In Brief: Ensign Settles Whistleblower Suit; First 5 L.A. Approves Initiatives
Ensign Group Settles Whistleblower Suit
The Ensign Group, the Mission Viejo-based operator of nursing homes and rehabilitation services, has agreed to settle civil federal charges of overbilling the Medicare program for $48 million.
The settlement was announced by earlier this week by the law firm Phillips & Cohen LLP, which has offices in San Francisco. It represented a former Ensign employee who filed two whistleblower suit against Ensign and its subsidiaries in 2006. Both suits were joined by the U.S. government, an action that often leads to a settlement before trial.
The suit alleged that six Southern California facilities operated by Ensign and its subsidiaries encouraged employees to admit Medicare patients and provide care that was not always medically necessary. Employees were rewarded with paid vacations for meeting what was termed “big, hairy audacious” revenue goals.
"The goals that administrators were required to set were 'audacious' not because they were overly optimistic but because the company was pressuring administrators to achieve goals that realistically could be met only by cheating Medicare," said Larry B. Zoglin, an attorney who is of counsel with Phillips & Cohen.
First 5 Los Angeles Commission Approves $13 Million For Initiatives
The First 5 Los Angeles Commission has approved $13 million for a variety of healthcare improvement initiatives in Los Angeles County, including $7.2 million to operate the ongoing Black Infant Health Program for the next five years. It also allocated another $4.9 million to help strengthen families in 14 communities countywide.
"The implementation of this plan creates a clearer pathway to strengthen the collaboration between First 5 L.A. and the Best Start communities," said Kim Belshé, executive director of First 5 LA. "Partnering with communities, First 5 L.A. is working to strengthen family capacities that support child well-being and promote systems change that will improve services and long-term outcomes for children, families in their communities."
First 5 L.A. also approved $500,000 to address birth outcomes in African-American households, which have a significantly higher infant mortality rate than other ethnic groups; and $600,000 to support fathers who are on probation or in foster care and have young children.
Radiology Group Joins Sutter Medical Foundation
Radiological Associates of Sacramento has agreed to fold its operations into the Sutter Medical Foundation, the medical group affiliate of hospital operator Sutter Health.
The transaction will be completed by Feb. 1, at which point RAS will provide radiological services to Sutter's patients in the Sacramento region, while its physicians will join the Sutter Medical Group. Terms of the transaction were not disclosed.
"Joining our two organizations makes perfect sense from a clinical value and patient quality perspective," said Jonathan Breslau, M.D., RAS Medical Group's president and chairman of the board.
