"What's that you say Joe DiMaggio...."

12/19/2017

Once again, for those new to this blog site, at present there are 46 posts on the blog and each has its own set of comments. To read the comments you have to hit the word "Comments" at the beginning or end of the post. Somewhat confusing is that when you bring up the comments for a specific post it eliminates the other posts from the screen. To bring the other posts back up simply go back to the top of the page and click on Blog. Feel free to comment should you wish. No email address is required to make a comment so anonymity is strong. Due to some previous abuse of this right to anonymously comment, I have had to include an approval option, but I try to approve within 24 hours. One last point of note, to read the earliest posts you have to click on the word "<<Previous" at the very bottom of the posts available. Finally, for those just looking for a good summary of the Dr. Kearney case, simply scroll down to the previous 12/10/2016 post. For social media developments on the Dr. Kearney situation I would encourage you to visit the excellent "Save Dr. Kearney Facebook Page":
https://www.facebook.com/search/top/?q=save%20dr%20kearney

Happy Holidays to all.

16 Comments

Deep End

12/19/2017 03:58:27 pm

Sorry but I am confused. The role UK Cardiology played in the prosecution of Kings Daughter. KDMC was notorious and well known for inappropriate procedures and got what they deserved. If UK cardiologists played a role they would have gotten money for it as whistleblowers which was never reported. Similar to Baptist cardiologists who blew the whistle on St Joe's London:

http://www.kentucky.com/living/health-and-medicine/article44468736.html

So there is nothing wrong with this. Appears that the author of this blog post is grasping as straws. If UK exposed KDMC for their illegal activities, good for them. It was needed.

Wow

12/20/2017 07:57:33 am

This is taking your conspiracies theories to an entirely new level... The truth is out there!.

Dan Noonan

12/20/2017 10:58:56 am

Thanks for the comments Deep End and Wow. From the speed and intensity of your response, it kind of looks like I might have touched a nerve with this one. I am sure you are right in your declarations of innocence and altruistic behavior on the part of UK Healthcare. I mean what could hospitals like UK and Central Baptist ever have to gain by St. Joes going under? Nothing right?

Then there is St. UK HealthCare/KMSF and UK’s Hazard Cardiology that amid secrecy did what? Oh yeh, wasn’t it, they paid 4.1 million dollars to Medicare and Medicaid to resolve billing issues (http://www.kentucky.com/news/local/education/article81581847.html). Well at least it wasn’t 16.5 million like those thieves over at St. Joes.

Finally, it appears that we can agree on one thing, that being “exposing fraud in hospital management and billing” is a good thing. I feel certain Dr. Kearney (but perhaps not some of UK HealthCare and KMSF’s upper administration and their lawyers) would agree.

12/20/2017 02:04:09 pm

Again I am confused. If General Motors was building cars that were accident prone, and Toyota uncovered the scandal and told the government about it, would that be a bad thing?

Of course every competing hospital system in the state has a vested interest in seeing the criminality of Kings Daughters exposed. And if they helped expose it, good for them.

We should congratulate the cardiologists at Central Baptist who blew the whistle on St Joe's London.

Again, the author of this blog post must be getting pretty desperate....

12/20/2017 11:14:12 am

Firstly the Hazard cardiology payback was not about unnecessary surgical procedures, it was about effectively bundling the costs of basic physical exams with the cardiology services. And its essentially settled. So there is zero possibility of the DOJ picking this up as a Qui Tam suit. Maybe it could be a bovis stercus suit?

Secondly, the only specific whistleblowing Kearney did was about the practice plan committee not meeting in strict accordance with the AR. He didn't know anything about the Hazard Cardiology matter at time and is only pushing this as a retrospective reason for his loss of clinical privileges. That's not going to fly in court.

Thirdly yes the DOJ looked at who was getting stents at other hospitals in the state/region and also asked other interventional cardiologists to look at some of the Kings Daughters cases "blinded" to determine if they would have placed stents. This did involve some of the interventional faculty at UK. Its frankly offensive that you are suggesting these individuals didn't provide a fair assessment. I'm not even sure that they would have known anything other than that the cases were from another regional hospital.

