming a lot of resources, and that by agreeing to resolve the matter, it can focus on caring for patients.

Catholic Health includes Mercy, Kenmore Mercy, and Sisters hospitals, as well as the St. Joseph Campus in Cheektowaga. It no longer operates the St. Francis skilled nursing facility, which was sold in 2015.

Based on more than $1 billion in operating revenue in 2016, the system ended the year with a slim operating margin, earning $149,000 from operations and $5.6 million on the bottom line, according to an analysis by rating agency SP Global. That was the 14th consecutive profitable year for the organization.

Joseph D. McDonald, president and chief executive officer since 2002, recently announced he will retire in the spring, a decision unrelated to the settlement, officials said.

The case was filed by Melanie Duhaine and Loda Trzebuniak, both registered nurses, who tried repeatedly over more than a year to bring the problems to the attention of senior management at Catholic Health, according to their attorney, Harvey P. Sanders.

Duhaine worked as vice president of clinical services at the subsidiary, formerly known as Continuing Care. Trzebuniak worked as director of prospective payment systems.

“Physical, occupational and speech therapy is physically draining and is only worthwhile if it will lead to patient improvement. Unnecessary therapy can do more harm than good, leaving the patient in a weakened state. This is especially true for end-stage terminal patients,” Sanders said, speaking on the women’s behalf.

In hopes of resolving the problems internally, he said Duhaine and Trzebuniak made multiple case-study presentations, engaged in one-on-one meetings with decisionmakers, and provided supporting information to Catholic Health about their concerns.

“It was not their desire to go to court or to bring any legal action against Catholic Health,” Sanders said, noting that the two former employees respect the many health care providers they worked with over the years.

“They hope that bringing this action will help spare future patients from experiencing the potential harm of unnecessary therapies,” the attorney said.

Joyce Markiewicz was named president and chief executive officer of Home Community-Based Care in 2014.

Upon taking over responsibility for nursing and sub-acute rehabilitation facilities, she has conducted a review of performances, and increased management oversight, according to Catholic Health.

“These allegations were never about the quality of care or the outcomes our patients achieved,” Leonardo Sette-Camara, corporate compliance officer for Catholic Health, said in a statement.

“We believe the care provided was appropriate and enabled our patients to return home sooner than if they had received less intense therapy. Defending these types of subjective allegations of overutilization, however, requires an unsustainable and ultimately unacceptable allocation of financial and personnel resources,” Sette-Camara said in the statement.

Reimbursement at skilled nursing facilities is tied to the level of care provided, which is based on such considerations as the condition of the patient, the type of service, and the number of days and minutes a patient receives the care.

Scrutiny of skilled nursing facilities has grown in recent years.

Government agencies have warned they intend to closely watch for upcoding of reimbursement for services to sub-acute rehabilitation patients.

A 2015 report by the Department of Health and Human Services Office of Inspector General found that Medicare payments for therapy greatly exceeded the costs for therapy at nursing facilities in the United States, and that facilities increasingly billed for the highest level of therapy even though patient medical conditions remained largely the same.

False Claims Act cases have been on the rise. There were 247 new health care cases reported nationwide in fiscal year 2000 and 570 in 2016, according to data from the Department of Justice.

The Department of Justice obtained more than $4.7 billion in settlements and judgments from False Claims Act cases in fiscal year 2016 ending Sept. 30, according to a report issued in December by the department.

Of the $4.7 billion recovered, $2.5 billion came from the health care industry, including drug companies, medical device companies, hospitals, nursing homes, laboratories, and physicians.

The $2.5 billion only reflects federal losses and, in many cases, additional funds for state Medicaid programs were recovered, according to the report.

Catholic Health overbilling suit stems from two former employees

Catholic Health will pay $6 million to settle a whistleblower lawsuit over allegations that its nursing home subsidiary overbilled Medicare and Medicaid for rehabilitation therapy services — including providing unnecessary therapy to some patients.

