Los Angeles Centers for Alcohol and Drug Abuse (L.A. CADA)

For 39 years, L.A. CADA has been providing vital treatment and prevention programs to Los Angeles County residents challenged by the diseases and conditions relating to alcoholism and drug addiction. At the heart of their mission is the desire to spread courage, compassion and hope for children, teens, and families affected by HIV/AIDS, addiction, and family violence.

Founded in 1971 by a group of area residents headed by Coast Plaza's Dr. Ethan Allen and his wife Alice, L.A. CADA celebrated its First Annual Gala and Awards Dinner on June 5, 2010. Among the honorees at this prestigious event was Reggie Berry, a former professional football player for the San Diego Chargers who for the past 21 years has been the Executive Director of Goals For Life, a non-profit foundation that helps students reach their full potential. Reggie believes that hard work, maintaining a positive attitude, and knowing how to effectively prepare are the keys to winning in any sport, and he applies the same formula to achieve success in life. The inspiration provided by L.A. CADA and Mr. Berry is truly amazing, and Coast Plaza congratulates them both for the wonderful things they do, each and every day.

Dr. Thomas Gionis

As Medical Director and head of the Emergency Department at Coast Plaza Hospital, the erudite wit and warm smile of Dr. Thomas A. Gionis are well known to all of us here in Norwalk. What some of you may not be familiar with are the many highlights that make up his diverse and distinguished career.

To begin, Dr. Gionis has been recognized as the youngest individual in United States to be awarded the medical degree (M.D.) Our good doctor first entered medical school at 17, and was awarded his degree by the Medical University of South Carolina at the astonishing age of 21. Thus began an illustrious career in medicine.

Dr. Gionis then completed his cardiovascular surgery fellowship at Tulane Medical Center- Charity Hospital, New Orleans, Louisiana, and followed up with a Research Fellowship in Emergency Medicine from Harvard University-Massachusetts General Hospital, Department of Emergency Medicine Research (MGH) in Boston. He then taught advanced trauma life support at Harvard- MGH for 18 years before joining us at Coast Plaza Hospital.

Even so, the study of medicine is only one of Dr. Gionis' many specialties. He obtained his J.D. degree (Cum Laude) from John Marshall Law School and his L.L.M. from St. Thomas University School of Law. Currently, he serves as President of Aristotle University, Dean and Professor of Law at Aristotle University College of Law, and Dean and Professor of Public Health at Aristotle University School of Public Health.

Dr. Gionis is a United States Fulbright Scholar in Law, a current member of the United States Fulbright PEER Review Committee Member/Global-Public Health, and UCLA Visiting Scholar in Public Health. He also serves as adjunct professor in the Executive Master of Public Health (MPH) program at the UCLA School of Public Health, where he teaches Health Law and Principles of Global Health.

In addition to his many responsibilities here at the Hospital, Dr. Gionis is also a frequent Lecturer in bioethics at international United Nations UNESCO bioethics meetings, and serves as chairman of the UNESCO International Bioethics Journal Club and chairman of the Joint Study Committee on Clinical Research Ethics. As if that weren't enough, he is also a published author and the Editor-in-Chief for Royal Society Law Review. Coast Plaza is undeniably fortunate to count this master of many trades as an integral part of our team.

RACS and MICS

Pursuant to section 306 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Congress

directed the Department of Health and Human Services (DHHS) to conduct a 3-year demonstration program using Recovery Audit Contractors ("RACs") to detect and correct improper payments within Medicare. The original goal of this program was to determine whether the use of RACs would be a cost-effective way to maintain the integrity of Medicare by ensuing provider payments were correct.

The original RAC demonstration program ended with more than $1.03 billion recovered. According to the Centers for Medicare and Medicaid Services (CMS), approximately 96% of these payments were overpayments collected from providers (85% of which were collected from hospital providers) and the remaining 4% were underpayments. Like Coast Plaza, many hospitals view this program as an opportunity to ensure that they maintain constant and strict compliance in this particular area of hospital operations.

This partnership between CMS and the States now reaches a new level under the Medicaid Integrity Program ("MIP"). Medicaid Integrity Contractors ("MICs") work with CMS to carry out this program. Under the MIP, Hospitals have an opportunity to identify, recover and prevent inappropriate Medicaid payments.

Hospitals should constantly strive to find ways to improve when it comes to billing, and following are a few guidelines that may help hospitals and other providers on a daily basis, not to mention with the RACs and MICs.

(1) Carefully review internal monitoring protocols to better identify and monitor areas that may be subject to review.
(2) Always identify ways to improve the Hospitals ability to respond to record requests.
(3) Keep a strong focus on compliance efforts including, but not limited to, documentation and coding education.
(4) Work with the Hospitals medical staff to improve the delivery of patient care at all times.

It is also a good idea to establish a Hospital "team" from various departments who have experience in processing these requests and managing denials. This team may include individuals from compliance, administration, Health Information Systems, case management, and members of the medical staff. Good communication within the team will prove critical during these programs, while helping to strengthen ties between departments for the long run. When it comes to patient care, communication between hospital departments and the medical staff rests at the foundation, so always be mindful that preparation for these Medicare and Medicaid programs will inevitably benefit our entire hospital community.

Young Legislators

On Saturday, June 5th, Coast Plaza Hospital was proud to host the last of this academic year's Young Legislators meetings, under the direction of Assembly Member Tony Mendoza. The meeting's focus was on health care education and included presentations from Rep. Grace F. Napolitano (D-Norwalk), Assembly Member Mendoza, and local community representatives.

In describing his vision for the meeting, Assembly Member Mendoza said: "My goal is that the young legislators get a better understanding of the health care challenges we face, not only in the 56th District, but in our state. The young legislators will learn how they can play an active role in making a difference in our community."

Our community's leader in the State Assembly created the Young Legislators program to enrich the lives of young people by empowering them with the tools necessary to make a difference in their communities. The program is free and open to all high school students. The 10-month program is designed to mirror California's State Assembly. It teaches high school students about the life cycle of legislation, and gives the students hands-on experience by encouraging them to attend community events hosted by the District Office. Coast Plaza was honored to be chosen as the venue for such a laudable program, and we wish them continued success in the future.