Nine Texas Vascular Associates Doctors Sued for Alleged Medicare, Insurance Fraud

A former employee of Dallas’ Texas Vascular Associates is suing the practice and its nine doctors. Cortez Mills, a former medical coding professional at TVA, alleges that she was fired in May after discovering fraudulent billing practices. According to the complaint, Mills discovered the irregularities while reviewing and releasing patient bills to Medicare and private insurers for payment. They include double-billing insurance carriers, coding insurance claims so certain services would not be bundled, and billing for services that were never performed. TVA is based in the Baylor Hamilton Heart and Vascular Hospital on the Baylor Dallas campus near downtown Dallas. Baylor, however, is not… Full Story

Morning Rounds (07.25.12)

NTEC is accepting applications for MedVentures 2012. Last year’s presenting companies raised an average of $1.9 million. Deloitte surveys C-suite executives and HR professionals on the U.S. healthcare system, the ACA, and strategies for employee health benefits coverage and cost containment. Becker’s Hospital Review shares five best practices for cultural changes following a hospital transaction. Hospital leaders share their opinions on their organizations’ budgets for EHR deployment? Integrated Healthcare Strategies‘ 2012 national healthcare staff compensation survey results.    

Legislation Could Stave Off Medicare Cuts for Doctors

Rep. Michael Burgess (R-Texas) has introduced legislation to provide a one-year extension for Medicare physician payment rates to ensure continued access for Medicare beneficiaries and TRICARE recipients. The legislation, called H.R. 6142, The Assuring Medicare Stability and Access for Seniors Act of 2012, is the latest in a set of attempts from Congress to stave off a nearly 30 percent pay cut for doctors accepting Medicare. “Despite Congress’ continual enactment of last-minute legislation to prevent these cuts from going into effect over the last few years, 11th-hour legislative maneuvers should no longer take the place of a stable and secure… Full Story

MedSynergies, Methodist, and NorthStar Anesthesia Named to Fastest-growing Healthcare Companies List

Three North Texas companies are among the 40 fastest-growing healthcare companies in the country, according to Modern Healthcare. The magazine released the names of the 40 contenders this morning; rankings will be revealed in September. Vying for recognition locally are Irving-based MedSynergies, Dallas-based Methodist Health System, and NorthStar Anesthesia, which is based in Arlington. One other Texas company—Hospital Housekeeping Systems of Austin—also made the list. The “fast 40” companies fall into four categories: hospitals/hospital systems, physician group practices, payers/insurers, and suppliers. Qualifying concerns must be based in the United States, have generated at least $20 million in revenue in 2011,… Full Story

Patience and Strategy Needed for Healthcare Reform

Following the U.S. Supreme Court’s ruling on the constitutionality of the Patient Protection and Affordable Care Act (PPACA), Texas will need patience and strategy with two important decisions regarding Medicaid expansion and the implementation of the State Health Insurance Exchange. Texas Governor Rick Perry recently announced Texas would not expand Medicaid coverage or implement a state health insurance exchange. Texas leads the nation with an overall 27 percent uninsured population. Those numbers climb to 30 percent in North Texas. Within our state, 1.2 million children have no medical insurance and 40 percent of Texas women do not receive appropriate prenatal… Full Story

Two-thirds of Local Emergency Department Cases Could Be Treated Elsewhere, Avoided Altogether

A recent Dallas-Fort Worth Hospital Council report underscores how local emergency departments are being jammed by cases that either could be treated elsewhere or avoided by proper primary care. The most common conditions treated in local EDs were low-back pain; painful or aching joints; chronic bronchitis, and asthma. More than two out of three cases—other than asthma—either were not emergencies or could have been treated in a primary-care setting. Nearly all of the asthma cases were emergencies that could have been avoided with proper primary care, according to the report, which was released in May. Charges for ED visits are… Full Story

Children’s Medical Center Opens Three Area Primary Care Offices

MyChildren’s, a network of pediatric primary care offices affiliated with Children’s Medical Center of Dallas has opened three new practices in Oak Cliff, East Plano, and Lake Highlands. The clinics are located in neighborhoods where fewer options exist for families that depend on Medicaid and the state’s Children’s Health Insurance Program, Children’s says. The network selected office locations based on patient demographics, access to pediatric primary care services, and the top ZIP codes where families are using the Children’s Medical Center Emergency Department for primary care. MyChildren’s locations take both Medicaid and commercially insured patients. “Many families resort to the… Full Story

Morning Rounds (7.20.12)

Choice Cancer Care opens a new office in Carrollton.   UT Southwestern documents Nobel Prize-winners Drs. Michael Brown’s and Joseph Goldstein’s 40-year journey.   Texas Health Denton becomes one of the first hospitals in the country to receive Cycle IV Chest Pain Center Accreditation.   Texas Health Presbyterian Hospital Allen releases a video to showcase its birthing options.

James Sammons Named CMO at Texas Health Arlington

Texas Health Arlington Memorial Hospital has named James H. Sammons Jr., M.D., as its chief medical officer. In this position he will promote clinical excellence and safety in patient care throughout all departments at Texas Health Arlington Memorial. He’ll assume his post July 30. Sammons will work with the hospital’s executive team and medical staff and report to Harold Berenzweig, M.D., Texas Health Resources’ executive vice president and Southwest Zone clinical leader. Kirk King, the hospital’s president, said Sammons’ expertise, clinical skills, and leadership will be a valuable resource throughout the Texas Health system. “We anticipate him helping us advance… Full Story

Methodist Health System’s Accountable Care Organization Will Be DFW’s Second

Methodist Patient Centered ACO, quarterbacked by the Dallas-based Methodist Health System, is one of 89 accountable care organizations (ACOs) selected this month by the Centers for Medicare and Medicaid Services (CMS). The Methodist ACO is the second in Dallas-Fort Worth. Texas Health Resources (THR) and North Texas Specialty Physicians were selected in December to participate in Medicare’s Pioneer ACO Model. An ACO is a network of healthcare providers willing to be accountable for achieving measurable quality improvements and reduced spending for a defined Medicare population. In exchange, an ACO would share the savings with Medicare. The government hopes the model… Full Story