UHS hospital in Oklahoma faces Medicare termination on heels of Buzzfeed News investigation

Tulsa, Okla.-based Shadow Mountain Behavioral Health System, which is owned by King of Prussia, Pa.-based Universal Health Services, is at risk of losing its Medicare contract Aug. 24, according to Tulsa World.

Shadow Mountain will also lose three of its Medicaid contracts on July 31.

CMS said in a May 26 letter to Shadow Mountain that deficiencies at the hospital limit its "capacity to render adequate care and prevent it from being in compliance with all the applicable Medicare Conditions of Participation for hospitals," according to the report.

CMS said Shadow Mountain is not in compliance with Medicare rules related to patient rights, governing body and special provisions that apply to psychiatric hospitals. Although the hospital can maintain its Medicare contract by correcting the issues identified by CMS, it may not have the same opportunity regarding certain Medicaid contracts.

The Oklahoma Health Care Authority sent a four-sentence letter to Shadow Mountain June 1, indicating it will terminate three of the hospital's Medicaid contracts July 31. "OHCA's decision to terminate Shadow Mountain's contracts without cause with a 60-day written notice is not appealable," the letter stated, according to Buzzfeed News.

In a statement to Tulsa World, Shadow Mountain CEO Mike Kistler called OHCA's action "unwarranted."

"We are hopeful that we will be provided the opportunity to open a dialogue with OHCA which will allow us to demonstrate the quality of the care and treatment provided to our patients as well as the vital role we play caring for the residents of Oklahoma with significant mental health issues," Mr. Kistler said.

In addition to the action taken by OHCA, the Oklahoma Department of Human Services will no longer send foster children and youths to the hospital, according to Tulsa World.

The Medicare and Medicaid termination letters come after Buzzfeed News reported in December that UHS psychiatric hospitals kept patients longer than necessary and against their will to maximize reimbursement from insurers. The report, which was based on a yearlong investigation, also raised questions about the quality of care provided at the psychiatric hospitals.

In a press release issued in response to the BuzzFeed News story, UHS denied the conclusions drawn by the reporter. UHS said the story "misses the mark in several important ways leading to an inaccurate portrayal of UHS's behavioral health operations."

In May, Buzzfeed News reported an investigation into billing practices used by UHS psychiatric facilities broadened to included the FBI and Department of Defense. 

More articles on healthcare finance:

Dallas hospital unexpectedly closes
CHI Health closes Nebraska hospital, opens new ED
Northwell's earnings dragged down by insurance division losses

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars