ER Docs Lobbying Group Says the Quiet Part Out Loud

Private equity is going big into emergency medical services, on the theory that there is an opportunity for massive up-coding (fraud) to generate outsized, and undeserved, profits.

Yet another example of my bromide, "There is nothing that the finance industry cannot ruin."

Well, the largest lobbying organization for ER doctors in the United States admitted it when they noted that doctors who follow Wall Street driven charging and coding advice are at risk of being prosecuted under the false claims act.

This is an admission that they are engaged in a criminal conspiracy to defraud patients and the US government:

Private equity firms have spent hundreds of millions of dollars convincing emergency room doctors and patients that they are all on the same team, fighting the greed of evil insurance companies. But in a remarkable “saying the quiet part out loud” moment, the major professional organization representing emergency physicians just admitted that private equity greed may be leaving the ER doctors vulnerable to criminal fraud charges.

The admission came in a document the board of the American College of Emergency Physicians (ACEP) circulated to its roughly 400-member council in advance of its annual conference, which began earlier this week in Boston. Robert McNamara, [no, not that one] a Temple University medical school professor who has been working for decades to galvanize ER doctors in opposition to the “corporate practice of medicine,” had proposed a resolution that would essentially force all ER staffing companies seeking to do business with ACEP to periodically furnish their physicians with data on the services and procedures the company had billed for under their license numbers.

Buried in the middle of the otherwise mundane memo on past resolutions, the board addressed McNamara’s proposal. Unsurprisingly, the Board expressed extreme reluctance to adopting the proposal, noting that four separate attorneys it had consulted believed there was “substantial risk to implementing the resolution as written.” The ACEP brass had previously cited the (dubious) threat that forcing transparency could somehow invite an antitrust lawsuit, but this time they provided a new and eyebrow-raising concern.

“ACEP engaged outside counsel to advise on whether securing regular reporting of billing in a physician's name could inadvertently subject that physician to potential liability under the False Claims Act [emphasis added], since provision of this information could now leave them considered to be ‘knowing,’” they wrote.

In other words: emergency room doctors are better off not knowing what their private equity overlords are billing under their license numbers, because they are less likely to go to jail for Medicare fraud if they didn’t actually know they were committing it. This admission is especially eye-opening coming from ACEP, an organization that has evolved over the past several decades into a willing mouthpiece for the private equity industry that controls most of the biggest ER staffing firms and has pushed the aggressive billing practices for which they have become notorious.

You know, the FBI might better serve the public if they spent their time investigating stuff like this, instead of staging sting operations against Muslims who are still living in their parents' basements.