Med Center continues review of physicians' billing procedures

and Maisie Wong Ongoing reform within the University Medical Center was not spurred by Medicare claims that Center physicians overbilled patients, according to William Kelley, chief executive officer of the University of Pennsylvania Health System. "Even before the audit began, we had an intensive program to enhance the reliability of [the Clinical Practices of the University of Pennsylvania's] billing systems to ensure compliance with billing requirements," Kelley said in a statement. And yesterday, Health System spokesperson Lori Doyle said the Center will continue to provide enhanced training for doctors and billing staff for all 19 CPUP divisions. She added that CPUP will attempt to strengthen the monitoring of its billing practices. Following last month's federal audit, the Hospital of the University of Pennsylvania agreed to pay $30 million to the United States Department of Health and Human Services to resolve claims that CPUP physicians falsified Medicare billing. Under the settlement agreement, CPUP is currently undergoing reformation of its billing procedures. Prior to the centralization of billing, each CPUP department handled its own bills and enacted individual policies. "That's why it's so important to centralize billing procedures to make sure we're in total compliance with government regulations," Doyle explained. She added that the Health System was working to design billing policies that would apply to the entire Medical Center. But she said the current goal "is to make our billing system function without error." Other parts of the compliance program are already underway, according to Doyle. At press time, however, she was not able to confirm whether the two hotlines required by the settlement were available or if the Health System had hired an independent auditing firm. This corrective action plan is regarded by the government as the "model compliance program," according to Doyle. She added that CPUP has been cooperating with peer institutions and offering them information about Penn's compliance program. Since the agreement issued last month called for the $30 million settlement to be paid within 30 days of the execution of the agreement -- making the due date January 11 -- CPUP has already paid the $30 million through electronic fund transfers. But Doyle emphasized that "just because we paid the $30 million doesn't mean that we are guilty." According to the agreement, CPUP decided to settle the matter with the federal government in order to avoid the "expense, burden and uncertainty of litigation." Doyle added that, if necessary, CPUP will take full responsibility for the alleged billing errors and is taking steps to correct any mistakes that may have occurred. Since the incident occurred only a month ago, it is still too soon to determine the effect it will have on the reputation and ranking of the School of Medicine or the rest of the Medical Center, Doyle said. University President Judith Rodin declined to comment on the issue.