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Saturday, December 22, 2007

Grady and Emory: Culture of Corruption

As I have delved deeper and deeper into the evolving narrative that links Emory University, Grady Hospital and potential malfeasance, I have realized that is very important to separate facts and evidence from speculation, assertion, and conclusions. For now, I want to report only facts, in other words, things I can verify.Thus, it is a fact that Grady Hospital is at the center of a culture of corruption. I know this to be a fact because one only needs to do a google search to see that there is documented corruption at Grady Hospital

...he wanted Grady to hire as many as 50 a day, though the public hospital - operated under the Fulton-DeKalb Hospital Authority - had previously hired asfew as three a day. Harris adds that her boss, then-Grady CEO Edward Renford,demanded that she "schmooze" Walker more and cautioned her not to make
him angry.

But Harris says she made the Augusta lawmaker angrier by not hiring more temps. She claimed in a sexual harassment and discrimination lawsuit that she was fired in 1998 partly because of her complaints about payments to Walker. Grady denied her allegations. Her lawsuit was dismissed in 2002.But she wasn't the only one accusing Walker of shady dealings.

Before Democrats lost power, when lobbyists came to his Capitol office seeking favors, he reportedly would pat the head of a toy dog on his desk and ask, "What's in it for my little friend?"According to a federal indictment, Walker's temp company earned $2.5 million from Grady between 1996 and 2000. His corruption trial begins May 23 in Augusta. Harris hopes to testify against him. Her 1999 TV interview about the senator helped spur inquiries into his dealings.

Now, let's look at more facts. Joyce Harris, the whistleblower, is no longer working at Grady and in fact doesn't even work in Georgia. Ed Renford (referenced in the article as Grady CEO)recently retired with a rather nice retirement package.Furthermore, let's look at two more high level people at Grady who weren't mentioned in the article. First, there is lead counsel Tim Jefferson who not only continues to be employed by Emory but as chief legal counsel. Then, there is Chief Trustee of Grady Robert Brown. He is no longer employed by Grady but if you click this link you will see why.

Again, I don't want to deal with anything but facts. The facts are that there were four people people that there were four people in a position of power when this scandal broke. The whistleblower lost her job and everyone else kept theirs. Again, I only deal in facts...as for assertions, speculation, and conclusions, those I will leave to the audience.

Now, let's look at another completely unrelated bit of corruption at Grady Hospital.

By contract with the Fulton-DeKalb Hospital Authority, the Emory Medical Care Foundation provides physicians to treat patients at Grady Hospital. Most of these services are billed to the Georgia Medicaid program. Since July 1997, the State Health Care Fraud Control Unit, composed of prosecutors from the Georgia Attorney General's office, Georgia Bureau of Investigation agents, and auditors from the State Department of Audits, has been investigating Emory's Medicaid billing. The State concluded that there were two specific areas in which Medicaid billing by EMCF was not in compliance with the policies and procedures of the Georgia Medicaid program. First, the State contended that from 1993 through mid-1997, EMCF billed for outpatient obstetrical services at higher service levels than were warranted by the documentation, a practice known as "upcoding." Second, the State's review also indicated that during the same period Medicaid billings submitted for services provided by residents and interns under the supervision of teaching physicians were inadequately documented and did not comply with Medicaid rules concerning "teaching physician presence."

Although the investigation revealed that inappropriate billing and documentation may have occurred, the State found that all of the patients whose records were examined had, in fact, received treatment. The quality of services provided by Emory physicians was not an issuein the investigation.Attorney General Baker stated that "Emory cooperated fully with the investigation and the investigation revealed no evidence of criminal wrongdoing." He further commended Emory for its role in consistently providing high quality health care to the indigent citizens of Fulton and DeKalb counties.Under the terms of the agreement, the Emory Medical Care Foundation expressly denies any wrongdoing, but has agreed to pay the Georgia Department of Medical Assistance a lump sum of $4,502,693 to settle all possible claims.

The Foundation also agreed to several compliance provisions, including continued implementation of a compliance office and program that were initiated in 1997. The State considered this compliance program, in addition to Emory's cooperation with the investigation, to be strongly mitigating factors in the settlement of the case.

Of course, if you still aren't convinced maybe you should .re read this, or this.

(Update)Much of the story surrounding Grady has many tentacles and thus one could get lost in the middle of it. I have found that to be the case for many readers with certain pieces. I don't believe this is one of them. I believe this piece speaks for itself, and it should be easy to follow no matter how big your exposure to the entire case. That said, I also think that everyone should understand how this culture of corruption fits into the overall picture. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

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