HFMA News Feb 2005 - Wyatt Tarrant & Combs LLP

Kentucky ChapterJune – July, 2006Upcoming EventsSummer InstituteJuly 27–28, 2006LouisvilleFall InstituteSeptember 28–29, 2006LexingtonMid-Atlantic RegionInstituteO ctober 22–25, 2006Richmond, VirginiaA/R WorkshopNovember 17Lexington.LTCAprilSan DiegoIn This Issue1 Report from ANI2 President’s Letter3 Meet a New Board Member4 DRA’s New False ClaimsRequirements6 Chapter Receives Awards6 US Supreme Court LimitsMedicaid Recoveries inPersonal Injuries SettlementsFor more news see thechapter websitewww.hfmaky.orgReport from ANI By Larry VaughnMany chapter members attendedHFMA’s Annual National Institute(ANI) in Orlando June 18 to 21. Itseemed each person attending foundthe sessions to be highly informative,the networking opportunities numerous,and the general session speakers“...Don’ t back down. Don’ t getout hustled. Have courage inyour leadership....”rewarding. Highlighting the generalsessions were 60 Minutes correspondentLesley Stahl, conservative commentatorDavid Gergen and Orlando Magic seniorvice president Pat Williams. Allspoke about leadership. In addition,Fred Lee spoke to the assembly at thefinal luncheon on lessons he learnedand included in his book entitled “IfDisney Ran Your Hospital: 9 ½ ThingsYou Would Do Differently.”HFMA Chairman Joe Fifer’s themefor the upcoming year is “Courage inLeadership.” Fifer said, “Healthcare isin dire need of courageous leaders. Onthe one hand, Main Street demands weprovide higher quality and safer patientcare. Wall Steet demands better financialperformance. On the other hand,we’re accused of cutting corners, notmeeting charity care needs, and on theother hand, we’re accused of havinglimited business savvy and out-of-controlcosts…We have margin pressures,capital demands, competitive pressure,physician relationship challenges.” Ifyou, as a healthcare leader, Fifer says,pick your battles carefully and thinkbefore you speak, your efforts willalmost always be appreciated.Fifer also said it’s time for HFMAto take on the biggest challenges in thebusiness of healthcare, such as consumer-directedhealth care, universaladoption of electronic health records,helping professionals inhealthcare finance and cliniciansspeak a commonlanguage, and workingto build practical strategiesfor serving the uninsured and providingcommunity benefit.“It’s time for us to use the tools thatHFMA provides to explain healthcarecosts and prices to the public and thebusiness community,” Fifer says.Healthcare professionals shouldn’t shyaway from discussing how financeworks in the healthcare industry.“HFMA can supply the tools. However,we cannot supply the courage necessaryto tackle these issues in a forthright,constructive way. That’s where yourcourage comes into play,” he says. Insummary, he said to each HFMA memberpresent and to you and I here inKentucky, “Don’t back down. Don’t getout hustled. Have courage in your leadership.Do the thing you think you cannotdo. It’s the right thing for yourcommunity, your organizations, and foryou.”Next year’s ANI is June 24 to 27,2007 in San Diego. Plan now to attend.The sessions, education, networkingand experience will reward you richly.❖

Page 2Financial ScenePRESIDENT’S MESSAGE Bob BarbierHowdy HFMA members!It’s that time of yearagain when the KentuckyChapter officers change andAfter tons of training sessions weclosed with Terry Paulson, PhD, author ofThey Shoot Managers, Don’t They? Followingare some of his borrowed pearls of wisdom:How can the chapter help you meet your goals by being more knowledgeable,proficient, networked, mentored, connected or faster?Financial SceneNewsletter Committee MembersSteve Price, Chairsprice@wyattfirm.comLarry Vaughn, Vice Chairjlvaughn@chc.netRonda BeckKatie BlackSteve MillerMike StiglerMelanie WatsonEditorial MissionFinancial Scene supports the mission of theKentucky Chapter by serving as a keyresource for individuals involved or interestedin the financial management of healthcare.Editorial PolicyOpinions expressed in articles or features arethose of the author and do not necessarilyreflect the view of the Kentucky Chapter,the Healthcare Financial ManagementAssociation, or the Editor. The Editor reservesthe right to edit material and accept or rejectcontributions whether solicited or not. Allcorrespondence is assumed to be a releasefor publication unless