Sunday, August 10, 2008

     

 

 

 

Judge rules for ETMC
By Michael V. Hannigan
Monitor Staff Writer

MARSHALL–A federal judge ruled in favor of East Texas Medical Center Athens last week in a whistleblower lawsuit alleging the hospital engaged in Medicaid fraud.
Judge T. John Ward of the Eastern District Court, Marshall, granted ETMC’s motion for summary judgment in the lawsuit. Jury selection for a trial had been scheduled to start Monday.
“We are extremely happy with the ruling,” ETMC attorney Dean Davis said. “This is a very complicated issue because of all the state and federal rules. But, we were confident that we’d be in great shape, because the law and the facts were on our side.”
While ETMC was celebrating, the other side wasn’t quite ready to give up.
Attorney Dean Gresham, who filed the original lawsuit on behalf of Linnea Rose, said the summary judgment covered just a portion of the lawsuit.
Other issues, including allegations that ETMC conspired with the Texas Organization of Rural and Community Hospitals to commit Medicaid fraud, could still be in play, Gresham said.
“We have to wait until we receive the court’s actual written order,” Gresham said.
Davis disagreed, saying the summary judgment wiped out the entire lawsuit.
The lawsuit was originally filed against both ETMC Athens and Tyler-based ETMC Regional Healthcare System. However, Ward recently split the lawsuit into two separate actions.
The summary judgment came in the lawsuit against ETMC Athens. The lawsuit against the entire ETMC system has been sealed, which is the normal procedure for a whistleblower lawsuit.
Davis said ETMC would deal with that lawsuit at the proper time, pointing out it is also before Ward’s court.
The original lawsuit was first filed by Rose in June, 2005, and sealed while the federal government investigated the allegations against ETMC in order to decide whether or not to become involved in the case.
The U.S. Attorney’s Office could have taken over the lead in the case. In February, 2007, however, the government “declined to intervene in the action.”
The lawsuit alleged that ETMC Athens used money transfers to the Henderson County Hospital Authority Board to illegally take part in the Medicaid Upper Payment Limit (UPL) program.
Medicaid is funded by both state and federal money. The UPL program is a mechanism to match state Medicaid money to federal Medicaid money.
In Henderson County’s case, the process included ETMC Athens placing money in a hospital authority board bank account, which was later forwarded through the state to the federal government, and then transferred back again – this time with matching federal money included – to the hospital authority.
This process is called an intergovernmental transfer. Both the initial money and the federal funds were then sent back to ETMC Athens.
One such intergovernmental transfer in September, 2002, turned an original deposit of $1.2 million into $2.8 million.
ETMC Athens never denied engaging in the process, but Davis said the hospital did so by following the rules set up by the Texas Health and Human Services Commission and the instructions of the Texas Organization of Rural and Community Hospitals (TORCH).
“This is a watershed moment for the entire UPL program,” Davis said. “It will benefit a number of hospitals in the same position as ETMC Athens.”
While other hospitals in Texas have been in the same situation as ETMC, Davis explained, only the Athens hospital has been sued and suspended from the program.
In April, the Henderson County Hospital Authority received word it had been suspended from the UPL program by the Texas Health and Human Services Commission (HHSC).
In a letter to Authority board president David Monk and ETMC Athens Administrator Pat Wallace, the HHSC said the hospital authority was suspended because of “significant questions” about the way the program was administered. Among the agency’s concerns was the Linnea Rose lawsuit.
Following this week’s court victory, Davis didn’t mince words on what he thought about the suspension.
“The idea that a state agency would refer to a private lawsuit in this situation is reprehensible,” he said. “They (HHSC) are costing Henderson County and the hospital $300,000 a month in indigent health care costs that we’re entitled to, and we are going to get it back for the county and the hospital.
“That’s why the celebration for the lawsuit can’t take too long, because that’s our next step,” he said. “We are not going to stop until we get this hospital back in the program.”

