Awkward Utopia

I was recently hired for a part-time job as a lab assistant in the University of Florida College of Medicine Pathology Department for the coming spring semester. In order to complete some of the necessary training and paperwork associated with this position, I went to the Shands Hospital 1329 (Administrative) building a couple of days ago. There, I realized the amount of hassle the federal government puts into gainful employment in this country.

Upon arrival, I was handed a stack of paper easily an inch tall. This included signing my work permit, agreeing to a certain code of conduct, arranging direct deposit of my paycheck, having my signatures notarized, yada, yada, yada. However, chief among these pains was filling out the required forms for the federal income tax. That means a 1040 and a W-2, figuring out what exemptions I was eligible for, whether or not I was a dependent and how that affects my tax liability, among a host of other issues. Fortunately, since I’ve been employed before, I was familiar with much of the tax-law lingo, and was able to finish these forms with only one issue. At the end of the 1040 sat a box for which I could write in EXEMPT if I was exempt from income tax, based on whether I was exempt the prior year. I sat for a good full minute debating whether or not to solve my obligations to Uncle Sam by filling in that box. I decided, though, that I wouldn’t want the IRS breathing down my neck if I made a mistake, so I’ll just submit a tax return in April (after the IRS has withheld a portion of my paycheck).

Next, I had to to attend a half-hour of Compliance Education, where I learn about Shands billing policy and how this relates to the Deficit Reduction Act of 2005. Of course, this is a complete waste of my time, since I will never be involved in the billing of patients- my job involves freezing cancerous tissue sample in liquid nitrogen and then transporting them to researchers. Nevertheless, all Shands employees are required to undergo this training within 30 days of beginning work, and must update their training on a yearly basis. I was told that, 10 years ago, a whistleblower at Shands notified the feds that Shands had not properly conducted their invoices for procedures, resulting in mistaken bills to Medicare, Medicaid, and perhaps insurance companies. The federal government slapped the hospital with an $8.5 million fine, which pales in comparison to the University of Washington’s $30 million. Apparently, this is a very profitable enterprise, as the government collects roughly $38 billion in fines each year, auditing each billing institution twice a year.

The final government-related portion of my training involves becoming acquainted with HIPAA, the Health Insurance Portability and Accountability Act of 1996. According to hipaadvisory.com, the fines associated with violating HIPAA are:

– fines up to $25K for multiple violations of the same standard in a calendar year

– fines up to $250K and/or imprisonment up to 10 years for knowing misuse of individually identifiable health information

I’ll begin going through the online training module on my first day of work, and it will take approximately 12 paid work-hours to complete.

I assume that in just my first few days as an employee in the health care sector, I’ve only scratched the surface of federal red-tape, fines, and bureaucracy in this industry. Although I have nothing against the support staff that helped train and walk me through the paperwork, I can only help but wonder how much more efficient Shands and every other hospital could be without massive billing and compliance personnel in each department. These savings, in turn, could be passed on to the consumer, and help to solve America’s crisis of spiraling health care costs.