EDITORIAL: Community Health Network should be accountable
Jan. 11—Community Health Network's $345 million settlement with the federal government after allegations of a years-long Medicare fraud scheme casts a shadow over the organization, which includes Community Hospital Anderson.
The local hospital is a tremendous resource, not only because it provides a wide range of health care services but also through its community involvement, business partnerships and charitable contributions. Via these efforts, the hospital has created deep equity in the Anderson area and has built relationships based on trust earned over more than six decades.
So it pains us to think that one of our local hospitals belongs to a network that has agreed to pay $345 million to settle a fraud case against it.
The U.S. Department of Justice reports that, beginning in about 2008, Community Health Network paid some physicians as much as double what they were receiving via their private practices.
Physicians, it's alleged, were given bonuses based on their volume of referrals. Some of those referrals were then billed to Medicare in violation of the federal Stark Law, which prohibits hospitals from billing Medicare for referrals by physicians with whom they have a financial relationship, according to a DOJ statement released in mid-December.
It doesn't help that comments from a network spokesperson after the settlement was announced deflected any responsibility from the organization.
"This is completely unrelated to the quality and appropriateness of the care Community provided to patients," Kris Kirschner, Community Health Network's director of corporate communication, said in an e-mailed statement.
"Community has consistently prioritized the highest regulatory and ethical standards in all our business processes."
Kirschner did add that the settlement will not impact the network's day-to-day operations. She said the $345 million would be paid using reserve funds and noted that the network will enter a five-year Corporate Integrity Agreement with the federal government.
But her statement still leaves us cold. Rather than denying any culpability, expressing accountability would have gone a long way toward regaining the public's confidence in the network.
It's difficult to believe that the network "prioritized the highest regulatory and ethical standards."
As it is, people served by CHN facilities are left to wonder whether the network has cleaned up its act. Are those involved in the scheme still working in the network? What safeguards assure that such fraud isn't continuing or that it won't happen again?
We don't know the extent to which Community Hospital Anderson might have been involved in the alleged scheme. Officials at the Anderson hospital declined to comment on the settlement.
But we do know that one particular doctor mentioned in a previous report on the allegations, Dr. James Callahan, works from an office on the CHA campus. According to the Department of Justice, network officials hoped to capture a third of neuro and spine cases in Madison, Grant, Tipton and Delaware counties when they brought Callahan on board.
In 2012, he entered a four-year agreement with CHN with a guaranteed base salary of $921,600.
Setting the story of Dr. Callahan aside, we have no doubt that Community Hospital Anderson will continue to be an active and important community partner. But we do wish the network to which it belongs would show more transparency and accountability to regain the public's trust.
