According to an article in the Boston Globe, the Beth Israel Deaconess Medical Center is under federal investigation for overbilling Medicare. The investigation has been underway since 2010 and was disclosed over the last six months. According to lawyers familiar with the investigation, if true, these allegations represent fraud. If intentional, the overbilling is not simply a civil matter, but constitutes criminal wrongdoing, and the hospital could be subject to criminal penalties.
According to the article: "Federal investigators have subpoenaed six years of records from Beth Israel Deaconess Medical Center as part of an investigation into whether the hospital overbilled Medicare by admitting patients for short stays who could have been treated less expensively as outpatients. Beth Israel Deaconess received a subpoena from the office of the inspector general of the US Department of Health and Human Services and the US Department of Justice, in 2010, the hospital disclosed in financial statements over the last six months." ...
"Thomas Crane, a partner at Mintz Levin in Boston, said “fraud recovery is going to be a significant contribution’’ to paying for the expansion of insurance coverage in the country, according to financial estimates in President Obama’s affordable care act. ... Paul Enzinna, a lawyer with Brown Rudnick in Washington, said: “Any individual case is a judgment call. What Medicare is worried about is a person saying ‘my stomach hurts’ and the hospital admits the person.’’ Civil penalties may be imposed when overbilling results from an oversight, he said, but when it is found to be intentional, hospitals may be subject to criminal fines. “If a hospital is putting pressure on doctors to do this upcoding, that is clearly fraud,’’ Enzinna said."
The Rest of the Story
This is a federal investigation of Beth Israel that is criminal in nature, conclusive (whatever that means) and non-political. The Beth Israel Deaconess Medical Center is the recipient of a FY2011 grant from the Susan G. Komen for the Cure Foundation. Therefore, according to the grant policies announced last Friday by the Susan G. Komen for the Cure Foundation, Beth Israel is no longer eligible for Komen Foundation funding.
I therefore expect that the Foundation will be making an announcement tomorrow that it is withdrawing its grant from the Beth Israel Deaconess Medical Center. After all, as it stated last Friday: "Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation."
Now we'll see whether the Komen Foundation was serious or whether it was just playing politics. Will it withdraw funding from the Beth Israel Deaconess Medical Center, as it now public knowledge that Beth Israel is the subject of a credible, non-political, criminal investigation by the federal government.
Obviously, the Komen Foundation is not going to rescind its funding of Beth Israel Deaconess. Why? Because it is not serious about this grant policy. The policy was never meant to be implemented across the board. It was designed as an excuse to de-fund Planned Parenthood. There was never any intention, I believe, of applying the policy equally across the board to all grantees. If there were, not only would grant funding have to be withdrawn from Beth Israel Deaconess, but it would also have to be withdrawn from Yale University, from Columbia University, from Penn State University, and from the University of California at Santa Cruz.
Unless the Komen Foundation announces tomorrow that it is withdrawing funding from the Beth Israel Deaconess Medical Center and these other university grantees, it will be clear to all that the revised grant policy was merely a hoax pulled on the public to make it look like the Foundation had a rational, fiduciary reason for its original grant policy, rather than the truth, which is that the Foundation implemented the policy specifically with an eye towards de-funding Planned Parenthood.
Ironically, the Komen Foundation's statement of last Friday emphasizes that politics should not play a role in the Foundation's activities: " We do not want our mission marred or affected by politics – anyone’s politics."
Sadly, the Foundation's mission continues to be marred by politics - its own politics. Despite the Foundation's rather weak attempt to disguise it, these politics are as obvious as an elephant in the room. And also sadly, there will continue to remain an elephant in the room for the Komen Foundation unless it comes forward and tells the truth about this sad affair. Breast cancer patients, Komen Foundation supporters, and women generally deserve nothing less.
I think that this quote from an article at AlterNet sums up the situation well: "This is already proving a disaster for the Komen Foundation. Once you institute an ideological litmus test for your funding decisions (and the group has no credibility on this front), people will begin to apply that same ideological litmus test to you. Now that the Komen Foundation has made it clear that their cancer research and prevention programs will be trumped by ideological motivations, I can't imagine why anyone wanting to donate money for anti-cancer efforts would not bypass them and give money directly to the groups that actually do that research and prevention."