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Medicare officials probed over lavish conferences

July 1, 1993

The chairman of the Senate Finance Committee thinks some Medicare officials need a dose of fiscal and ethical medicine. Sen. Charles Grassley, R-Iowa, has launched a probe of their behavior.

Grassley is calling for a detailed accounting of travel and expenses for all employees attending conferences since 2003. He also wants to know who covered the costs.

The Washington Post, in an article about the investigation, said Medicare officials who oversee $300 million awarded annually to private contractors were regular attendees at conferences sponsored by the groups they supposedly regulate.

One such conference was conducted at the Don CeSar Beach Resort near St. Petersburg, Fla. Grassley said, “it appeared to be more of a party than a diligent working meeting.” He said photos of the conference site “suggest a cruise ship atmosphere. The photos depict a luxurious resort, lavish dinners, dessert buffets, and Hawaiian dance parties—all in a tropical beach locale.”

Grassley’s request for financial information centers on two doctors—Steven Jencks and William Rollow—who are responsible for oversight of the contractors, termed Quality Improvement Organizations (QIOs).

The senator’s letter was received by Barry Straube, acting chief medical officer for the Centers for Medicare and Medicaid Services, which administers the vast government insurance program. Straube said the agency is seriously regarding the concerns raised by Grassley and promised a prompt response to the committee.

The Finance Committee opened its inquiry into the Medicare contractors last summer after The Post reported the groups infrequently investigated patient complaints and that some executives were enjoying lavish pay and perks.

Medicare compensates 53 state-based QIOs to look into complaints of poor quality and to improve services by doctors, hospitals and nursing homes. These overseers receive very little scrutiny, and are barred by law from telling patients about their findings. Medicare audits the QIO’s performance, but keeps the evaluations secret.

The conferences being examined were sponsored by the American Health Quality Association, which is a trade group for QIOs. David Schulke, chief executive of the association, denied the meetings were in any way frivolous. “It is inappropriate,” he said, “to draw conclusions and insinuate impropriety based purely on the meeting location or pictures of a networking reception held after meeting hours.”

A former top executive for the Missouri QIO, Sarah A. Grimm, told The Post there seemed to be a lot of competition in Medicare’s regional offices to attend the Florida conference. She said she quit attending them because she found many “lacking in substance” or prohibitively expensive.

The trade group’s Web site lists a leadership retreat last July that was held at the Silverado Country Club and Resort, a 1,200-acre spread in Napa, Calif. The resort has a four-diamond rating from AAA. It features two 18-hole golf courses, a spa, and the biggest tennis complex in Northern California. A room goes for $250 per night.

Locales of other conferences were: the Broadmoor Hotel and Resort in Colorado Springs and the 400-acre Ocean Edge Resort and Golf Club on Cape Cod.

From the Jan. 11-17, 2006, issue

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