The claims involved patients referred from hospitals for short-term rehabilitation as well as long-term care residents.

“A healthcare system that is infected with dishonesty is susceptible to one of the worst afflictions known to mankind — human greed,” Acting U.S. Attorney James P. Kennedy Jr. said Friday. “Today’s settlement demonstrates our unwavering commitment to eradicating this cancer from our federal health care programs.”

The subsidiary, now known as Home Community-Based Care, filed claims for the highest, most expensive levels of therapy that were not reasonable, necessary for patients, and unsupported by records, according to the U.S. Attorney’s Office.

The complaint in the case also alleged false claims from using software that automatically selected payments for services for more days than were provided, and using billing procedures that improperly boosted payments for services.

“When health care companies charge federal government health programs for medically unnecessary services just to boost profits, taxpayers are victimized and the health care industry’s reputation takes a hit,” Scott J. Lampert, special agent-in-charge in the Inspector General Office of Investigations, said in a statement.

Catholic Health, in a statement, said the organization admitted no liability or wrongdoing in the settlement, and that the government’s case was based on a small sample of cases.

Decisions about the necessity of care, after the fact, are subjective, Catholic Health officials said in the statement. Catholic Health disagrees with the government’s position, Catholic Health officials stated.

The system holds the position that the care was provided in ways that were approved by doctors and watched over, Catholic Health officials stated. The hospital system’s patients also returned home faster that patients elsewhere, according to Catholic Health.

Catholic Health said litigation of the case would have gone on for years, consuming a lot of resources, and that by agreeing to resolve the matter, it can focus on caring for patients.

Catholic Health includes Mercy, Kenmore Mercy, and Sisters hospitals, as well as the St. Joseph Campus in Cheektowaga. It no longer operates the St. Francis skilled nursing facility, which was sold in 2015.

Based on more than $1 billion in operating revenue in 2016, the system ended the year with a slim operating margin, earning $149,000 from operations and $5.6 million on the bottom line, according to an analysis by rating agency SP Global. That was the 14th consecutive profitable year for the organization.

Joseph D. McDonald, president and chief executive officer since 2002, recently announced he will retire in the spring, a decision unrelated to the settlement, officials said.

The case was filed by Melanie Duhaine and Loda Trzebuniak, both registered nurses, who tried repeatedly over more than a year to bring the problems to the attention of senior management at Catholic Health, according to their attorney, Harvey P. Sanders.

Duhaine worked as vice president of clinical services at the subsidiary, formerly known as Continuing Care. Trzebuniak worked as director of prospective payment systems.

“Physical, occupational and speech therapy is physically draining and is only worthwhile if it will lead to patient improvement. Unnecessary therapy can do more harm than good, leaving the patient in a weakened state. This is especially true for end-stage terminal patients,” Sanders said, speaking on the women’s behalf.

In hopes of resolving the problems internally, he said Duhaine and Trzebuniak made multiple case-study presentations, engaged in one-on-one meetings with decisionmakers, and provided supporting information to Catholic Health about their concerns.

“It was not their desire to go to court or to bring any legal action against Catholic Health,” Sanders said, noting that the two former employees respect the many health care providers they worked with over the years.

“They hope that bringing this action will help spare future patients from experiencing the potential harm of unnecessary therapies,” the attorney said.

Joyce Markiewicz was named president and chief executive officer of Home Community-Based Care in 2014.

Upon taking over responsibility for nursing and sub-acute rehabilitation facilities, she has conducted a review of performances, and increased management oversight, according to Catholic Health.

“These allegations were never about the quality of care or the outcomes our patients achieved,” Leonardo Sette-Camara, corporate compliance officer for Catholic Health, said in a statement.

“We believe the care provided was appropriate and enabled our patients to return home sooner than if they had received less intense therapy. Defending these types of subjective allegations of overutilization, however, requires an unsustainable and ultimately unacceptable allocation of financial and personnel resources,” Sette-Camara said in the statement.

