Audit Finds No Evidence of Medicare Fraud, Motion Picture Hospital Director Says

The executive director of the Motion Picture & Television Country House and Hospital said Thursday that a nearly completed federal audit of the facilities’ Medicare billing and reimbursement practices has found no evidence of fraud or other improprieties.

“We feel even more secure in our belief they’ll find nothing,” John M. Pavlik said of the probe by the U.S. Department of Health Human Services’ inspector general. The inquiry was prompted last May by allegations of wrongdoing.

“We’re not guilty of anything,” Pavlik said.

He said his assessment was based on what the inspector general’s staff told the country house and hospital’s attorneys.

However, Barbara Broman, a spokeswoman for the Office of Inspector General, said Thursday, “There is an investigation under way. It is still an open case, and we can’t discuss open cases.”

Contradicts Report

Pavlik also contradicted a published report that the Woodland Hills facility was negotiating a settlement with Medicare.

“We’re not making a deal,” he said in an interview. “We’re not making a settlement. We’re merely responding to things the inspector general is asking for.”

The Motion Picture & Television Fund, a 66-year-old private charity supported by some of Hollywood’s leading entertainers and executives, runs the Motion Picture & Television Hospital and the residential Motion Picture & Television Country House. The facilities’ 41 acres are home to 275 retired actors, directors and technical workers from the entertainment industry.

The fund has been buffeted in recent months by charges it overbilled Medicare by placing patients who were not acutely ill in the acute-care wings--ostensibly to receive higher reimbursement costs--and provided substandard care.

The allegations that prompted the federal investigation were made by “unidentified sources,” Pavlik said.

Two Reviews

The inspector general’s staff completed its on-site review of the facility’s Medicare cost reports for 1982 through 1985 several months ago, Pavlik said. At the same time, Blue Cross of California, which handles Medicare billing, was conducting its routine annual review, he said.

Carol Kinsey, a Blue Cross spokeswoman, said Thursday: “We cannot confirm or deny the fact there is an audit going on, routine or otherwise, although we routinely audit facilities.”

Some of the most serious charges are leveled in a $7.5-million lawsuit filed by Audrey R. O’Donnell, the facilities’ former nursing director. She alleged she was fired nine days after she questioned whether the hospital’s placement of some patients in the acute-care ward was tantamount to Medicare fraud.

She also charged in the suit that she was told the federal audit could mean “millions of dollars that the fund would have to pay because Medicare would not cover the service.”

O’Donnell, who was fired in September, 1986, further asserted in the suit that medicine was improperly administered, outdated drugs were retained and patients were physically and verbally abused. The fund has not yet responded to the suit, which is pending in Van Nuys Superior Court.

Pavlik, who has been executive director since 1982, denied O’Donnell’s charges.

“I vehemently deny we give substandard care,” he said. “We give outstanding care here.”

Pavlik said he was prevented by privacy laws from discussing individual cases. He maintained that, in general, the criticism emanates from “a couple of disgruntled employees and a couple of disgruntled ex-employees who have decided they’re going to get even for something.”

The Motion Picture Fund was founded, largely at the behest of actress Mary Pickford, to give financial assistance to the destitute. Its first residential facility, the Motion Picture Country House, opened in 1942 and the hospital followed in 1948. The fund’s motto is: “We Take Care of Our Own.”

The facilities’ occupants have included Bud Abbot, Mary Astor, Mae Clark and Regis Toomey. The late movie producer Samuel Goldwyn Sr., Bob Hope, George Burns and MCA Chairman Lew Wasserman and his wife, Edie, have been among the major contributors in recent years.