Former Neurosurgery Chair Resigns, Pleads Guilty in Billing Probe

Former UW Neurosurgery Chair H. Richard Winn resigned from the University July 16 and pleaded guilty to one count of obstruction of justice, the first legal settlement in a two-year probe of Medicare and Medicaid billing practices at the UW Academic Medical Center and affiliated medical groups.

Winn, 60, had been a member of the faculty for 20 years and since 1983 was head of neurosurgery, building the department into a top-ranked unit. But court documents say during the investigation he asked other doctors to lie for him and created an "atmosphere of fear and intimidation."

As part of the felony plea bargain with federal prosecutors, Winn agreed to resign from the University, pay $500,000 to compensate the government for improper bills, perform 1,000 hours of community service and write an article in a medical journal about the importance of following federal billing rules. Prosecutors recommended that Winn serve no prison time and that he be allowed to keep his medical license.

Government attorneys also admitted that federal billing practices are subject to multiple interpretations and that bills submitted by Winn were "not intended" to be fraudulent but were instead "the product of mistake and confusion" about government regulations.

In a separation agreement between the surgeon and the UW, Winn will receive at least $970,000 and up to $3.7 million for resigning and dropping any legal challenges. The settlement money will not come from taxpayer funds or private gift dollars.

Over the last five years, federal auditors have investigated billing practices at 28 teaching hospitals across the nation and most other cases have been settled with large civil fines. For example, the University of Pennsylvania paid $30 million, the University of California system paid $22.5 million and the University of Pittsburgh paid $17.3 million.

However, B. David Collier Jr., the former head of nuclear medicine at the Medical College of Wisconsin in Milwaukee, pled guilty to a felony fraud charge in 1999 and served five months in prison. He billed the government for procedures that were actually done by an unlicensed foreign doctor and then lied about it to investigators.

These investigations target physicians who charge the government for procedures they did not personally perform (usually a medical resident did them instead) or for "upcoding" a procedure to make it more expensive under federal guidelines.

Substantial civil fines could still be imposed on UW Physicians and Children's University Medical Group, the non-profit billing groups for doctors at UW Medical Center, Harborview, Children's Hospital and Regional Medical Center, and eight clinics. Both billing units report to the UW Board of Regents.

"We are deeply concerned that one of our physicians has pleaded guilty to such serious allegations. Dr. Winn is an excellent physician and scientist who has been a key person in transforming Harborview Medical Center into the leading institution that it is today. But the University of Washington Academic Medical Center will not tolerate the actions to which Dr. Winn has pleaded guilty," said Medical School Dean Paul Ramsey, who is also vice president for medical affairs at the UW.

"A trial in this matter would have had a significant negative impact on our Department of Neurological Surgery, one of the leading neurosurgery departments in the country and a department essential to Harborview and the entire UW Academic Medical Center," he added.

Winn stepped down as neurosurgery chair in February but still practiced at Harborview until the plea bargain. U.S. District Judge Robert Lasnik will review the terms of the agreement in a hearing in October.

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