Reimbursement at skilled nursing facilities is tied to the level of care provided, which is based on such considerations as the condition of the patient, the type of service, and the number of days and minutes a patient receives the care.

Scrutiny of skilled nursing facilities has grown in recent years.

Government agencies have warned they intend to closely watch for upcoding of reimbursement for services to sub-acute rehabilitation patients.

A 2015 report by the Department of Health and Human Services Office of Inspector General found that Medicare payments for therapy greatly exceeded the costs for therapy at nursing facilities in the United States, and that facilities increasingly billed for the highest level of therapy even though patient medical conditions remained largely the same.

False Claims Act cases have been on the rise. There were 247 new health care cases reported nationwide in fiscal year 2000 and 570 in 2016, according to data from the Department of Justice.

The Department of Justice obtained more than $4.7 billion in settlements and judgments from False Claims Act cases in fiscal year 2016 ending Sept. 30, according to a report issued in December by the department.

Of the $4.7 billion recovered, $2.5 billion came from the health care industry, including drug companies, medical device companies, hospitals, nursing homes, laboratories, and physicians.

The $2.5 billion only reflects federal losses and, in many cases, additional funds for state Medicaid programs were recovered, according to the report.

Computer server in Catholic Charities’ Glens Falls office targeted by hackers


GLENS FALLS – The personal information of about 4,600 past and present clients and several employees of Catholic Charities may have been exposed after a computer server in the Glens Falls office was hacked, according to Catholic Charities for the Diocese of Albany.

Catholic Charities said that when the breach was discovered on Aug. 30, it took immediate steps to end the hackers’ unauthorized access to the server and to further enhance the security of its servers. The agency also notified State Police, the attorney general’s office, Division of Consumer Protection and U.S. Department of Health and Human Services and reached out to potential victims who received services at Catholic Charities’ Saratoga, Glens Falls or Schenectady offices.

“We take very seriously our responsibility for protecting private information, and we sincerely apologize for any inconvenience this may cause our clients and staff,” said Sister Charla Commins, executive director of Catholic Charities of Saratoga, Warren and Washington Counties in a statement. “We have modern digital security measures in place, but every day it seems criminals intent on invading computer systems find new ways to do so.”

The cyber attack was discovered by staff at the agency as they were doing computer security updates and found unauthorized software on the computer  server. A forensics analysis indicates the illegal access to the server may date back to 2015.

A technology firm called in to investigate the matter determined that information, including birth dates, dates of service and diagnosis codes and Social Security numbers, stored on the server may have been accessed.

 The server did not contain case notes about individual clients’ treatment or therapy, or financial or banking information or information about donors or clients of other Catholic Charities agencies.

Catholic Charities is offering identify theft and credit monitoring free of charge for one year and has established a special telephone number to provide additional information and assistance. Anyone who received services from Catholic Charities of Saratoga, Warren, and Washington Counties and is concerned about their personal information should call Catholic Charities toll-free at 1-888-235-7282, and those with questions about the incident can contact the Saratoga office at 518-587-5000.

Catholic Charities of Saratoga, Warren and Washington counties serves more than 5,000 people each year with individual and family counseling, nutrition outreach and education, mentoring, support for victims of domestic violence, a community home for the dying and emergency assistance.

Catholic Health to pay $6 million to settle false claims allegations – WKBW

BUFFALO, N.Y. (WKBW) – Catholic Health System has agreed to pay $6 million to settle allegations that its subsidiary submitted false claims to government health care programs over an eight-year period.

According to federal prosecutors, Home Community Based Care – formerly known as Continuing Care – submitted or caused to be submitted false claims to Medicare for rehabilitation therapy services from January 2007 through December 2014.

The services in question were provided by Catholic Health at short and long-term skilled nursing and health care facilities including Father Baker Manor in Lackawanna, the McAuley Residence in the Town of Tonawanda and St. Francis Williamsville.

The services were administered at levels that were unreasonable, not medically necessary, and not supported by the residents’ medical records, prosecutors said.

