Wichita Cardiologist, Coffey Health System Settle Medical Fraud Lawsuits
Wichita cardiologist Joseph Galichia, MD, has agreed to pay $5.8 million to settle a false claims lawsuit that alleges he billed federal health programs for unnecessary medical procedures.
In an unrelated case, the Coffey Health System agreed to pay $250,000 to settle a lawsuit that alleges it violated the False Claims Act by falsely reporting it had done security risk analyses on its electronic records system, which is required when filing claims for a federal incentive payment program.
Dr. Galichia denied the allegations in a written statement, according to The Wichita Eagle. The lawsuit alleged he had surgically implanted dozens of “medically unnecessary and unreasonable” heart stents in at least 14 Kansas patients between 2008 to 2014, the Eagle article said. Some patients had multiple stents, as many as 20 to 35 stents each. Medicare and other federal health programs were billed for the procedures, with Dr. Galichia and his medical group receiving between $10,000 to $11,000 for each stent.
This recent settlement was the third and highest settlement between Dr. Galichia, his medical group and the federal government. The other settlements were in 2000 and 2009, with respective payments of $1.5 million to settle a lawsuit for overbilling and double billing of services or charging for procedures not performed and $1.3 million for billing for services not provided or not properly documented.
In the Coffey Health System settlement, the federal government alleged that the system had falsely attested that it conducted and/or reviewed security risk analyses of patient electronic health records as required under a federal incentive program for the reporting periods of 2012 and 2013. The health system operates a 25-bed critical access hospital in Burlington, Kansas.
Under the American Recovering and Reinvestment Act of 2009, the U.S. Department of Health and Human Services (HHS) offers incentive payments to healthcare providers that adopt certified EHR technology and meet certain requirements relating to their use of the technology. To obtain the payments, providers must attest that they satisfy applicable HHS-adopted criteria, including measures for analyzing and addressing security risks to electronic health records.
Both lawsuits were the result of whistleblower actions; the individuals who filed the suits on behalf of the government will share in the settlements.
Edwards County Medical Center Receives Healthy Kansas Hospitals Centers of Excellence Award
In 2018, Edwards County Medical Center in Kinsley created a Worksite Wellness Committee charged to provide employees with the tools and resources to improve their health. Policy changes and incentives for employee participation have produced tangible results, and employees are enjoying healthier food and beverage options and using the on-site fitness center more frequently. In recognition of the hospital’s work to reduce sugary beverages, offer more fresh fruits and lean meat options, provide healthier snacks and flavored waters in the vending machine, and incentivize physical activity, the Kansas Hospital Association has presented one of two 2019 Healthy Kansas Hospitals Centers of Excellence Awards to Edwards County Medical Center.
Representatives of the Worksite Wellness Committee at Edwards County Medical Center (left to right): Jorden Sones, Brandi Wheaton, Jim Hansel, CEO, Monique Funk, Lisa Stuckey and Celeste Schroetlin
“It is humbling to receive this award,” says Jim Hansel, Chief Executive Officer. “We didn’t initiate our wellness focus for the purpose of winning an award. Promoting wellness is part of serving our community.
The award and a monetary contribution to help support the hospital’s wellness activities were presented during a special recognition ceremony on June 7 at the hospital.
“We are honored to be recognized with this award,” Hansel says. “We want to be sure our employees are healthy — physically and mentally. Our employees are here to take care of people in the community, so the hospital needs to take care of its staff members.
“There are very few things you can invest in that are more important than people,” he adds. “We’re creating a partnership with our employees by showing we care. As a result, we’ve seen a tremendous decline in employee turnover. We have built a lot of trust.”
Working closely with the Edwards County Health Organization, the hospital also has implemented several health improvement initiatives for the community, including tobacco use cessation, bicycle safety awareness — with an emphasis on wearing helmets — and physical activity events.
“The hospital should be a role model for the community, and through our wellness activities and policy changes, we are trying to set a positive example,” Hansel says.
Worksite Wellness Committee Co-chair Brandi Wheaton said her group’s focus was on making employees enjoy working at the hospital.
“It’s nice to see our hard work recognized,” the physical therapy assistant says.
While meeting some resistance initially with the decrease of pop, chips and candy options in the vending machine, employees, patients and visitors now enjoy flavored water options, nuts and protein bars. With a goal of reducing sugary options by 50%, Wheaton reports that “about 65% to 75% of the vending machine options are healthier,” and when the healthy options are sold out, people ask when the machine will be refilled.
