False Claims Suit Alleges Improper Privileging
A word to hospital leaders…
Do you think that medical staff credentialing and privileging is just low-level paper-work? Does your organization provide ongoing education and support, not just for the employees who work in the Medical Staff Services Department, but also for the physicians who sit on your Credentials and Medical Executive Committees, as well as for Board Members who must make the final credentialing and privileging decisions?
When it comes time to make the hard choices, do you back those who must make them?
When the message is uncomfortable, do you listen?
A recent press release from the U.S. Department of Justice clearly shows why those actions are so vital to both the health of your patients, and the health of your organization.
Patient safety is the primary focus of an effective credentialing and privileging program, but the financial health and reputation of the hospital are also at stake, as is clearly shown by a recent U.S. Government press release.
The U. S. Department of Justice joined a False Claims act law suit alleging that a Waycross, Georgia hospital and physician member of the medical staff submitted claims for medically substandard and unnecessary services to Medicare and Medicaid.
The complaint also states that after the physician joined the staff the hospital management allowed him to perform endovascular procedures in the hospital’s Heart Center even though he lacked experience in performing such procedures and did not have privileges to perform them.
The complaint further states that the nurses recognized that the physician was incompetent to perform endovascular procedures and repeatedly raised concerns with hospital management.
Serious allegations, and significant food for thought for all healthcare leaders.
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