“A healthcare system that is infected with dishonesty is susceptible to one of the worst afflictions known to mankind – human greed,” said Acting U.S. Attorney James Kennedy, Jr. “Today’s settlement demonstrates our unwavering commitment to eradicating this cancer from our federal health care programs.”

The lawsuit was brought fourth by a whistleblower under the False Claims Act, which allows private citizens to bring lawsuits on behalf of the United Sates and receive part of the proceeds of a settlement.

Catholic Health System admits no wrongdoing or liability as part of the settlement. In response to the allegations, it released a statement, which reads in part:

The government’s case was based on findings of alleged overutilization in a small sample of cases. The government also relied on statistics indicating that rehabilitation services utilization at Catholic Health sub-acute rehabilitation facilities exceeded national averages. Determinations of the medical necessity of therapy services made years after care was provided are highly subjective, and Catholic Health does not agree with the government’s conclusions concerning the medical necessity of rehabilitation services provided at its facilities. 

 

Catholic Health maintains that therapy was provided pursuant to physician approved and monitored plans of care. Moreover, Catholic Health maintains that while its rehabilitation patients received more intense therapy on average than patients at other facilities, its patients’ stays were significantly shorter than national averages – meaning the more intense level of therapy services resulted in Catholic Health patients returning home faster.

 

Catholic Health cooperated fully throughout the government’s three year investigation. Litigation of this matter would have gone on for years and consumed substantial internal and external resources. By agreeing to resolve this matter now, Catholic Health will instead direct those resources to continuing to provide patients the highest level of care.

 

Catholic Health to pay $6 million for alleged false claims

The Catholic Health System will pay $6 million to satisfy a federal case against it for allegedly filing false medical claims to government health care agencies, the U.S. Attorney’s Office reported this afternoon.

The alleged incidents occurred between 2007 and 2014.

The health system was accused of submitting false claims to Medicare for rehabilitation therapy services it provided at nursing homes and other facilities in the region, including Father Baker Manor, St. Francis Williamsville, and the McAuley Residence, according to Assistant U.S. Attorney Kathleen A. Lynch.

[PDF: Department of Justice announces settlement]

“A healthcare system that is infected with dishonesty is susceptible to one of the worst afflictions known to mankind—human greed,” said Acting U.S. Attorney James P. Kennedy, Jr. “Today’s settlement demonstrates our unwavering commitment to eradicating this cancer from our federal health care programs.”

Federal prosecutors said the services “were administered to beneficiaries at levels that were unreasonable, not medically necessary, and unsupported by the medical records,” according to a statement the U.S. Attorney’s Office issued this afternoon.

Catholic Health, in a statement, said that the organization admitted no liability or wrongdoing in the settlement, and that the government investigation was based on a small sample of cases.

“Determinations of the medical necessity of therapy services made years after care was provided are highly subjective, and Catholic Health does not agree with the government’s conclusions concerning the medical necessity of rehabilitation services provided at its facilities,” officials said.

“Catholic Health maintains that therapy was provided pursuant to physician-approved and monitored plans of care. Moreover, Catholic Health maintains that while its rehabilitation patients received more intense therapy on average than patients at other facilities, its patients’ stays were significantly shorter than national averages – meaning the more intense level of therapy services resulted in Catholic Health patients returning home faster,” officials said.

This is a developing story.

Catholic Health strikes settlement with Justice Department over billing practices

Catholic Health strikes settlement with Justice Department over billing practices

Catholic Health has agreed to a large settlement with the U.S. Justice Department in a whistleblower lawsuit over billing practices in such government health programs as Medicare and Medicaid, according to two sources with knowledge of the case.

The hospital system also agreed to enter into a corporate integrity agreement with the Health and Human Services Office of Inspector General to ensure compliance with regulations. Those agreements usually last five years.

The settlement arose from a whistleblower lawsuit that is brought under the False Claims Act and entitles whistleblowers to a portion of any settlement.

