EBONY JOYNER: Okay. Um, the email which was, um, from a provider. Okay. Thank you for the following inquiry. Um, because the new Health Care Reform Bill specifically excludes Medicaid payment for elective termination of pregnancy, I am contacting you to make sure that our office protocol is in compliance with GHP regulations for Medicaid patients. Patients who are a member of GHP Medicaid Program frequently call us to either – call us either – to determine whether they are pregnant and how far along or and/or because they wish to terminate the pregnancy. We immediately inform the patient that the voluntary pregnancy termination is not covered by Medicaid. If the patient would like to set an office visit to confirm the pregnancy, the office visit and diagnostic tests are covered by Medicaid. However, if the patient then decides to terminate the pregnancy and is medically el – eligible, she may do so but is personally responsible for all charges related to the abortion procedure. We would like to know the established guidelines and if any changes need to be
made on our current protocol. Thank you.
Um, and the response. Hello. Your current protocol is absolutely correct. As you mentioned, the patient will be covered for the office visit and tests; however, the procedure itself is not covered under the Georgia Medicaid Program. Informing the patient of this in advance is also correct. If the patient decides to terminate the pregnancy, you may want to have the patient sign a waiver created by your facility before the service is rendered that clearly informs the patient that they will be responsible for any charges related to the abortion procedure. If you have any questions, please – the – the rest is just a signature.
DR. MALLOY: Okay. Thank – thank you.
EBONY JOYNER: Uh-huh.
DR. MALLOY: Okay. So if – if [indistinct] and how long have you been a – a Field Rep for Medicaid?
EBONY JOYNER: Um, a Field Rep for Medicaid? [Overlapping conversation] a year.
DR. MALLOY: How [overlapping conversation]. I’m sorry?
EBONY JOYNER: A – for a year. One year.
DR. MALLOY: Okay. And how long have you been
affiliated with Medicaid?
EBONY JOYNER: Oh, for – since April 2003, so that’s what, seven years?
DR. MALLOY: Okay. All right. That’s all the questions I have.
JUDGE TEATE: Cross-examination?
TARA DICKERSON: Do you perform any audits on billing practices and procedures for healthcare providers?
EBONY JOYNER: Audits [indistinct].
TARA DICKERSON: Do you do any utilization reviews to providers of services for Medicaid?
EBONY JOYNER: No.
TARA DICKERSON: Do you have anything to do with the preparation of the Policies and Procedures Manual, Part I Medicaid?
EBONY JOYNER: No.
TARA DICKERSON: Do you have anything to do with the, um, compilation of the Policy and Procedures Part II Physician Services, um, under Medicaid?
EBONY JOYNER: No.
TARA DICKERSON: And with regard to this particular notation, what was the date that you sent this out?
EBONY JOYNER: Oh, I don’t have the paper in
front of me, but it – I think the date was in April
2010.
TARA DICKERSON: It was in April of 2010, correct?
EBONY JOYNER: Right. I think that’s the date that I saw at [overlapping conversation] - -
TARA DICKERSON: So [overlapping conversation] - -
EBONY JOYNER: - - at – at least, that’s when we received it.
TARA DICKERSON: - - would April 29, 2010, be correct?
EBONY JOYNER: Say it again?
TARA DICKERSON: April 29, 2010?
EBONY JOYNER: I think that’s what I said.
DR. MALLOY: Your Honor, can I - -
JUDGE TEATE: You can bring that to her [indistinct].
TARA DICKERSON: With regard to the, uh, message that you sent out, did you know any policy manual or procedure manual? Did you refer him to any policy or procedure manual?
EBONY JOYNER: In this response? No, I did not refer him to those.
TARA DICKERSON: Did you refer [overlapping
conversation] for him to any CFR code or citation?
EBONY JOYNER: No.
TARA DICKERSON: And with regard to your statement, Before the service is rendered that clearly informs the patient that they will be responsible for any charges related – any charges related to abortion procedures?
