Friday, December 23, 2005

More on UMDNJ: "New Jersey - It's Worse Than You Can Imagine"

It's getting hard to keep up with the bad news coming out of the University of Medicine and Dentistry of New Jersey (UMDNJ), now operating under a federal deferred prosecution agreement. (See most recent post here, with links chaining back to a now voluminous set of posts.)

More Resignations

To start with the ironic - in an email sent last week, Marykate Noonan, Director of the Office of Business Conduct at UMDNJ, reminded all employees of newly introduced mandatory ethics training:

Recipients: All Employees
Delivery Priority: Standard
DATE: December 15, 2005
TO: All Employees of UMDNJ
Cc: Dr. John Petillo, President, UMDNJ
FROM: Marykate Noonan, DPM - Director, Office of Business Conduct
RE: Mandatory Ethics Training for ALL New Jersey State Employees
Executive Order 41, issued by Acting Governor Codey, requires ethics training for ALL employees of New Jersey State Authorities, of which UMDNJ is one. There are two ways in which to take this training. The Executive Commission on Ethical Standards will conduct on-site ethics training at all our campuses during the month of January. The dates and times of this training will be announced shortly. The alternative way to take this ethics training is to use the State of New Jersey's on-line training modules. This on-line training MUST be completed by December 31, 2005.
The irony is that Noonan just resigned, along with two other top managers at UMDNJ who had allegedly in involved in questionable activities there, according to the Newark Star-Ledger.
Vivian Sanks-King, vice president for legal affairs, formerly recipient of $280,000 a year in salary, a $36,500 performance bonus, and the use of a 2002 Buick Park Avenue, resigned. The Star-Ledger reported that US Attorney Christopher Christie alleged Sanks-King "conspired" to cover up overbilling of Medicare and Medicaid.
Noonan earned $119,600 a year, received a $11,381 bonus last year, and drove a 2000 Dodge Intrepid supplied by UMDNJ.
Deidre Henry-Taylor, head of compliance at University Hospital in Newark, resigned, giving up her salary of $117,488 a year. Her bonus last year was $10,263.
Golden Parachutes Revealed
Another Star-Ledger article revealed that other top managers who had resigned recently received previously undisclosed "golden parachutes." It took the threat of a law-suit for UMDNJ to reveal this information to the newspaper.
James Archibald, former senior vice president for administration and finance, received two years worth of salary, at $285,312 a year, health and pension benefits, secretarial services, and the use of a Chevrolet Suburban SUV with an option to buy, plus a gas card and cell phone. "Federal investigators have subpoenaed a series of records tied to Archibald, whose name figures prominently in memos and other documents related to questions internally about the legality of UMDNJ's Medicare and Medicaid filings." Archibald now works at Drexel University College of Medicine, where he is Senior Vice President for Health Sciences.
John Ekanius, former vice president for government and public affairs, received one year of his $180,525 salary, health benefits, secretarial services, a laptop computer, and use of a car. Ekanius was named in a federal subpoena seeking documents. Ekanius also now works at Drexel, as Associate Dean for External Relationships and Strategic Development.
Sidney Mitchell, president of University Hospital, will receive two years of his $418,470 salary. Mitchell was also the target of a subpeona. He is still on the UMDNJ payroll, and is also currently president of Pascack Valley Hospital in Westwood.
The newspaper also noted that the severance packages included clauses that "the recipients make no comments or statements that might disparage UMDNJ, and with other confidentiality clauses." Such clauses may not be legal given UMDNJ's status as a state institution. And to add more irony -- the initiator of the policy on severance packages was apparently James Archibald, himself.
More Local Comments

The mess at UMDNJ continues to incite local commentary (although I have yet to find any reaction from farther than New York state.)

According to the Glocester County Times, NJ state legislator warned that UMDNJ may face a crack-down by the legislature. "They have to do the right thing and bring people in to clean this thing up. If they don't get their house in order, I think you're going to see the Legislature take some action."

And Jeffrey Page, a columnist for the Bergen County Record had plenty of choice words.