otherwise indicated.Publication O bjectiveFinancial Scene is the official publication ofthe Kentucky Chapter HFMA and is writtenand edited principally to provide memberswith information regarding Chapter andnational activities, current and useful news ofboth national and local significance, informationabout seminars and conferences andnetworking with colleagues, and to serveas a forum for the exchange of ideas andinformation.Article SubmissionFinancial Scene encourages submission ofmaterial for publication. Articles should betypewritten and submitted electronically tothe Editor by the deadlines listed below. TheEditor reserves the right to edit, accept orreject materials whether solicited or not.HFMA Founder Points are granted for anyarticles published in Financial Scene.Deadline for Articles:September 1, 2006November 1, 2006January 1, 2007March 1, 2007everyone begins thinking about vacationand making sure they plan to attend thesummer institute in Louisville July 27 and28 at the Marriott East. I am excited to bethe chapter president this next twelvemonths, although I feel like the theme songfrom the movie Bandit, “We got a long wayto go and a short time to get there.” So let’sput the pedal to the medal and giddy up go.I want to start by saying “Thank you!”to Michele Lawless and the outgoing 2005-06 officer group who not only covered all ofthe Davis Chapter Management bases, buthad some fun, too. In recognition, we collectedsome education honors at the awardsbanquet in June at the Annual NationalInstitute (ANI) in Orlando. The excitingdetails are included later in this newsletter.A group of incoming officers attendedthe Leadership Training Conference (LTC)in sunny Huntington Beach, California. Itwas truly a privilege to attend this year as wewere treated to Ms. Erin Gruwell as thekeynote speaker. She told us the story of hertrying to teach the unteachable at an innercity high school in Los Angeles. Somehowshe was inspired to throw out the cannedlesson plan and replace it with the Diary ofAnne Frank and related Anne’s horrific lifeto their current day challenges of teenagepregnancy, drugs, poverty, gangs and murder.The incredible story of their success ischronicled in The Freedom Writers’ Diary. Ihope we all have a bit of Erin Gruwell insideof us. This is the year for it to emerge.“Only the paranoid survive.” Andy Grove.“Always do what is right. It will gratify mostof the people, and astound the rest.” MarkTwain. “You miss 100% of the shots younever take.” Wayne Gretzky.Upon our return we held a mini LTCwhere the new officers, board members andcommittee chairs worked on our three prioritiesfor this year: education, communicationand quality improvement. We coveredin detail the Helen Yerger award applicationprocess. Ms. Yerger was one of the foundingmembers of HFMA. Yerger awards aregiven for identifying and meeting the needsof the chapter. The first step is needs identification.Here is where you come in to theprocess. Let us know now what your goalsare for this year. How can the chapter helpyou meet your goals by being more knowledgeable,proficient, networked, mentored,connected or faster? Let’s work together onachieving your goals.In closing please mark your calendars:Summer Institute July 27–28 in Louisville.Fall Institute September 28–29 inLexington. Mid-Atlantic Region InstituteOctober 22–25 in Richmond, Virginia.A/R Workshop November 17 in Lexington.By the way, next April the LTC is inSan Diego. Officers and board members areinvited. You might want to think about volunteering.Let’s have a great year.HFMA National’s On-line Membership DirectoryHave you visited HFMA National’s On-line Membership Directory lately? Here’s thelink: http://www.hfma.org/dual_login.cfm. When you select “HFMA Directory” notonly can you search for members of our chapter, you can also search for all of yourHFMA colleagues by name, company, and location — regardless of chapter! Youmay also view your current contact information and make edits to your profile, aswell as view any products you have ordered, events you have registered for, yourCPE credits, your Founders points, and more!hfma.orgIt is vital that HFMA has your correct information, so please take a moment to viewyour record now. By doing so, you will ensure that HFMA continues to provide youwith valuable information and insights that further your success.