So, yes, I am afraid you are really clutching at straws here.

However, the fact that a professional crime writer and big time conspiracy theorist is also interested really kicks this up to another level. Lets hope he writes a book about the Kearney case and someone makes a movie of it!

12/20/2017 02:58:57 pm

Thanks for the comment Wow. Wow Wow, I love all of the lawyer speak you provide here. It really supports the contention that this stuff touches a nerve. I must confess, the problem I have with lawyer speak is that it has me constantly checking my back pockets.

I guess to begin with, with regards to the billing issues, I am only quoting the Herald Leader article:

“But in the past year, UK HealthCare and its billing arm, the Kentucky Medical Services Foundation, have paid $4.1 million to Medicaid and Medicare, and $1 million to David Douglass, a Washington, D.C. lawyer who specializes in federal health care issues, to resolve billing issues involving the Hazard cardiology practice.”

Hmmm, I also love how you read so much into my few questions and statements. For example, nowhere in my brief statement did I say or infer that faculty at UK didn’t provide a fair assessment of whatever cases might have been brought before them. Well anyway, your exculpatory knowledge of these proceedings probably usurps anything I might provide.

Oh but I do like your suggestion that someone make a movie about the Dr. Kearney case. It is your idea and I don’t want to be accused of stealing it, so why don’t you simply tell us your name and I will pass it on to any producer or director that might contact me about this possibility.

Will

12/21/2017 04:30:23 am

Thanks for adding some life to the blog. I’m with you on this one Dan. UK HealthCare is clearly not the saint that Deep End would like us to believe them to be. I think they got off easy with the $4,100,000.00. With regard to the Kearney case, I’m of the opinion that it all started back at that Faculty Council meeting wherein he suggested the audit of KMSF. Common, you don’t do all the things they did to him simply because he used improper language in a trauma ward while attempting to save some persons life. Furthermore you do not spend hundreds of thousands of dollars to block every attempt to access KMSF records though open records laws if you don’t have anything to hide. You want to shut everyone up then simply allow that public audit of KMSF (essentially taxpayer money). What the hey, you’ve had nearly 3 years to cook the books.

12/21/2017 07:41:39 am

Thanks for the comment Will. I tend to agree with you. The Faculty Council discussions concerning the mystery Practice Plan Committee and its potential for mismanagement of UK HealthCare/public university revenue resulted in the EVPHA requesting a special meeting of the Faculty Council to discuss a “legal matter”. This by itself points to a legal concern with respect to what was being discussed by the Council. Then we had the suggestion by Dr. Kearney at this special meeting of the Faculty Council that a public audit of KMSF might help clarify the concerns aired. This of course resulted in the statement made by the EVPHA that multiple people interpreted as a threat and subsequently a statement by the university lawyer (General Council Bill Thro) attending this meeting that in essence suggested this matter was none of the Faculty Council’s business. Very shortly after that we had the extreme UK HealthCare/KMSF employee organized vendetta against Dr. Kearney that resulted in his loss of clinical privileges, expulsion from the university and a variety of other absurd mandates. They even went so far in their character assassination to tell the folks in his office area that he was considered a “dangerous person”. Again, this was all predicated upon a behavior that these administrators endorsed for over 25 years with outstanding performance evaluations, tenure, promotion to full professor, an endowment and a variety of teaching awards. So I guess the courts will have to decide whether or not this was retaliation. They also will probably need to clarify whether the concerns with respect to KMSF financial mismanagement as it was aired through the avenue of the Practice Plan Committee might also extend to other areas such as the Hazard debacle and who knows what else. Like you, I feel the university and UK HealthCare’s willingness to invest huge sums of money for outside lawyers to fight the public audit of KMSF only fuels the fire with respect to the financial mismanagement issues, and with it the attempts to silence Dr. Kearney.

12/21/2017 07:47:21 am

Just an FYI. As mentioned in previous posts, I tend to automatically delete comments that are overly insulting or use crude language.