The feds are looking into a stinking little mess in which the University of Medicine and Dentistry of New Jersey may have double-billed the federal and state governments....
You can do nothing to avoid the stink when reading the UMDNJ story. Nor, of course, could you be accused of extreme cynicism if, after reading about the mischief at UMDNJ, you had sent [Acting Governor] Codey an urgent e-mail suggesting the five finalists [for new NJ state slogan] be scrapped and that the slogan be 'New Jersey: It's Worse Than You Can Imagine.'

But more seriously, Page suggested one small remedy.

When physicians take the Hippocratic Oath they swear to conduct their medical lives honorably. A pure life will bring doctors the blessing of God and the respect of their peers and the public. 'But should I trespass and violate this oath, may be reverse be my lot,' they conclude grimly.
Clearly, UMDNJ administrators should have to swear a similar oath - and suffer a similar reversal of their lots should they falter.
Getting the leaders of health care organizations to openly, publicly embrace a clear code of ethics would be one small step in the right direction, and not just for UMDNJ.


InformaticsMD said...

I wonder if some of the billing problems were due to computer malfunctions.

Business IT has never been a strength at academic medical centers. For example, Yale has had its problems:

"Insufficient IT management depth results in Justice Dept. investigation"

Anonymous said...

Interestingly, as an alumna of UMDNJ-NJMS, I receive weekly e-newsletters from the University and never once have they mentioned the current scandal (but of course their alumni fundraisers haven't stopped asking for money).

In addition, my parents and in-laws still live in NJ and claim to have heard nothing about the scandal. Since both families read the daily newspapers and watch nightly news shows, it suggests that you have to look deep, even in NJ for details of the situation.

Roy M. Poses MD said...

I suppose I am much too optimistic that the anechoic effect is diminishing. I was happy that at least this case got some coverage in the New York Times. But of course, given the magnitude of the issue - the largest US health sciences university operating under a deferred prosecution agreement - this case has been hardly visible in the main stream media outside of NJ, and invisible in the medical/ health care literature. The anechoic effect, unfortunately, lives.

Anonymous said...

I am not surprised that James Archibald and his "gang" was involved in this mess. They are playing a similar havoc at Drexel College of Medicine and yield such enormous political backing that they continue to thrive. They have systematically and strategically replaced all administrators in the key position at Drexel with members of their gang...some of whom have since been replaced. I wish the goverment would take legal action fast and hard to stop them from destroying another organization.

Anonymous said...

I know one thing, Miss Noonan's mother was probably turning over in her grave! She was a good and honest person.

Anonymous said...

It appears Ms. Noonan takes after her father.
NOONAN, Frank, M.D.
License # MA015093
189 Franklin Avenue
Nutley, NJ 07110-3823
Georgetown Medical School, 1954
National Examination

FINAL ORDER OF REVOCATION filed August 12, 2004. This matter was returned to the Board upon entry of an Initial Decision by Administrative Law Judge Barry N. Frank dated May 10, 2004. ALJ Frank recommended that the license of Dr. Noonan to practice medicine and surgery in New Jersey be revoked and that cost and penalties should be set by the Board. This Decision proceeded ex parte due to Dr. Noonan's giving notice that no one would appear on his behalf. At the ex parte proceeding, fourteen patient medical records, a transcript of Dr. Noonan's sworn testimony before the Preliminary Evaluation Committee on April 26, 2000 and an expert report from Dr. Krauzer were accepted into evidence. ALJ Frank sustained all charges made by the Attorney General, to include charges that Dr. Noonan improperly treated patients, ignored patients' symptoms, failed to maintain adequate medical records, prescribed inappropriate and in some instances, contraindicated medications for patients, and falsified letters on behalf of patients so as to mislead their employers. ALJ Frank concluded that the evidence presented provided "overwhelming proof of Dr. Noonan's violation of statutes and regulations governing the practice of medicine in the State of New Jersey". The Board, having reviewed this matter, concurred with all findings of fact and conclusions of law made by ALJ Frank and that Dr. Noonan took part in gross repeated acts of negligence, malpractice and incompetence in his care and treatment of numerous patients outlined in the statements of fact, endangering their lives, health and safety. The Board ordered the license of Dr. Noonan to practice medicine and surgery in New Jersey be revoked. Dr. Noonan was assessed civil penalties in the amount of $140,000 and costs in the amount of $26,991.05. EFFECTIVE DATE: August 4, 2004