Details of the case were not available. Officials at Catholic Health and the U.S. Attorney’s Office in Buffalo declined to comment on Tuesday, saying the settlement remained sealed, preventing them from talking publicly about it. Such cases remain “under seal” when initially filed while federal authorities investigate the allegations.

The Department of Justice obtained more than $4.7 billion in settlements and judgments from False Claims Act cases in fiscal year 2016 ending Sept. 30, according to a report issued in December by the department.

Of the $4.7 billion recovered, $2.5 billion came from the health care industry, including drug companies, medical device companies, hospitals, nursing homes, laboratories, and physicians. The $2.5 billion only reflects federal losses and, in many cases, additional funds for state Medicaid programs were recovered, according to the report.

Covington Catholic football continues to lead the rankings

b66d4_35546123001_5610912069001_5610841277001-vs Covington Catholic football continues to lead the rankingsx

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Covington Catholic honored its history Oct. 13.
James Weber

The top teams in the Kentucky Associated Press high school football polls, with first-place votes, records, total points and previous rankings:

CLASS A

Rank-School (FPV)         Rcd   TP  Pvs

1. Paintsville (9)                7-1   161  1

2. Beechwood (8)             6-2   160   2

3. Hazard                          5-2   121   3

4. Kentucky Country Day  7-1   116   4

5. Raceland                       5-3    91   6

6. Russellville                    6-2    72   7

7. Paris                              7-1    54   8

8. Ludlow                           7-1    47   5

9. Pikeville                         3-4    40   9

10. Williamsburg                5-3    29  10

Others receiving votes: Bracken County 12. Lynn Camp 11. Eminence 9. Frankfort 6. Holy Cross 3. Bishop Brossart 2. Fairview 1.

CLASS 2-A

Rank-School (FPV)         Rcd  TP    Pvs

1. Danville (6)                    9-0   154   2

2. DeSales (10)                 8-0   153   1

3. Mayfield (1)                    7-1  132    3

4. Lexington Christian        8-0   127   4

5. Christian Academy         6-2     97   6

6. Glasgow                          6-2    66   8

7. Somerset                         5-4    44   7

8. Walton-Verona                 6-2    40   9

9. Newport Central Catholic 4-4    38   5

10. Lloyd Memorial               6-2    37  NR

Others receiving votes: Owensboro Catholic 27. Prestonsburg 12. Shelby Valley 6. Ballard Memorial 2.

CLASS 3-A

Rank-School (FPV)     Rcd   TP  Pvs

1. Belfry (12)                7-1   164   1

2. Corbin (2)                 7-1   144   2

3. Boyle County (1)      7-1   130   3

4. Elizabethtown (1)     7-1   110   5

5. Central                      6-2  108   4

6. Caldwell County        8-1    76   6

7. Casey County (1)      8-0    72   7

8. Lexington Catholic     4-4    33   9

CLASS 4-A

Rank-SchooL (FPV)       Rcd   TP   Pvs

1. Johnson Central (16)   8-0   160    1

2. Wayne County              8-1   136   2

3. Collins                           6-2   120   3

4. Ashland Blazer              7-2   109   4

5. Logan County                8-0     74   5

6. Franklin-Simpson           5-3     69   6

7. Rockcastle County         6-2     63   7

8. Knox Central                   6-2    38   9

9. Scott                                5-3    31  T10

(tie) Shelby County              6-2    31   8

Others receiving votes: Taylor County 15. Madisonville-North Hopkins 6. John Hardin 6. Franklin County 5. Bourbon County 4. Allen County-Scottsville 3. Hopkinsville 3. East Jessamine 2. Mercer County 2. Western 2. Boyd County 1. 