“I’m really proud of the staff, especially the ones who have taken leadership roles in implementing the Worksite Wellness Program,” Hansel says.
Leaders of the wellness initiative include Brandi Burkhart, a medical laboratory technician; Jacobs; and Wheaton.
Hernandez Elected Chairman, 4 Kansans Earn New Terms on the Blue Cross and Blue Shield of Kansas Board of Directors
Leonard R. Hernandez, New Strawn, was elected to a one-year term as Chair of the Blue Cross and Blue Shield of Kansas Board of Directors at its annual meeting May 9 in Topeka. James A. Klausman, Topeka, was elected to a one-year term as Vice Chair.
Hernandez, CEO of Coffey Health System, joined the Blue Cross board in 2012, and recently completed three years as Vice Chair. Klausman, President/CEO of Midwest Health, has served on the board since 2015.
Hernandez and Klausman were among four directors who were re-elected to new, four-year terms at the meeting. Also re-elected to new terms were Rick C. Jackson, Topeka, and Kenneth W. Winter, Dodge City. Jackson is Executive Vice President and Chief Lending Officer at Capitol Federal and has served on the board since 2015. Winter joined the board in 2007 and is General Manager of Lariat Feeders LLC.
Other members of the board are Matthew D. All, Lawrence; Carolyn R. Banning, CPA/PFS, Dodge City; Gregory V. Binns, Hutchinson; Jennifer L. Brull, MD, Plainville; Megan L. Jones, Topeka; Diane L. Lee, CPA, CSEP, Hutchinson; Jena K. Lysen, SHRM-SCP, SPHR, Wichita; Jeff D. Mullen, Wichita; Steve W. Sloan, Pittsburg; Cathy Mih Taylor, MD, Chanute; Jeffrey R. Thompson, Salina; and Angela N. Wilson, DDS, Lawrence.
King Leads Ascension Via Christi
Don King is leading Ascension Via Christi as its Senior Vice President and Kansas Ministry Market Executive. King, who took on the new role April 15, has nearly 20 years of healthcare leadership experience with Ascension, Lee’s Summit (Missouri) Medical Center and a research center in Kansas City. King was the Chief Operating Officer for Ascension Alabama before taking his new position in Kansas. King grew up in the Kansas City area and earned both his undergraduate and master’s degree in physical therapy from Loma Linda University in southern California.
Clinics Returning to 2 Kansas Communities Affected by Closures
Two communities that lost their clinics and hospitals because of financial issues experienced with their former management company, EmpowerHMS, are regaining hometown medical clinics.
The Labette Health Oswego Clinic and Express Care opened a temporary clinic at 608 Commercial Oswego in April, with plans to build a permanent location at 515 Commercial. Amy Smith, APRN-C, and Cindi Major, APRN-C, are the providers. The community had been without healthcare options following the Feb. 14 closure of Oswego Community Hospital and its Oswego and Chetopa clinics. The new clinic is part of the Labette Health, which operates a hospital in Parsons and several clinics and express care locations in southeastern Kansas.
In Horton, Kansas, hospital officials and community members are working to tentatively reopen the Horton Rural Health Clinic by July 1 and the hospital by August, according to a Topeka TV news report. The Horton hospital closed its doors March 15.
The Oswego, Horton and Hillsboro hospitals in Kansas had all been managed by EmpowerHMS and had financial issues, including not paying its employees and vendors.
The Horton and Hillsboro hospitals filed for Chapter 11 bankruptcy in March. In January, a Marion County judge appointed a receiver to manage the Hillsboro Community Hospital when it faced a bank foreclosure lawsuit. According to a Hillsboro Free Press report, the hospital was placed fully into the hands of the receiver, Cohesive Healthcare Management, in early March.
Popular Storytelling Newscaster Wins Sweet Humanitarian Award
Larry Hatteberg, a longtime popular storytelling newscaster in Wichita, was awarded the 14th annual Sweet Humanitarian Award in May. The award was created in 2005 by Donna Sweet, MD, a world-renowned HIV/AIDS expert with the University of Kansas School of Medicine-Wichita Internal Medicine Department, to recognize those who contribute to the community through philanthropic and selfless actions. The award gala raises money to benefit the Sweet Emergency Fund, which helps HIV/AIDS patients with their healthcare needs when other resources are not available.