EBONY JOYNER: As in the actual abortion procedure.
TARA DICKERSON: So with regard to your statement then, the only thing that they would pay for would be the abortion procedure?
EBONY JOYNER: That who would pay for, the patient?
TARA DICKERSON: The [overlapping conversation] the Medicaid [indistinct].
EBONY JOYNER: Right. I mean, because basically, I mean, I was just saying that the tests, of course, and the office visit would be something that Medicaid would cover. You know, and, of course, that’s contingent upon that all other things are met as far as – as the patient – I mean, as far as the office visit, if they hadn’t exceeded visits. You know, it’s more to it than just that, but as far as just the abortion procedure itself being covered by Medicaid, it was not. And if they – the patient – opted to get an abortion, then they would be responsible for that - -
TARA DICKERSON: Okay.
EBONY JOYNER: - - service.
TARA DICKERSON: Okay. I’m gonna show you – you sent this out on April 29, 2010. I’m gonna show you [indistinct; pages shuffling] would be R-I [indistinct; pages shuffling].
EBONY JOYNER: Uh-huh.
TARA DICKERSON: Section 904.2 – Abortion. Could you read that entire section?
EBONY JOYNER: This? Starting here?
TARA DICKERSON: Right, it starts up there.
EBONY JOYNER: Okay. In accordance with federal regulations and recently Congressionally-enacted, uh, revision of the Hyde Amendment, the Division will reimburse for abortion performed for Medicaid-eligible patients if the life of the mother would be in danger if the fetus were carried to term or if the mother was a victim of a rape or incest.
TARA DICKERSON: Could you continue - -
EBONY JOYNER: [Indistinct]
TARA DICKERSON: - - continue and read that last paragraph?
EBONY JOYNER: Uh-huh. A Certification of the
nec – Necessity for an Abortion (which is a DMA-311) certifying the above situation must be properly executed and attached to the claim form when submitted to the Division. Form DMA-311 applies to surgical and non-surgical abortion procedures such as the use of Mifepristone 200 mg when used for abortion purposes. In compliance with 42 CFR 441.206, this documentation is required for any expenditures for abortions or other medical procedures otherwise provided under § 441.203, which will include associated services such as lab tests or ultrasound studies.
TARA DICKERSON: And are you aware in Georgia that you cannot have an abortion at a clinic if the fetus is more than 14 weeks old? Are you aware of that?
EBONY JOYNER: You mean, me personally? No. No.
TARA DICKERSON: No other questions.
JUDGE TEATE: Anything on redirect?
DR. MALLOY: Yes, sir. Um, just for the record, um, are you aware that you cannot terminate a pregnancy beyond 14 weeks in a private doctor’s office?
EBONY JOYNER: No, I’m not aware [indistinct].
DR. MALLOY: Okay. I just wanted for the record,
a clinic is different than a private doctor’s office
and the rules are different. I just wanted - -
EBONY JOYNER: Uh-huh.
DR. MALLOY: - - that correct. Ms. – Ms. Moore(sic), do you, when providers call you and ask opinions or information, um, it’s based on knowledge that you’ve gathered from working at the organization?
EBONY JOYNER: Right.
DR. MALLOY: So it’s not based on your personal feeling, your opinion; it’s based on something that you were either taught, you learned, instructed? You just don’t make decisions on your own?
EBONY JOYNER: Right, no.
DR. MALLOY: So somewhere - -
EBONY JOYNER: Uh-huh.
DR. MALLOY: - - in the Medicaid system, somebody stated that what you put in your memo is acceptable and compliant?
EBONY JOYNER: Correct.
DR. MALLOY: Okay. No further questions.
TARA DICKERSON: No other questions.
JUDGE TEATE: All right. You can step down.
EBONY JOYNER: Uh-huh.
JUDGE TEATE: Your next witness, Dr. Malloy?
[Indistinct conversation in background]
DR. MALLOY: Thank you very much.
EBONY JOYNER: Uh-huh.
