Mercy Payments


This is story is as interesting as it is crazy. It seems that Mercy Springfield Communities last week had been paying more than 250 physicians bonuses that violated the law.  Pediatricians were getting bonuses up to $48,000 per doctor per year in the 2013 fiscal year.  The system had to pay the Feds over $5 million but admitted no wrongdoing and they went on record stating that none of the physicians had any knowledge of what the system dubbed an “accounting error.”

No wrongdoing?  Accounting error?  Child, please.  There are 30 administrators to one doctor in hospitals and these guys fudge numbers all day (in between eating bagels, drinking coffee, having meetings and going on vacation).

Here is what Mercy did.  They set up up a bonus structure for some of its doctors that violated the Stark law and the anti-kickback statute.  How it worked was that physicians who were specialists in the clinic system were “taxed by the Clinic such that a portion of their profits were redistributed to primary care physicians”, which resulted in “PCP value payments” to primary care physicians within the clinic network of about $23,000 annually.

PCP value payments!  I just love the “administralian” language.  Make up a term and it sounds real.  What does it mean?  Well, as far as this article goes, they believe that these payments were “not linked to productivity” and were paid only to certain categories of physicians. Who were those docs?  Well, they were the ones who “routinely refer patients for procedures and hospitalization to the hospital owned and operated by Mercy Health.”

So, to sum this up.  You get “PCP value payments” if you refer to the hospital owned specialists.  You’re a good doctor for keeping referrals in the family, so here is some money.

This is just another example of why doctors being employed by hospitals is an unholy marriage.  By, the way, you can calculate the numbers but $23K x 250 doctors is $5.75 million.  So, their penalty is less than what they were paying in bonuses in one year and this has been going on since 1999.  Guess who really won here?   No administrators got fired for this andI bet they got bonuses for this “PCP value payment” scam.

If you have a similar story please send them my way.  It will be kept anonymous.

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