UVA SURGEONS DETAIL "UPCODING" THEY SAY ALLOWED HEALTH SYSTEM TO FRAUDULENTLY BILL PATIENTS - THE DAILY PROGRESS REPORTS
Current and former UVA Health physicians and administrators say the hospital under its current leadership has prioritized 'profits over patients'
By Emily Hemphill
October 17, 2024
The Daily Progress article above contains illuminating and disconcerting information and we encourage everyone who is concerned about UVA Health to read it in full.
We highlight a few excerpts here…
About a year ago, surgeons working for the University of Virginia Health System raised concerns they could face jail time for overcharging patients as they said their superiors were instructing.
“The message was, ‘You guys don’t bill enough, and there’s clear evidence that you could be billing more because this other group bills a ton. They bill double what you guys are billing,’”said one of the surgeons, who has since left UVa. “And we said, ‘For us to bill more would be fraud, because we’re already billing more than we think we should.’”
UVa physicians who have spoken with The Daily Progress say hospital leaders, including Kent, were repeatedly made aware of accounts of fraudulent billing for more than a year. Those accounts were only made public, however, on Sept. 5, when 128 UVa Health physicians and UVa School of Medicine faculty members penned a letter of no confidence in Kent and Medical School Dean Dr. Melina Kibbe. That letter claims Kent and Kibbe pushed their employees to fraudulently bill, creating a toxic work environment that reached the point of endangering patients.
While none of the assertions made in the letter of no confidence are particularly comforting, one claim crosses the line from irresponsible to illegal: “Disregarding valid reports of fraudulent billing and requests by senior leaders to fraudulently modify patient records in order to obfuscate adverse outcomes and boost productivity metrics.”
Given the ubiquity of upcoding in health systems across the country, the fact that it reached a degree at UVa Health that more than 100 physicians took such a public stand is cause for concern, said more than one health policy expert who spoke with The Daily Progress.
Physicians who spoke to The Daily Progress acknowledged that while they did not receive orders directly from Kent or Kibbe regarding billing, the recent changes “undoubtedly had to do with feedback and direction [the division chairs] were getting from Kibbe and Kent.”
“Essentially, individuals no longer mattered,” said a former UVa Health surgeon. “It was really all about either money or reputation.”
This focus on “money and reputation” was a change that occurred “overnight” upon Kent’s arrival, according to a former C-suite hospital executive. That executive had been with the health system for more than 20 years working as a professor and “a beloved leader,” as colleagues characterized them, but left fewer than two years after Kent took over.
Aside from a complete change in how finances were handled, the former executive also described the emergence of a “bullying and hostile environment.” Collaboration and constructive conversations were no longer tolerated, and disagreeing with the CEO’s decisions— “even within closed sessions” — could mean risking one’s job.
Another former hospital executive who was in an administrative position when Kent was named CEO repeated those claims, saying Kent’s actions warranted a letter of no confidence long before Sept. 5 but that employees were too fearful of retaliation.
“Everybody was so scared, so the fact that they finally got up the courage to come forward is monumental,” that executive said. “If anyone’s worked there at UVa Health, you would know that just this action alone is monumental. I think he has destroyed that place.”
Read the entire article: THE DAILY PROGRESS REPORTS — UVA SURGEONS DETAIL "UPCODING" THEY SAY ALLOWED HEALTH SYSTEM TO FRAUDULENTLY BILL PATIENTS.
*** If you are employed by UVA Health, the UVA School of Medicine, and/or the UVA Physicians Group, your colleagues have engaged legal representation to support each of you in bringing forth your evidence in the safest way possible.
No one should feel pressured to meet with Williams & Connolly’s attorneys without having your own legal representation present.
If you are contacted by Williams & Connolly or wish to initiate contact with them, your UVA School of Medicine Faculty Senate Representatives and CSEC Leadership can provide information on how other faculty members have approached receiving advice, preparing for discussions, and ensuring appropriate protections, given the seriousness of these matters.
You can also email FightingForUVAHealth@proton.me for more information. ***
What is going on at UVA Health?
We are Concerned Citizens of Charlottesville and Patients of UVA Health who are troubled by what we have heard from many UVA Health professionals over the past year.
These professionals are not only our doctors and nurses but also our friends, family and neighbors. We believe our community should value and protect its health care workers who have dedicated their lives to helping UVA patients.
A Parrhesiastes is someone who speaks the truth in a clear and honest way…
It's about the courage to speak one’s mind even when it's difficult or unpopular…to prioritize truth over social niceties or personal gain...
But speaking the truth can be dangerous. A Parrhesiastes understands this risk and is willing to face the consequences, from social disapproval to vindictive employers or even violence...
Because ultimately Parrhesiastes act out of a sense of duty.
They believe speaking the truth is necessary for the greater good and to protect the people and institution they love.
A former UVa Health System executive said he thinks Kent has "destroyed that place".... Wow!