DR. MALLOY: All right. My next witness would be Dr. Juaquita Callaway.
JUDGE TEATE: Okay.
[Indistinct conversation in background]
JUDGE TEATE: Dr. Callaway, if you’ll come up to the chair [indistinct] and before you take a seat, if you would please raise your right hand? Do you solemnly swear and affirm that the testimony you’re about to give is the whole truth and nothing but the truth, so help you God?
JUAQUITA CALLAWAY: I do.
JUDGE TEATE: All right. Be seated and state your name for the record.
JUAQUITA CALLAWAY: My name is Dr. Juaquita Callaway.
JUDGE TEATE: Is that, uh, J-U-A-Q-U-I-T-A?
JUAQUITA CALLAWAY: Yes, it is.
JUDGE TEATE: Okay. All right, sir.
DR. MALLOY: Uh, Dr. Callaway, I know you have a busy schedule. Matter of fact, you rearranged your patients, um, to see me – to be here, rather – and I – I truly appreciate that, um, because this is – this – this is important. Um, how long have you known me,
Dr. Callaway?
JUAQUITA CALLAWAY: I’ve known you since 1989.
DR. MALLOY: Okay. And in what capacity, um, have you either worked with me or have known me?
JUAQUITA CALLAWAY: Well, from 1989 to 1990, you were my Attending Physician at, uh, Georgia Baptist Medical Center. In 1990 to 1998, you employed me as an Associate Physician in your OB/GYN practice in Decatur. And from 1998 until now, we’ve, um, had a, uh, supportive relationship where you provide coverage for me and I have served as a Surgical Assistant to you.
DR. MALLOY: Okay. Dr. Callaway, um, you don’t work in my office right now?
JUAQUITA CALLAWAY: No, I do not.
DR. MALLOY: Okay. And the last time you actually worked in my office was how long ago?
JUAQUITA CALLAWAY: Hmm, 1999, so if I do the math, uh, 11 years?
DR. MALLOY: Eleven years. So you have your own private practice?
JUAQUITA CALLAWAY: Yes, I do.
DR. MALLOY: Okay. And – but, in addition to that, you, um, with some other physicians, work in a private practice that emphasizes GYN services, one of
which is pregnancy termination?
JUAQUITA CALLAWAY: That is correct.
DR. MALLOY: And when you heard about my audit in January, um, what was your feeling about that?
JUAQUITA CALLAWAY: I was very concerned, uh, because, in the same, uh, in – in this particular group practice, uh, a few years before January, we were, um, billing Medicaid for family planning services, including, uh, workups for missed periods. Um, if it was determined to be pregnant, uh, we would do ultrasounds and then do counseling on pregnancy options. Some patients would leave and some would stay for a termination, and I was very concerned because we had, um, done some checking to see if the – those services would be reimbursable by Medicaid at that location.
DR. MALLOY: And what did you find out in doing your research?
JUAQUITA CALLAWAY: Well, initially, I was told by the office managers that the investigation and inquiry had been done. And this was round about the time the CMOs came out and I personally requested that each CMO be queried about that rule, and we were told as long as it’s appropriately coded for the services that were rendered, we could submit the claims, but Medicaid would not be billed for abortions since abortions are not covered under Medicaid. Um, and so I never had a personal reason; I just took that for face value. But I began to have concerns after what happened, uh, with your audit, and I asked for a formal inquiry that I would have proof.
DR. MALLOY: Okay. Uh, I want to show you what has already been marked as, um, Petitioner’s Exhibit. Um, will you identify that for me?
JUAQUITA CALLAWAY: Yeah. This is the, uh, a paper copy of an email that was sent to me, uh, regarding the, uh, query that, uh, I requested in April regarding the services and whether or not they still met the Medicaid guidelines.
DR. MALLOY: And just [indistinct] – you don’t have to ‘cause we – it’s already been read.
JUAQUITA CALLAWAY: Yes.
