UNIVERSITY OF WASHINGTON

Health Sciences and Medical Affairs News and Community Relations

July 8, 2001

FOR IMMEDIATE RELEASE:

The following statement responds to news coverage concerning an ongoing federal investigation of Medicare and Medicaid billing practices at the University of Washington Academic Medical Center; it is for attribution to Dr. Paul G. Ramsey, vice president for Medical Affairs and dean of the University of Washington School of Medicine:

"The federal investigation of our Medicare and Medicaid billing practices is a matter we take most seriously. Now almost two years old, this probe has prompted us to re-examine our billing procedures and compliance program. We have concluded that some of our procedures and compliance efforts have fallen short, and we are making a number of improvements. Some of these improvements are well under way, including increases in the staffing of our training and compliance programs. As federal regulations became more complex over the last five to ten years, our compliance programs have evolved, and yet further improvements will be forthcoming.

"Federal investigations into health-care billing in academic medical centers are common. In fact, the government has completed 19 investigations of billing practices at other teaching hospitals. Many of these have involved the same kind of issues that we believe the government is examining in its investigation of us. Five institutions have been exonerated. Fourteen others have reached civil financial settlements totaling about $117 million. We know of no instance in which criminal charges have been filed for billing improprieties in these settings; we should be treated no differently.

"It is extremely challenging for busy physicians to keep up with complex and changing billing requirements. Across the country, physicians are spending more and more time in attempting to comply with the federal regulations. Given these challenges, billing mistakes are made. And while we have made mistakes, we have seen nothing to date that suggests that anyone_s actions were designed to commit fraud.

"The University of Washington Academic Medical Center (including the UW School of Medicine, Harborview Medical Center and UW Medical Center) works in collaboration with our affiliated institutions (including Children_s Hospital and Regional Medical Center) to provide the very best in medical care, education and research. We are recognized worldwide for our leadership in these areas. Over the years, many individuals have dedicated their professional lives to attain and build upon this distinction. It is one we are committed to preserving and extending far into the future.

"Our medical care system consists of about 1,200 physicians in 18 clinical departments providing services in three hospitals and eight neighborhood clinics. This system has over 40,000 hospital admissions and over 900,000 outpatient clinic visits per year. Our providers serve as a critical resource for people in our community and the region--including many of the sickest, poorest and otherwise disadvantaged. We provide more charitable care to the uninsured in our state than any health-care provider in Washington. Our physicians, hospitals and clinics are an essential part of the medical care "safety net" for our region. We are very proud of the high quality of the clinical services that we provide, and our first responsibility is to the patients that we serve.

"We take very seriously the importance of conducting the business aspects of our work in a professional and ethical manner. One of those business aspects--billing for health-care services--is among the most confusing, burdensome, ever-changing, and expensive areas of federal regulation today. Even the government and federal courts acknowledge this. Those who seek reimbursement under the existing, complex guidelines face the very real risks of an honest mistake being cast by prosecutors as an intentional act of criminal fraud. This risk is driving physicians across the country and in our state to retire early, refuse all insurance and accept only direct payments from patients, or restrict the number of Medicare and Medicaid patients they serve. Last month, for example, Olympia's 74-doctor Memorial Clinic closed after 51 years; among reasons cited for the closure was the increasing administrative burden associated with insurance reimbursements.

"Approximately 20 years ago, the UW became one of the first academic medical centers in the nation to voluntarily institute a program to review the accuracy of health-care billing documentation. Since then, as federal regulations have changed and become more complex, we have expanded our billing and compliance program. Today, we spend about $2.5 million annually for billing and compliance. Even so, we must do better. Our responsibility is to have a first-rate compliance program and strive for an error-free system.

"We are dedicated to our roles as teachers, health-care providers and researchers. This strong commitment to our mission, however, does not mean that we can be lax about the business side of our work. All of us here at the UW and in our practice plans have been and will continue to be dedicated to excellence in all of our activities, including our business procedures. Together, we will take whatever measures are necessary to ensure lawful and ethical compliance with all health-care reimbursement regulations and standards._

Seattle Times

-- Anonymous, July 08, 2001