CLASS 5-A

Rank-School (FPV)           Rcd   TP  Pvs

1. Covington Catholic (16)   8-0   160    1

2. Bowling Green                  6-2  132    2

3. Christian County               8-0  128    3

4. South Warren                    7-1  111    4

5. South Oldham                   7-1  100    5

6. Southwestern                     6-2   66    6

7. Madison Southern              6-2   60    7

8. North Laurel                        7-2   47   T9

9. Montgomery County            6-2   15   NR

10. Apollo                                6-2   13   NR

Others receiving votes: Anderson County 12. Whitley County 12. Perry County Central 7. Owensboro 5. Graves County 5. Highlands 3. Doss 2. Pulaski County 2. 

CLASS 6-A

Rank-School (FPV)     Rcd TP  Pvs

1. Trinity (16)                9-0   160   1

2. St. Xavier                  7-1   138   3

3. Simon Kenton           9-0   119   4

4. Male                          7-2   108   2

5. Scott County              7-2   107  5

6. Pleasure Ridge Park  6-2    76   6

7. Ryle                            6-2    64  7

8. Frederick Douglass    6-2    44  8

9. Butler                          6-3    34  9

10. Tates Creek              6-2    12  NR

Others receiving votes: Ballard 6. Central Hardin 5. Campbell County 4. Madison Central 3.

All Associated Press members in Kentucky are eligible to participate in the high school football poll. Those who voted for this week’s poll are: The Daily Independent, Ashland; Daily News, Bowling Green; Kentucky Enquirer, Cincinnati; Times-Tribune, Corbin; East Kentucky Broadcasting, Pikeville; The News-Enterprise, Elizabethtown; Daily Enterprise, Harlan; The Gleaner, Henderson; Kentucky New Era, Hopkinsville; Lexington Herald-Leader, Lexington; The Courier-Journal, Louisville; The Ledger Independent, Maysville; The Middlesboro Daily News, Middlesboro; Times Leader Princeton, Princeton; WDKY, Lexington; WKYX, Paducah; WRUS, Russellville.

COMPUTER RATINGS

The Litkenhous computer ratings compiled by the Louisville Courier-Journal of Oct. 16.

