Battle Brewing Over New Hospital Proposal Tied to Mattiello’s Top Lobbyist
GoLocalProv News Team
Battle Brewing Over New Hospital Proposal Tied to Mattiello’s Top Lobbyist
Mark Ryan, the lobbyist for Twin River, National Grid, and the Providence Journal, has a new client — Encompass Health, an Alabama healthcare company.
The company is proposing to build a rehab facility in Johnston — a facility that Rhode Island’s healthcare industry and a consultant hired by the state’s Department of Health says is unnecessary and will adversely impact Rhode Island's already financially fragile healthcare industry.
Both Lifespan and Care New England have reported significant financial losses.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTAccording to the Rhode Island lobbying reports, Ryan is paid $10,000 a month to promote the Encompass proposal to build a new facility.
Encompass Health describes itself as a leading provider of inpatient rehabilitation and home-based care committed to delivering high-quality, cost-effective, integrated care across the post-acute continuum.
Medicare Settlement -- and Payout
In 2019, Encompass agreed to pay $48 million to resolve allegations that some of its IRFs provided inaccurate information to Medicare to maintain their status as an IRF and to earn a higher rate of reimbursement, and that some admissions to its IRFs were not medically necessary.
“This settlement demonstrates our commitment to ensuring that those who participate in federal healthcare programs follow the rules,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division. “Medicare and Medicaid providers who seek to profit inappropriately at the expense of taxpayers will be held accountable.”
According to the Justice Department, Medicare and Medicaid use information about patients’ diagnoses to determine whether a facility is properly classified as an IRF, and to determine the level of reimbursement the facility is awarded for specific patients.
The government alleged that beginning in 2007, in order to ensure compliance with Medicare’s rules regarding classification as an IRF, and to increase Medicare reimbursement, some Encompass IRFs falsely diagnosed patients with what they referred to as “disuse myopathy” when there was no clinical evidence for this diagnosis. Additionally, Encompass IRFs allegedly admitted patients who were not eligible for admission to an IRF because they were too sick or disabled to participate in or benefit from intensive inpatient therapy.
“This important civil settlement concludes a lengthy, comprehensive investigation that brought to light a nationwide scheme that the government contends was intended to defraud our fragile public health programs,” said U.S. Attorney Maria Chapa Lopez. “In doing so, we confirm our commitment to civil health care fraud enforcement as a key component of the mission of our office.”
While Rhode Island’s healthcare industry is warning that the company will be financially detrimental to the existing local industry, the Providence Journal’s editorial writer Ed Achorn — who is closely linked to Encompass and the Providence Journal’s lobbyist Ryan, wrote in an editorial strongly endorsing the project:
“Encompass believes there is a market in Rhode Island for such expert acute care, and is willing to invest in a new facility. The company has experience in providing such care efficiently by stripping down office jobs while putting its money into nursing. It's a big company. Nationwide, in the area of inpatient rehabilitation, it employs 30,100 people and produces annual revenue of $3.3 billion. It operates three such hospitals in Massachusetts, one in New Hampshire and one in Maine.”
Meanwhile, one of Rhode Island’s most successful business leaders has been a constant critic of the Mattiello-Ryan-Providence Journal triad.
“I checked, apparently it’s totally legal for a Rhode Island politician to admit a mistake. Even a public admission is allowed. Allowed even if your buddy at the editorial board agrees to cover your back on your mistake. Who knew!?," Tweeted the former CEO of America’s first offshore wind farm Deepwater Wind, Jeff Grybowski.
Grybowski has repeatedly questioned the motivations of Achorn, the Providence Journal’s remaining editorial writer, Tweeting, “If you think @RISpeakerwas interested in an audit of the Convention Ctr b/c of something @repmorgan said five years ago, Rudy Giuliani would like you to help rooting out some corruption in Ukraine. @Ed_Achorn."
In October, WPRO talk show host Dan Yorke said on air that the Providence Journal’s coverage of Twin River's effort to secure the state’s lottery contract was biased -- and is being influenced by Ryan, the former newspaper executive who is now a lobbyist for the casino company.
“The Journal is on the take,” said York.
Is Encompass' Project Needed?
According to a report to the Health Services Council on the Encompass proposal submitted to Rhode Island Department of Health in February conducted by Faulkner Consulting Group, Encompass is capable and highly experienced, but questions the need for the proposal.
“There are nearly 1,200 IRFs nationwide; 76% of these are distinct units in acute care hospitals, the remaining 24% are freestanding facilities. The applicant, Encompass Health Corporation (f/k/a HealthSouth Rehabilitation Corporation), is the IRF industry’s largest chain. As of 2017, almost half of freestanding IRFs nationwide were owned by Encompass Health,” according to the state’s consultant report.
The study says, “Utilization of existing statewide IRF capacity is low; based on Rhode Island’s historical IRF utilization rate, existing statewide IRF capacity appears to be more than sufficient to support the anticipated IRF utilization through 2030, even after accounting for an increase in volume driven by an aging population. From this perspective, the substantial increase in statewide capacity that Encompass Johnston’s proposal represents does not appear to be needed.”
Further, the study found, “Rhode Island currently has five operating IRFs, with a combined total of 109 licensed beds, 89 of which are currently available. Although some of Rhode Island’s existing IRFs are highly utilized, on a combined basis, utilization of existing statewide capacity is low. In 2018, the statewide occupancy rate was 63% of available beds, and 51% of licensed beds.”