Hatteberg is known for his national award-winning “Hatteberg’s People” segment that features ordinary Kansans doing interesting and extraordinary things. The segment now airs on the Wichita public television station KPTS.
KUSM-Wichita Becomes Site for Schwartz Rounds Program in Kansas
The University of Kansas School of Medicine-Wichita launched a bimonthly program that is Kansas’ first such site of an international program dedicated to nurturing the patient-caregiver relationship and to improving compassion.
The KUSM-Wichita’s Department of Pediatrics and the pediatrics residency program at Wesley Medical Center started the Schwartz Rounds program in February, with a program themed “the first patient I lost.” More than 70 people from 10 disciplines attended.
The Wichita program is assisted by the Schwartz Center for Compassionate Healthcare (theschwartzcenter.org), which takes its name in honor of Boston attorney Ken Schwartz who died at age 40 of cancer. The Schwartz Rounds happen at more than 600 sites in the U.S., Canada, Australia, New Zealand, United Kingdom and Ireland.
The program is interdisciplinary, including not only medical professionals but also chaplains, social workers and others working in health care. The program’s goal is to enhance compassionate care, improve teamwork and reduce stress and isolation. According to the Schwartz Center’s website, research has shown that when caregivers are more compassionate, patients do better and are more satisfied.
Ascension Via Christi Epilepsy Center Accredited
The Epilepsy Center at Ascension Via Christi St. Francis has achieved two-year accreditation by the National Association of Epilepsy Centers as a Level 3 center for adults.
“According to NAEC, Level 3 Epilepsy Centers have the professional expertise and facilities to provide the highest level medical evaluation and treatment for patients with complex epilepsy,” says Ricky Lee, MD, a board-certified and fellowship-trained epileptologist who serves as the center’s Medical Director.
Stormont Vail Health Announces Administrative Changes
Kevin Steck has joined the Stormont Vail Health leadership team as Senior Vice President, General Counsel and Chief Compliance Officer. Steck had worked for 10 years with St. John Health System in Tulsa, Oklahoma, after a more than 20-year career with the Federal Bureau of Investigation.
The health system also had a number of administrative changes. Darlene Stone, Senior Vice President and Chief Human Resources Officer, is now also overseeing a new patient experience department. Carol Perry, RN, is the system’s Senior Vice President and Chief Nursing Officer, Acute Care Operations. Tracy O’Rourke is Senior Vice President and Chief Administrative Officer with the added duties of operational oversight of behavioral health and several allied health departments and of serving as the liaison for the Mayo Clinic Care Network. Sridevi Donepudi, MD, was promoted to Senior Vice President and Chief Medical Quality Officer and will also oversee medical staff services. Amy McCarter joined the organization as Vice President, Marketing and Communications.
Pharmacist Pleads Guilty to Illegally Dispensing Controlled Substances
A Salina woman once employed as a CVS pharmacist and her husband have pleaded guilty in cases related to controlled substances. Kirsty Hartley pleaded guilty to one count of distributing and dispensing controlled substances without a legitimate medical reason; she admitted to unlawfully dispensing more than 21,000 tablets of hydrocodone with acetaminophen. Dalton Hartley, her husband and co-defendant, Dalton Hartley, pleaded guilty to one count of acquiring controlled substances through fraud. In his plea, Dalton Hartley admitted he fraudulently received 450 tablets of hydrocodone with acetaminophen and 360 tablets of alprazolam from his wife. He would consume the medication himself or trade tablets to other people for marijuana, according to a release from the office of U.S. Attorney Stephen McAllister.
Wesley Children’s Hospital Patient Given National Hero Award
Andres Arambula, a victim of a road-rage shooting in Wichita in October, received the national Kids Wish Network Hero of the Year Award in a special ceremony in Wichita in May. Andres, who was 4 years old at the time, was a passenger in his family’s SUV when he was hit with a bullet. A patient at Wesley Children’s Hospital, he underwent several surgeries to remove the bullet and repair the damage to his kidney and liver, as well as his fractured hip bone. He also had physical therapy to help him walk again. The hospital nominated him for the national network’s monthly hero award in November. As part of his recognition as the network’s national hero, Andres received a $5,000 check and the network donated a pallet of toys worth $20,000 in his honor to the Kansas Children’s Foundation (formerly Wesley Children’s Foundation).
