Update on "The Cost of Admission"

60 Minutes

16 Feb 201400:57

Summary

TLDRThe report highlights a whistleblower case involving Health Management Associates (HMA), the fourth-largest for-profit hospital chain in the U.S. Doctors accused HMA of pressuring them to admit emergency room patients unnecessarily, setting quotas regardless of medical need. The U.S. Department of Justice has now joined lawsuits targeting these practices, particularly focusing on former CEO Gary Newsome, who has since retired and now runs a Mormon mission in Uruguay. The case sheds light on Medicare fraud and unethical hospital admissions.

Takeaways

📝 The script provides an update on a story first reported a year ago called 'The Cost of Admission'.
🏥 Doctors at Health Management Associates (HMA), the fourth-largest for-profit hospital chain, reported being pressured to admit emergency room patients regardless of medical need.
🎯 HMA set quotas for doctors to meet, with one department chief stating that 20% of patients needed to be admitted, or someone would be fired.
⚖️ The U.S. Department of Justice has joined eight whistleblower lawsuits against HMA, focusing on unnecessary hospital admissions and Medicare fraud.
🚨 The lawsuits allege that HMA engaged in fraudulent activities by admitting patients who didn’t require hospitalization.
👤 Gary Nome, HMA's former Chief Executive, is singled out as being responsible for the scheme.
🚪 Gary Nome retired last summer and is currently running a Mormon mission in Uruguay.
💼 The lawsuits indicate significant federal involvement, raising the stakes for HMA's accountability.
📊 The focus on Medicare fraud suggests widespread financial implications within the healthcare system.
📺 The segment is from the show '60 Minutes', hosted by Steve Croft, who promises to return with another edition next week.

Q & A

What is the main focus of the story being updated?
-The story focuses on Health Management Associates (HMA) and the allegations that they pressured doctors to admit emergency room patients to their hospitals, regardless of medical need, as part of a scheme to meet quotas.
What unethical practice was HMA accused of?
-HMA was accused of pressuring doctors to meet quotas by admitting a specific percentage of emergency room patients, regardless of whether they needed hospitalization.
Who was behind the alleged scheme at HMA according to the report?
-Gary Nome, HMA's former Chief Executive, was singled out as being behind the scheme of unnecessary hospital admissions.
What consequence did doctors at HMA face if they didn't meet admission quotas?
-Doctors were reportedly told that if they didn’t admit 20% of patients, someone would get fired, indicating pressure to meet admission quotas.
How has the U.S. Department of Justice responded to these allegations?
-The U.S. Department of Justice has joined eight whistleblower lawsuits against HMA, targeting unnecessary hospital admissions and Medicare fraud.
What role did whistleblowers play in this investigation?
-Whistleblowers played a significant role, as the Department of Justice joined eight lawsuits brought by them, highlighting the issue of unnecessary admissions and Medicare fraud at HMA.
What is Gary Nome’s current role after leaving HMA?
-After retiring from HMA last summer, Gary Nome now runs a Mormon mission in Uruguay.
What type of fraud is HMA accused of engaging in?
-HMA is accused of Medicare fraud, specifically related to unnecessary hospital admissions to inflate revenue.
How large is HMA in the U.S. healthcare industry?
-HMA is the fourth-largest for-profit hospital chain in the United States.
What is the next step for the 60 Minutes show according to the transcript?
-The 60 Minutes show will return next week with another edition, as stated by Steve Croft at the end of the report.