Man dies in boating accident
Monitor Staff Reports
MABANK–One man was killed and another injured in a boating accident on Cedar Creek Lake Aug. 1.
According to Henderson County Game Warden Shawn Smith, a boat carrying Mark Robin “Bo” Anderson and Samuel Stevens collided with a retaining wall across from the area known as The Bluffs, near Eustace, around 11 p.m.
Anderson was care-flighted to East Texas Medical Center in Tyler, where he died of his injuries the next day.
Stevens is recovering in Trinity Mother Frances Hospital in Tyler.
Smith said details of the accident are sketchy and the investigation continues.
Anderson, 47, was a graduate of Athens High School and Tyler Junior College.
He owned Green Source Lawn Services.
He is survived by wife Tonya, daughters Natalie, Marci and Bailey and son Tyler.

Commissioners ponder records requests
By Pearl Cantrell
Monitor Staff Writer

ATHENS–Henderson County Commissioners were uncertain when it came to hiring outside legal counsel to review half a dozen open records requests made to the county auditor.
After some discussion, commissioners Jerry West and Ronny Lawrence agreed to accept the advice from the Attorney General’s office to hire independent legal counsel.
However, Precinct 1 Commissioner Joe Hall and County Judge David Holstein chose to abstain from participating in the decision.
Precinct 2 Commissioner Wade McKinney was not present at Tuesday’s regularly scheduled meeting.
The requests came from County Auditor James Owen and were received by auditor Ann Marie Lee.
Lee distributed one-inch thick packets on the law and its interpretation to commissioners Tuesday.
At least one request asks for records going back to January, 2007. Researching and finding them will take some time and staffing to get done, Lee said.
“I’m not a lawyer and the law in this area seem convoluted to me,” Lee said.
She responded to most of the requests asking that the request be narrowed more specifically.
Owen made the open records request as a private citizen and not as the county attorney, he told The Monitor.
“I don’t see what’s so unclear about what I’m asking for,” he added.
Owen is requesting a list of written records/information requests submitted to the auditor’s office and a copy of the auditor’s response to those requests, whether they be from other county departments or the public.
“We distribute information all the time. That’s what we do,” Lee told commissioners.
Owen also requested a copy of any document or compilation related to an evaluation of the treasurer’s office.
Also, a copy of documents she’s provided to any member of the Hospital Authority Board, and specifically David Monk, president of that board, along with any document evidencing any fees collected for providing record requests.
“We just follow the law on fees. It’s about 10 cents a copy and any overhead. If it’s just one sheet of paper or something minimal like that we don’t bother with fees,” she said.
In other business, commissioners:
• renewed a 13-month contract on the Title IV-E Child Welfare Services for supplemental foster care maintenance. The funding helps with back to school needs, specific transportation costs, graduation expenses, gifts, personal items and allowances and clothing. The federal grant contract is valued at $38,900, grant officer Jennifer Nicholson said.
• renewed another 13-month contract on the Title IV-E Child Welfare Services for legal services to compensate the county for personnel working on Child Protective Services cases. The contract is set at $115,718 in reimbursements, which can be amended as necessary Nicholson said.
• approved a contract change that reduces an agreement with Tyler Technologies by $820.
“Thanks for checking into this and saving taxpayers $800,” Holstein said to IT director Betty Spencer.
• approved a request from the City of Poynor for labor and equipment to repair certain streets within the city limits.
West estimated the labor and equipment use at $5,000. The city will purchase the 40 to 50 tons of hot mix needed to make the repairs.
• accepted $485 from Caney City for reimbursement on a patch Precinct 1 performed on a road partly maintained by the county and the city.
• paid bills totaling $178,100.76.
• tabled action on a request to increase a contract with the meal service provider at the jail, so certain details could be clarified.

Slip-sliding away


Monitor Photo/Kerry Yancey
Area youngsters splash down a blow-up slip-and-slide during the Tamarack
festivities marking National Nite Out in Gun Barrel City Tuesday. For more
images from the event, see page 4A.
 

 


 


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