Financial Scene Page 3Meet a New Board Member: John BurgettI grew up nearEdinburgh, Indianaand went to IndianaUniversity where Ireceived a B.S. inaccounting and aMBA. I passed theCPA exam in 1975and have held CPAlicenses in Indiana and Missouri. I startedmy professional career with the IndianaFarm Implement Dealers Association, travelingsouthern Indiana doing financialstatements and tax returns for Implementdealers before landing a job as a cost reportauditor with Indiana Blue Cross in 1971. Ileft the Blues in 1983 to work for Ernst andWhinney’s (a predecessor firm of Ernst andYoung) St. Louis office. I left Ernst tobecome the first Chief Financial Officer ofTricounty Community Hospital (nowBaptist Northeast Hospital). I have alsobeen Chief Financial Officer of MarymountMedical Center and Our lady of the WayHospital. I am now the Team Leader forFinance and Chief Financial Officer ofBaptist Regional Medical Center in Corbin,Kentucky.Baptist Regional is a 240 bed RuralReferral Center with Adult, Adolescent, andChemical Dependency Psychiatric services,a Rehabilitation unit as well as inpatientand outpatient medical and surgical services.Corbin is about eighty miles south ofLexington on Interstate 75.My wife Shelley and I have been marriedfor thirty-four years and have two sons,James and Gregory and one granddaughter,Celeste. Shelley is director of library servicesfor Somerset Community College. Weenjoy traveling and spending time with ourfamily.I enjoy reading and listening to musicand the radio in my free time. I have read allof the Tony Hillerman, James Lee Burkeand Elmore Leonard novels and the HarryPotter series. My musical tastes run to folkand old time rock and roll. I try and go to aconcert or two each year and have recentlyseen the Rolling Stones, Bob Dylan, TheSmothers Brothers, and Jimmy Buffett. Ihave both Sirius and XM radio licenses andlisten to one or the other almost everyday. Ilike the various public broadcasting feedson Sirius and the major league broadcastsand Wolfman Jack rebroadcasts on XM.I have been a HFMA member since1983 when I joined the Southern Illinoischapter. I passed the fellowship exam in1986 and became a fellow the same year. Ihave been a board member of the Kentuckychapter on two previous occasions and amember of the National Matrix in 1991. Ihave served as chair of the of the careeradvancement committee on several occasionsand often help teach the coachingcourse for the fellowship exam.I value my membership in HFMA andbenefit from my participation in it. I havemade a lot of good friends in the Kentuckychapter and in other chapters around thecountry. I consider the meetings a good useof my time.Members on the MoveTodd Dougan, CPA of Madisonville, KYhas joined Wellmont Health System inKingsport, TN as Senior Vice Presidentof Finance and Operations, For-ProfitEntities. Wellmont Health System isa healthcare provider in NortheastTennessee and Southwest Virginia,consisting of five hospitals, over 600medical staff, and ancillary services.KY HFMA ChapterLeadership 2006–2007Officers and DirectorsPresidentRobert (Bob) BarbierUniversity of Louisville HospitalPresident ElectDavid E. TateBKD, LLPImmediate Past PresidentMichele LawlessCommonwealth Health CorporationVP EducationDale SkaggsBlue & Company, LLCVP CommunicationBill JonesMethodist HospitalVP Membership ServicesKaren DonahueJewish Hospital Medical Center EastTreasurerChris WoosleyBKD, LLPSecretaryCindy SharpFloyd MemorialDirectorTommy PateyARH-MiddlesboroughDirectorJohn BurgettBaptist Regional Medical CenterDirectorBob Steltenpohl, CPARegional Network of Jewish HospitalHealthCare Services, Inc.DirectorTheresa SchollClark Memorial HospitalWant to PlanAhead?ANI 2007Marriott HotelJune 24–27, 2007San Diego, CA

Financial Scene Page 5The DRA’s New False Claims RequirementsContinued from page 4not, however, use the terms “false claim” or“whistleblower protection.” Likewise, thecodes generally do not specifically discussfederal and state false claims laws that maygive an employee a right to bring a falseclaim lawsuit wherein the employee mayshare in false claims recoveries and a rightto be protected from retaliation by theemployer for bringing such a lawsuit.Many providers have shied away fromsuch discussions and instead have encouragedeither reporting the perceived violationto a supervisor, to the complianceofficer, or to a hotline where the reporter’sidentity is protected. This allows theemployer to investigate and, if necessary,take corrective action. Providers can andshould continue to encourage internalreporting methods as the primary meansfor an