S. Claus

12/21/2017 10:35:44 am

Just a few tidbits of what Santa has heard about the role UK Cardiology played in the prosecution of Kings Daughter. Dr. Paulus, the cardiologist who was at the center of this was exonerated in Federal Court by Judge Bunning. There were many experts who supported Dr. Paulus. The major prosecution witness against Dr. Paulus was UK’s David Moliterno MD. Although maybe of no relevance, I think it also interesting to note that the wife of Assistant US Attorney Andrew Sparks who prosecuted KDMC, is an employee of UK Cardiology.

Although this may not have been a factor, UK did stand to gain many referrals with the destruction of a major regional competitor. By the way, the fine paid by KDMC was for the way they unbundled and billed for the procedures, not whether or not the procedures were indicated. Dr. Paulus did the procedures, not the billing. This was technically not a whistleblower case. This was more like a Cardiologist at UK throwing another Cardiologist in UKs referral basin under the bus. If Dr. Moliterno thought the procedures were unindicated he should have provided an expert outside of the region to weigh in. That avoids the conflict of interest question.

Ho, Ho, Ho, Merry Christmas to All

12/21/2017 10:53:45 am

Thanks for taking the time out of your busy day to comment on the blog. It sounds like you know more about this than I may even wish to know, so I will leave it at that. Merry Christmas to you, Mrs. Claus and all of your helpers.

Elf on the shelf

12/23/2017 09:15:15 am

UK is no saint. I'm waiting to see how all this works out, but examples of fraud at UK are rampant.

1. Doctors regularly allow their extenders and residents to log-in to the EMR under their username in clinic to boost their RVU totals...thus increase their bonuses and allowing for higher billing rates. Administration turns a blind eye because it bring in more money.

2. There is surgeon that has not scrubbed into a surgery in over 2 years. Sometimes he doesn't even show up in the room. A patient had a problem in the OR a while back and it took almost 2 hours to reach him. All this was covered up in the interested of money and productivity.

3. Another surgeon, who routinely operates on two patients simultaneous with the help of residents, has been unbundling procedures for years in order to increase billing. He's savvy though, he specifically limits the number of medicare patients he will operate on as to not raise flags.

Sickening that this is our academic institution.

I have everything I need to take the place down. However, I think Kearney has beat me to it. GO KEARNEY!

12/23/2017 11:28:11 am

Thanks for the comment Elf and Merry Christmas to you and your family. Interesting post. Not being a physician I know little about this stuff, but I do remember when I was on Faculty Council that the physician faculty on that council aired concerns that the RVU system tended to emphasize quantity of care, which could have an impact on quality of care.

From a personal perspective, as I have detailed in a comment on an earlier post, while at UK I had what turned out to be an unnecessary knee surgery performed on the wrong part of my knee. When I noticed that the surgeon who I expected to be doing the surgery had not signed off on the surgery, I asked an acquaintance I knew who was part of the surgery team whether or not the surgeon was present for this surgery. This person replied, "you did not hear this from me, but Dr. X sometimes never even shows up for these surgeries." Although Donald Trump may call all of this "Fake News", the university was concerned enough about it that they told me I could go out and have my continuing knee problem serviced by whomever I wanted and they would cover the cost.

Still a man hears what he wants to hear and disregards the rest

1/8/2018 09:32:32 am

Moliterno was one of 14 other physicians who provided expert testimony for the Paulus case.

Do you think all of these physicians were acting on behalf of UK Healthcare to put a competitor out of business?