STATEWIDE TOP 20

Covington Catholic (8-0), 143.8

Boyle County (7-1), 129.4

Trinity (9-0), 127.4

Male (7-2), 124.8

Scott County (7-2), 124.8

St. Xavier (7-1), 123.5

Lexington Christian (8-0), 122.0

DeSales (8-0), 119.8

Simon Kenton (9-0), 119.0

Danville (9-0), 118.9

Butler (6-3), 114.4

Tates Creek (6-2), 113.3

PRP (6-2), 112.6

Mayfield (7-1), 112.0

Belfry (7-1), 111.7

Corbin (7-1), 111.3

Ryle (6-2), 111.2

Frederick Douglass (6-2), 110.8

Beechwood (6-2), 110.8

Madison Central (4-4), 110.6

CLASS 6-A

Trinity, 127.4

Male, 124.8

Scott County, 124.8

St. Xavier, 123.5

Simon Kenton, 119.0

Butler, 114.4

Tates Creek, 113.3

PRP, 112.6

Ryle, 111.2

Frederick Douglass, 110.8

Madison Central, 110.6

Ballard, 107.3

Henry Clay, 104.3

Lafayette, 102.0

Manual, 101.7

Central Hardin, 101.6

Campbell County, 101.6

McCracken County, 97.3

Meade County, 96.2

Eastern, 95.6

Henderson County, 94.6

Daviess County, 92.0

Conner, 89.5

North Hardin, 87.7

Bryan Station, 86.5

Clark County, 84.4

Cooper, 80.1

Ohio County, 73.9

Paul Laurence Dunbar, 65.6

Jeffersontown, 65.3

Boone County, 59.3

Seneca, 58.1

Muhlenberg County, 54.9

CLASS 5-A

Covington Catholic, 143.8

Southwestern, 108.9

South Oldham, 107.9

Christian County, 106.6

Bowling Green, 106.1

South Warren, 104.7

Madison Southern, 103.4

Highlands, 101.8

North Laurel, 101.6

Owensboro, 99.4

Fern Creek, 97.2

Graves County, 96.5

Montgomery County, 94.3

Harlan County, 93.3

Doss, 93.2

Whitley County, 92.9

Pulaski County, 92.7

Apollo, 90.3

Anderson County, 85.1

Oldham County, 84.4

Dixie Heights, 83.5

Bullitt East, 82.4

Bullitt Central, 80.9

Perry Central, 80.8

Lincoln County, 79.7

South Laurel, 78.7

Greenwood, 75.8

Atherton, 75.2

North Bullitt, 71.1

Marshall County, 70.4

Southern, 67.4

Letcher Central, 64.4

Iroquois, 62.4

Fairdale, 59.7

Woodford County, 58.6

Grant County, 48.1

Grayson County, 43.7

Barren County, 40.1

Nelson County, 37.8

CLASS 4-A

Collins, 110.1

Johnson Central, 109.9

Wayne County, 107.0

Franklin-Simpson, 103.4

Ashland Blazer, 95.7

Western, 95.5

Knox Central, 92.3

Rockcastle County, 91.5

Madisonville, 90.2

Hopkinsville, 87.9

Taylor County, 86.1

Moore, 85.8

Scott High, 85.1

Warren East, 84.4

John Hardin, 82.8

Mercer County, 82.7

East Jessamine, 82.5

Greenup County, 82.5

Allen County, 81.7

Bourbon County, 79.6

Logan County, 79.0

Mason County, 77.5

Shelby County, 77.1

Franklin County, 75.7

Russell County, 71.8

West Jessamine, 69.5

North Oldham, 68.8

Valley, 67.1

Spencer County, 62.8

Clay County, 60.7

Warren Central, 59.3

Holmes, 59.1

Rowan County, 56.4

Harrison County, 52.7

East Carter, 48.0

Marion County, 44.7

Breckinridge County, 44.4 

Hopkins Central, 43.7

Calloway County, 37.5

Boyd County, 28.9

CLASS 3-A

No NKY teams

CLASS 2-A

Lexington Christian, 122.0

DeSales, 119.8

Danville, 118.9

Mayfield, 112.0

Christian Academy, 107.0

Walton-Verona, 98.9

Somerset, 96.7

Glasgow, 91.2

Owensboro Catholic, 89.4

Lloyd, 86.7

Newport Central Catholic, 86.5

Prestonsburg, 79.4

Monroe County, 78.2

Washington County, 66.7

Murray, 66.2

McLean County, 64.6

Leslie County, 62.4

Hancock County, 62.2

Metcalfe County, 61.8

Middlesboro, 60.1

Carroll County, 59.9

Shelby Valley, 59.3

Clinton County, 56.9

Owen County, 56.1

Green County, 55.1

Ballard Memorial, 48.5

Newport, 46.6

Todd Central, 46.0

Gallatin County, 43.3

Butler County, 38.1

Holy Cross, 36.1

Trimble County, 33.8

Betsy Layne, 31.8

East Ridge, 31.6

Shawnee, 18.9

Webster County, 3.3

CLASS A

Beechwood, 110.8

KCD, 100.7

Raceland, 93.2

Paintsville, 93.1

Hazard, 92.7

Lou. Holy Cross, 81.1

Pikeville, 78.3

Paris, 78.0

Ludlow, 76.1

Williamsburg, 75.5

Frankfort, 74.2

Bracken County, 71.0

Eminence, 70.1

Campbellsville, 67.6

Russellville, 66.8

Lynn Camp, 62.2

Harlan, 56.2

Phelps, 55.3

Crittenden County, 55.2

Bishop Brossart, 54.8

Fairview, 51.8

Bellevue, 50.5

Bethlehem, 49.5

Nicholas County, 42.1

Pineville, 39.5

Dayton, 39.0

Fulton County, 35.2

Fort Knox, 33.5

Berea, 12.9

Caverna, 10.1

Fulton City, 1.4

Jenkins, 1.0

 




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