employee to address perceived violations.At the same time, however,affected providers also will need to discussfalse claim and whistleblower remediesmore specifically.As one might gather, there are somegrey areas in how states will implement theDRA’s false claims provisions. CMS haspromised states further guidance. In themeantime, providers should consult legalcounsel to obtain advice about how toproceed well in advance of January 1,2007. If providers do implement changesto written policies, conduct codes or otheremployee handbooks before January 1,2007, however, additional revisions maybe necessary in 2007 if Kentucky passes anew false claims law. For more information,contact Kathie McDonald-McClure,Wyatt, Tarrant & Combs, LLP, 500 WestJefferson Street, Suite 2800, Louisville,Kentucky, direct dial (502) 562–7526 ore-mail kmcclure@wyattfirm.com.This information is a summary of oftencomplex legal issues and may not cover all the“fine points” related to a specific situation orcourt jurisdiction. Accordingly, it is notintended to be legal advice, which shouldalways be obtained in direct consultationwith an attorney.1 Pub. Law 109-171, Chapter 3, Sec. 6032, to becodified at 42 U.S.C. 1397.2 Pub. Law 109-171, Chapter 3, Sec. 6033, to becodified at 42 U.S.C. 1396a(a)(68).3 31 U.S.C. §§ 3729 – 3733.4 31 U.S.C. §§ 3801 – 3812.5 For Kentucky, see KRS § 205.8463.6 31 U.S.C. § 3730(h); KRS 205.8465(3).2006–2007 HFMA Officer InstallationImmediate Past President – Michele Lawless, President – Bob Barbier, VP ofEducation – Dale Skaggs, President Elect – David Tate, VP of Member Services– Karen Donahue, VP of Communications – Bill Jones, Secretary – CindySharp, Treasurer – Chris Woosley.2005–2006Committee ChairsAccounts Receivable Focus WorkshopLynn Leavittlynn_m_leavitt@sjhlex.org • 859-313-4633Certification/Career Advancement ChairRobert Mitchellrmitchell@arh.org • 859-226-2537CFO ForumJoe Grossmanjgrossman@arh.org • 859-226-2468Corporate Sponsorship ChairAndy Strausbergandrew.strausberg@nortonhealthcare.org502-629-8269Entertainment ChairShawn Adamsshawn.adams@ey.com • 502-585-6621Forum for Members New to HealthcareChris Roszmancroszman@bkd.com • 502-581-0435Information Systems ChairBill Leachmanbleachman@bkd.com • 502-581-0435Membership ChairElaine Younceedyoun2@email.uky.edu • 859-257-9521Membership Directory ChairTheresa Scholltheresa.scholl@clarkmemorial.org812-283-2442Newsletter ChairSteve Pricesprice@wyattfirm.com • 502-562-7305Past Presidents Advisory ChairDavid Kottakdkottak@bkd.com • 502-581-0435Rural Healthcare & Reimbursement ChairMike Stiglermstigler@blueandco.com • 502-992-3500Student Membership ChairScott Reedsreed@blueandco.com • 502-992-3500Yerger Awards ChairMelanie Watsonmwatson@tjsamson.org • 270-651-4820

Page 6Financial SceneChapter Receives Awardsby Michele LawlessLast week I was fortunate to attend theHFMA Annual National Institute inOrlando Florida. On Monday night I wasproud to represent the Kentucky Chapter atthe Annual President’s Dinner where wereceived six awards for the services we providedto Chapter members over the 2005-2006 year. The awards presented to thechapter were:• John M. Stagl Silver Award forExcellence in Education — TheChapter received this award formeeting a goal set by NationalHFMA to provide greater than15.06 registrant education hours perChapter member. With a grand total9,050 registrant education hours,the Chapter provided 16.45 registranteducation hours per Chaptermember.• C. Henry Hottum Award forEducational Performance Improvement— The Chapter received thisaward by exceeding the goal set byNational HFMA to increase educationhours by 7.1%. The Chapterincreased total registrant hours by37.04% from 6,604 hours in2004–2005 to 9,050 hours in2005–2006.• Yerger Award for Education —Accounts Receivable focus Workshop.This past year we added afall Accounts Receivable focusWorkshop to the educationalagenda. The Workshop was a greatsuccess with approximately 172attendees.• Yerger Award for Education —Online Registration and EducationManagement System. The chapterimplemented online registration thispast year as well as an EducationManagement System that significantlyenhanced the way we handleeducation registration.• Yerger Award for Education —Collaboration with KHA on aneducational event. KHA andHFMA wanted to provide educationto critical access hospitals thereforewe collaborated with KHA to bringJohn Sheehan, a nationally renownedspeaker on the subject to theSpring Educational Meeting.