Derby’s First Hospital Opens
Rock Regional Hospital, the first hospital to open in Derby, Kansas, began accepting patients April 24. The nearly 90,000-square-foot hospital at 3251 N. Rock Road is part of a new 15-acre medical campus that will include two medical office buildings. The $40 million hospital has four operating rooms, two cardiac catheterization labs, two procedure rooms, a six-bed ER and 31 acute care beds, with seven being in intensive care and the other 24 being medical/surgical rooms. The for-profit hospital is primarily owned by Rock Medical Assets, comprising local investors, real estate developers and private capital firms; Ascension Via Christi has 25 percent ownership. Day-to-day operations are being handled by Candor Healthcare, located in the Dallas area.
Medical Mission at Home in Wichita Helps 200+ Patients
More than 200 participants were provided with free medical services and resources, including exams, onsite lab testing and pharmacy, and hearing, vision and dental screening during the daylong Ascension Via Christi Medical Mission at Home in Wichita. Several community partners, including Wichita State and Newman universities and the City of Wichita, and more than 600 volunteers helped during the April 13 event held at a Wichita public elementary school.
Radiation Oncologist Returns to Stormont Vail Health
Stormont Vail Health is proud to announce that John Ma, MD, PhD, will re-join their team and practice as a radiation oncologist. He will be located at the Cotton O’Neil Cancer Center, 1414 SW Eighth St.
Dr. Ma is no stranger to Stormont Vail Health. From 2015 to 2017, he provided radiation oncology services for Cotton O’Neil Cancer Center through a partnership with Radiology and Nuclear Medicine LLC. He is looking forward to returning to Stormont Vail because of the relationships he built here.
“It’s the people that truly make this place special,” Dr. Ma says. “I’ve had the privilege of working with the physicians and support staff here and it’s an honor to be coming back to serve the community with such wonderful people.”
An interest in physics — a passion that continues today — led him to earn a PhD in biochemistry and biophysics while he received his medical degree from The University of Mississippi, Jackson, in 2009. He completed a clinical fellowship with the Department of Radiation Oncology at The University of Mississippi, in 2010. He also completed a clinical internship with the Department of Internal Medicine, University of Arkansas, Fayetteville, Arkansas, in 2011. Back at The University of Mississippi, he completed his residency with the Department of Radiation Oncology, in 2015, serving as the Chief Resident from 2014–2015.
“Growing up, my grandmother was diagnosed with cancer and later died due to complications from the disease,” Dr. Ma says. “Since then, there have been tremendous strides and improvements in technology thanks, in part, to physics. I enjoy being able to use both my passions and medical knowledge to assist my patients as they are going through their toughest battles.”
Blue Cross and Blue Shield of Kansas, Hutchinson Clinic Partner to Improve Health and Lower Costs for Hutchinson Clinic Patients
With an eye toward improving population health and member experience while better controlling the overall cost of health care, the Hutchinson Clinic has entered into an accountable care agreement with Blue Cross and Blue Shield of Kansas. This agreement will support patients of the health system’s Hutchinson-based primary care physicians associated with Hutchinson Clinic, according to Matt All, President/CEO of the state’s largest health insurer.
The Accountable Care Organization (ACO) agreement, BlueStem+, is designed to create better overall outcomes for patients, and in doing so, lower healthcare costs over time for members. The agreement has been in place since Jan. 1, 2019, and initially includes an annual payment to Hutchinson Clinic if certain quality and financial measures are achieved. In the latter years of the agreement, Hutchinson Clinic will continue to be eligible for such payments, but also will assume risk if certain cost and quality targets are not achieved.
BlueStem+ adds incentives to improve population health and member experiences while reducing overall health care costs over time. ACOs have proven they can reduce hospital admissions, reduce readmissions and prevent unnecessary emergency room visits. Care coordination seeks to provide enhanced preventative care and improve overall health and the avoidance of chronic conditions.
“The Hutchinson Clinic has chosen to enter into this type of arrangement because it allows our primary care physicians to focus on health care instead of sick care and aids in identifying small issues before they become bigger health concerns,” says Mike Heck, Hutchinson Clinic CEO. “Our goal is to keep patients healthy while providing an exceptional patient experience and improving overall community health outcomes.
The goal of the agreement, according to All, is to help patients by increasing coordination among providers, focusing on preventive health care and ensuring patient care is based on evidence.
“Blue Cross and Blue Shield of Kansas is proud to be leading the shift toward new reimbursement partnerships with providers that improve both quality and total cost of care for patients,” All says. “We are confident this new approach will improve the overall health of Kansans while better controlling health care costs and positively impacting premiums for employers and members.