DR. MALLOY: But from your – after receiving that memo - -
JUAQUITA CALLAWAY: Uh-huh?
DR. MALLOY: - - okay, what – what – how did you feel?
JUAQUITA CALLAWAY: I felt better about it. Um, prior to this, I had requested – since there had clearly been something that was, uh, not communicated with us that I felt, uh, given what was happening with you, I requested that the facility no longer bill Medicaid until we had direct answer as to what our current service limitations would be. So once we got this, the rest of us – the physicians in the group – met and discussed whether or not we felt okay with this. And we felt this gave us adequate protection to continue to provide just these lab and ultrasound services and physician evaluation.
DR. MALLOY: Okay. So, suffice it to say, when Ms. Joyner sent you that email, it – it gave you some reassurance that you were in compliance with the rules of Medicaid as far as laboratory procedures done in a private doctor’s office, um, regardless of what happened after that laboratory procedures(sic) were done?
JUAQUITA CALLAWAY: Yes. Yes.
DR. MALLOY: All right. I have no further questions.
JUDGE TEATE: Cross-examination?
TARA DICKERSON: Now you indicated that you don’t work with Dr. Malloy at his location, right?
JUAQUITA CALLAWAY: No - -
TARA DICKERSON: And you don’t - -
JUAQUITA CALLAWAY: - - not any longer.
TARA DICKERSON: You don’t submit his bills,
correct?
JUAQUITA CALLAWAY: I do not.
TARA DICKERSON: Okay. And this particular email was actually something you inquired about, correct?
JUAQUITA CALLAWAY: Regarding the services, yes.
TARA DICKERSON: And then you forwarded a copy to him, is that correct?
JUAQUITA CALLAWAY: That is correct.
TARA DICKERSON: Okay. So this wasn’t a email that he generated, correct?
JUAQUITA CALLAWAY: No.
TARA DICKERSON: Okay. No other questions.
DR. MALLOY: Re – redirect.
JUDGE TEATE: Go ahead.
DR. MALLOY: Um, and I – I’m sorry, Dr. Callaway. I should have asked you this in the very beginning. The facility that you have been mentioning where you and the other physicians, what has been my role at that role, um, as far as, you know?
JUAQUITA CALLAWAY: Uh, you served as our Medical Director.
DR. MALLOY: Thank you. So, therefore, anything that would be in – out of compliance with respect to that facility, being that I’m the Medical Director (or was the Medical Director), would have a direct impact
on me?
JUAQUITA CALLAWAY: I would think so.
DR. MALLOY: Okay. Thank you.
JUDGE TEATE: Any re-cross?
TARA DICKERSON: Nothing, Your Honor.
JUDGE TEATE: Thank you for coming. Is she free to leave, sir?
DR. MALLOY: Yes.
JUDGE TEATE: All right. Thank you for coming [indistinct]. Dr. Malloy, your next witness?
DR. MALLOY: Thank you. My next witness would be Ms. Trina Thompson.
JUDGE TEATE: Ms. Thompson, if you’ll come up beside me up here and, before you take a seat, if you would raise your right hand? All right. Do you solemnly swear that the testimony you’re about to give is the whole truth and nothing but the truth, so help you God?
TRINA THOMPSON: Yes.
JUDGE TEATE: All right. Please state – take a seat and state your name for the record.
TRINA THOMPSON: Trina Thompson.
JUDGE TEATE: All right. Your witness, Dr. Malloy.
DR. MALLOY: Okay. Um, Ms. Thompson, um, again,
this is kind of last-minute, I know, and you also gave up some time to be here and I appreciate it. Um, Ms. Thompson, could you for the Court, um, state, um, what you do at Old National GYN?
TRINA THOMPSON: I’m a, uh, Sonographer.
DR. MALLOY: And – and, as a sonographer, what are your responsibilities?
TRINA THOMPSON: So, um, do ultrasounds on the, uh, patients.
DR. MALLOY: Okay. And you – you do those ultrasounds to determine, um, what information?