• Yerger Award for Collaboration —Region 4 Mid-Atlantic Conference.Chapter received this award for collaboratingwith the other chapters inRegion 4 on the Mid-AtlanticConference.I thank all members, vendors, and allwho participated in the chapter this pastyear. The level of participation amazed me.So many individuals were ready to jump inand make sure that things were done properly.It takes many volunteer hours to provideso many services to the members!US Supreme Court Limits Medicaid Recoveries in Personal Injuries Settlementsby Kathie McDonald-McClure, Esq.On May 1, 2006, in ArkansasDepartment of Health & Human Services, etal. v Ahlborn, Case No. 04-1506, theUnited States Supreme Court held that astate cannot assert a Medicaid lien on personalinjury settlement proceeds that arenot attributable to medical costs. In addition,the Court held that the ArkansasMedicaid recovery statute violated the federalMedicaid anti-lien law to the extentthat it allowed Medicaid to recoup the nonmedicalportion of settlement proceeds.The Court rejected the state’s argumentthat parties could manipulate the settlementto reduce Medicaid’s recovery, particularlywhere the state does nothing morethan move to intervene so it can file a lienon any judgment or recovery in the action.In Kentucky, the Cabinet for Health &Family Services may recover its medicalpayments on behalf of a Medicaid recipientfrom any third party who may be liable forthe recipient’s injury, disability or death.KRS 205.624. Kentucky law automaticallysubjects “any settlement, judgment, oraward obtained by a recipient or the recipient’slegal representative against a thirdparty” to the Cabinet’s claim. KRS205.626(2). The recipient’s attorney mustnotify the Cabinet when filing a personalinjury action. KRS 205.629. Once notified,the Cabinet may either intervene or join inthe personal injury action or allow theMedicaid recipient to proceed withoutbeing joined to the action. KRS205.624(2)(a). A Medicaid recipient shallnotify the Cabinet of any settlement orjudgment of the action. KRS205.624(2)(b). The Kentucky statute doesnot limit the Cabinet’s recovery in the personalinjury lawsuit to only those medicalcosts recovered via settlement or judgment.Moreover, the statute deems a recipient tohave assigned his or her rights to third-partypayments to the extent of the Cabinet’s paymentof medical assistance on behalf of therecipient. KRS 205.624(1).Large Medicaid liens often lead tolarge settlements because states traditionallyhave asserted a right to full recoveryfrom any settlement. Perhaps the Ahlborndecision can be used to temper this resultand bring settlement costs down. Shouldthe Kentucky Cabinet seek full recovery ofa Medicaid claim irrespective of the medicalcosts recovered in the settlement orjudgment, the parties can refer to theAhlborn decision for guidance. It’s noteworthythat in Ahlborn, the settlementagreement did not allocate its proceedsbetween medical and non-medical costs.Nevertheless, the Court reduced the state’srecovery from $215,000 to $35,800,accepting the parties’ stipulation that thesettlement was about one-sixth of theclaim’s value. The Court suggested that thestate could have been more active in thepersonal injury action if it wanted to protecta greater portion of its claim. As aresult, it’s possible that states will take amore active role during personal injurylawsuits involving Medicaid recipients,particularly during mediations and othersettlement negotiations. For more information,contact Kathie McDonald-McClure, Wyatt, Tarrant & Combs, LLP,500 West Jefferson Street, Suite 2800,Louisville, Kentucky, direct dial(502) 562–7526 or e-mail kmcclure@wyattfirm.com.This information is a summary of oftencomplex legal issues and may not cover all the“fine points” related to a specific situation orcourt jurisdiction. Accordingly, it is notintended to be legal advice, which shouldalways be obtained in direct consultation withan attorney.

Financial Scene Page 7Photos from the Annual Institute, Lexington, KY

Page 8Financial SceneHFMA of Kentucky thanks the following sponsorswho have made this year’s newsletter possible:Gold SponsorshipAccordia of KentuckyBKD, LLPBlue & Company LLCChamberlin Edmonds & AssociatesChase BankClark & Mascaro, PCCredit SolutionsData AdvantageDean, Dorton & Ford, PSCErnst & Young, LLPMedAssist IncorporatedOwens & MinorTodd Investment AdvisorsWehr ConstructorsWyatt Tarrant & Combs, LLPSilver SponsorshipNCO Financial ServicesBronze SponsorshipFranklin Collection Service, Inc.MedShield Healthcare Claims ManagementPRST STDU.S. POSTAGE PAIDBOWLING GREEN, KYPERMIT NO. 512KENTUCKY CHAPTERBob BarbierUniversity of Louisville Hospital530 S. Jackson St.Louisville, KY 40202