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NEWS
FROM CAMBRIDGE HEALTH ALLIANCE
February
13, 2006
CAMBRIDGE HEALTH ALLIANCE WEIGHS IN ON DEBATE OVER THE UNCOMPENSATED
CARE POOL
Cambridge Health Alliance (CHA) was one of many stakeholders consulted
in the Office of the Inspector General’s (OIG) study of the uncompensated
care pool, which was published in November, 2005. Information about
individual hospitals in this blinded study was recently revealed
to the Boston Globe (BG) by an unnamed source in an article published
on 2/11/06. The timing of this disclosure is disconcerting
given that Legislative discussions around healthcare reform have
reached a critical point.
CHA agreed with the intent of the study, which was to make improvements
to the uncompensated care pool. We were completely cooperative
and transparent with the OIG regarding all aspects of their study.
Pharmacy data entry and software errors were found during the review
of unaudited claims from the two year period from October 1, 2002
to March 7, 2005. We immediately informed the Division of Health
Care Finance and Policy (DHCFP) and requested that the audit be
scheduled. We replaced the software, and as an extra precaution,
a reconciliation mechanism has been put in place to verify all changes
to the pharmacy system and to ensure data integrity.
These
errors were corrected and steps were taken to immediately self-disclose.
Both the OIG and CHA acknowledged that these errors occurred during
an unaudited period, and that the customary audit should be performed
to identify any overcharging and/or undercharging of the pool. Of
course any reimbursements derived from identified billing errors
are refunded to the Commonwealth.
Focusing
on charges for a few services also doesn’t tell the whole story.
Hospitals are reimbursed on an aggregate basis for free care – not
on departmental charges. In fact, Massachusetts Hospital
Association/DHCFP data for 2003 and 2004 shows only one hospital
out of the 67 analyzed had a lower overall markup of charges in
relationship to costs than CHA. We have not excessively
billed for free care as borne out by our financial results. We suffered
a $21 million loss during the first period examined and barely broke-even
the following two fiscal years.
In summary, CHA is, and will continue to be, a prudent steward of
the funds we have received from multiple government sources. CHA
is the last remaining public safety net provider in the Commonwealth
for the poor, the working poor, and severely indigent. We
can say with absolute confidence that our patients are truly deserving
of the outstanding care our dedicated staff provides.
Dennis D. Keefe
Chief Executive Officer
Cambridge Health Alliance
1493 Cambridge Street
Cambridge MA 02139
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Media
Contacts
Alison
Harris
Director Media Relations
Phone: 617-499-8323
Cell: 781-424-3293
Pager: 617-546-8696
aharris@challiance.org
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