FAHC case prompts state to review regulations

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(Host) Vermont’s auditor of accounts says she’ll look at how the state oversees major health care projects. Auditor Elizabeth Ready’s review follows allegations that Fletcher Allen hospital in Burlington evaded state oversight when it began construction of a $55 million parking garage.

VPR’s John Dillon reports.

(Dillon) Major hospitals like Fletcher Allen Health Care in Burlington get a substantial portion of their revenues from taxpayer funded programs. According to auditor of accounts Elizabeth Ready, Medicaid and Medicare account for $267 million of Fletcher Allen’s revenues in fiscal year 2002.

With that much of the public’s money involved, Ready says Vermonters deserve greater input in how the state’s largest hospital is run. She says Fletcher Allen should be subject to the state open meetings law:

(Ready) “And for my part, I would commit to an independent review of the way Vermont can improve its controls over the financing of health care facilities. We need to assure we have in place the proper controls and the proper oversight when we have this amount of public money at stake.”

(Dillon) State and federal prosecutors are investigating Fletcher Allen, following allegations raised by the hospital’s former chief financial officer. The former official, David Cox, says hospital president William Boettcher directed him to develop an elaborate financing scheme to keep a $55 million parking garage off the books and outside state regulatory review.

After the state began investigating the garage issue, officials at the Department of Banking, Insurance and Heath Care Administration told Fletcher Allen it needed a permit for the project. But by then, state officials conceded it was too late to stop construction.

Critics say the state has also failed to be an effective watchdog over other Fletcher Allen projects. Jeanne Keller is a health policy analyst in Burlington who has closely followed the Fletcher Allen project, which is now expected to cost $225 million.

Keller says the state should now order Fletcher Allen to undergo a separate review for its new birthing center. She says the hospital has changed its plans for the birthing center and is building it in a different place than it had originally told state officials.

(Keller) “Again part of a pattern where it seems Fletcher Allen is able to construct a situation where they get what they want and come into compliance after the fact. This to me is another example of how completely overwhelmed our regulatory process has been by the scale and scope and talent of Fletcher Allen’s administration or team. The regulators are a couple of steps behind every step of the way, apparently.”

(Dillon) Fletcher Allen says the birthing center project won’t add to the overall cost of the project. And the Department of Banking, Insurance, Securities and Health Care Administration says it will schedule a hearing on the project changes.

For Vermont Public Radio, I’m John Dillon.

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