Would it help if I put a swear word in so you can have a reason not to post this?

https://www.leagle.com/decision/infdco20170308g38

The Government presented both direct and circumstantial evidence against Dr. Paulus. The Government's primary evidence consisted of angiograms and medical records of Dr. Paulus's patients, as well as expert opinion testimony by Dr. Ragosta,6 Dr. Moliterno,7 Dr. Morrison,8 and Dr. Ali9 that Dr. Paulus's angiogram assessments were incorrect and that the stent procedures were unnecessary. The Government also called several other physicians, including six cardiologists10 and one neurologist,11 who testified that they believed Dr. Paulus performed unnecessary procedures. The Government also presented testimony regarding the American College of Cardiology standard for stenting coronary blockages and details of payer requirements for stent procedures. (Doc. # 245 at 4) (citing Doc. # 200 at 14-15 (Dr. Robert Touchon); Doc. # 206 at 35-46 (Dr. Arshad Ali); Doc. # 195 (Dr. Earl Berman); Doc. # 198 (Lee Guice)). Additionally, the Government called several of Dr. Paulus's patients who "testified that he made statements about their conditions that were either inconsistent with the procedures he performed, or that were later shown to be false by other physicians."

1/9/2018 08:21:01 am

Well just for clarification purposes, one last response to a comment made in this missing post. Thank you for your comment Still, and I apologize for the delay in my response and for only posting a response to the last of your many other comments sent in the past week or so. They all basically aired the same message/complaints. Before I respond I would like to also state that for “private reasons” I removed this blog post. This does not mean that I am shutting down the blog, but rather waiting till matters more germane to the Dr. Kearney case surface. So in other words, keep monitoring.

I opted to put up this last comment simply because I see that Still/Wow obviously views some of the comments made by others in this post, especially those targeting Dr. Moliterno, to be unfair and/or unjust. Being a retired basic scientist, I really have no horse in this race for UK’s credibility, other than the peripheral relationship it may have on the matter of UK’s lack of transparency, distortion of due process and clear attempt to destroy the career of a university faculty member predicated upon a behavior that they have signed off on and therefore endorsed for over 25 years.

First off I would like to thank Still for supplying this URL to Judge Bunning’s Opinion and Order on the Dr. Paulus court case. It is an interesting read. As I mentioned before, this is completely out of my area of both legal and medical expertise, but in looking over this document I would be willing to agree with you on your defense of UK/Dr. Moliterno, in that he was one of many physicians that testified in this court proceeding. Having said that I must also add that it would appear to me that Mr./Ms. Clause’s point in his/her comment was not with regards to the number of physicians testifying, but rather to the competitiveness of the facility the testifying physician worked at with respect to KDMC. If all or most of these testifying doctors likewise worked at competing facilities then your point is a valid one. But then again, should that be the case, I have to wonder if any of this played out in Judge Bunning’s verdict below.

Although I would tend to agree that after reading this testimony by these physicians that I would probably never think of going to Dr. Paulus for my cardiac care, I think it also important to point out Judge Bunning’s “Conclusions and Orders” resulting from these proceedings:

“DAVID L. BUNNING, District Judge.

Defendant Richard E. Paulus, M.D. has filed three motions, which are currently pending before the Court: a Motion for Judgment of Acquittal (Doc. # 220), a Renewed Motion for Judgment of Acquittal (Doc. # 263), and a Motion for a New Trial (Doc. # 298). The Government has filed its Responses (Docs. # 245, 300, and 306), and Dr. Paulus has filed his Replies (Docs. # 304 and 309). The Court having heard oral argument on February 22, 2017, the motions are ripe for review.1 For the reasons stated herein, Dr. Paulus's Motion for Judgment of Acquittal (Doc. # 220) will be granted.2 Accordingly, Dr. Paulus's Motion for a New Trial (Doc. # 298) will also be conditionally granted.”

If I read this summary correctly, this order, in spite of all of these government witness testimonies against Dr. Paulus, acquits Dr. Paulus of the majority if not all of these medical practice related charges placed against him. One can only conclude from this that Judge Bunning felt, for whatever reason, that this testimony and evidence did not provide enough real merit to take these issues and this person to court.

Does this involve kmsf?

2/16/2018 11:32:57 am

Critics say UK abused power by having state collect debts. Judge orders it to stop.
http://www.kentucky.com/news/local/education/article200482274.html

Your comment will be posted after it is approved.

"What's that you say Joe DiMaggio...."

Leave a Reply.

UKy College of Medicine Discussions