TRINA THOMPSON: To determine gestational age.
DR. MALLOY: Okay. And, Ms. Thompson, just – just for the Court, give us a little background on your experience. Are you a certified sonographer?
TRINA THOMPSON: Yes, I am.
DR. MALLOY: Um, are you certified in doing both 2D and 3D ultrasounds?
TRINA THOMPSON: Yes.
DR. MALLOY: Um, about how many offices around the state of Georgia, um, have you been performing ultrasounds?
TRINA THOMPSON: Um, probably about 10. I’ve been, uh, a sonographer for 20 years.
DR. MALLOY: Okay. And be – and because you do
3D ultrasounds, um, which are more complex, you are quite – and correct me if I’m wrong – quite versed at looking at fetal anatomy?
TRINA THOMPSON: Yes.
DR. MALLOY: Placenta location?
TRINA THOMPSON: Yes.
DR. MALLOY: Maternal anatomy?
TRINA THOMPSON: Yes.
DR. MALLOY: Uh, as a matter of fact, um, one of the requirements of the Women’s Right to Know – one of the requirements is that the patient has the right to look at the ultrasound?
TRINA THOMPSON: Yes.
DR. MALLOY: And they have the right to ask questions about the ultrasound?
TRINA THOMPSON: Yes.
DR. MALLOY: Matter of fact, they even have the right to listen to the heartbeat?
TRINA THOMPSON: Yes.
DR. MALLOY: Uh, that’s the Georgia law?
TRINA THOMPSON: Yes.
DR. MALLOY: Okay. And they also, as far as you know from the Women’s Right to Know Act, they are to be told about any fetal abnormalities?
TRINA THOMPSON: Yes.
DR. MALLOY: Um, any maternal abnormalities?
TRINA THOMPSON: Yes.
DR. MALLOY: So if you were to see a fibroid, an ovarian cyst, um, if you saw a fetus that had, um, some sort of, um, intracranial issue, you would be obligated to tell the – the – the patient?
TRINA THOMPSON: Yes.
DR. MALLOY: And so part of what you do is to look at – do the ultrasound, look at the fetal anatomy, look at the maternal anatomy, and give the patient the opportunity to ask any questions about the ultrasound?
TRINA THOMPSON: Yes.
DR. MALLOY: Okay. And would you say that every patient that comes to Old National that you’ve done an ultrasound on was pregnant?
TRINA THOMPSON: No.
DR. MALLOY: Okay. So some of the patients that come in aren’t pregnant?
TRINA THOMPSON: Are not pregnant, no.
DR. MALLOY: And you know that the law in Georgia states that we, in a private practice, you cannot do an abortion beyond 14 weeks?
TRINA THOMPSON: Right.
DR. MALLOY: So you also do ultrasounds on
patients whose fetuses are greater than 14 weeks?
TRINA THOMPSON: Oh, yes, uh-huh.
DR. MALLOY: And when they leave you, do we know what they’re going to do with those pregnancies in all instances?
TRINA THOMPSON: No.
DR. MALLOY: Okay. Some of them, um, request information about terminating their pregnancy?
TRINA THOMPSON: Yes.
DR. MALLOY: Some of them, um, take – they’re undecided?
TRINA THOMPSON: Right.
DR. MALLOY: And some of them ask for obstetrical services?
TRINA THOMPSON: Exactly.
DR. MALLOY: And the patients that come in who are not pregnant, um, it’s – you tell them they’re not pregnant?
TRINA THOMPSON: Yes.
DR. MALLOY: And some of them, they’re so early that you can’t really tell if they’re pregnant?
TRINA THOMPSON: Right.
DR. MALLOY: And sometimes we have them come back?
TRINA THOMPSON: Yes.
DR. MALLOY: But the – the bottom line is – is that patients come in to find out if they’re pregnant and for how long they’re pregnant when you do the ultrasound?
TRINA THOMPSON: Yes.
DR. MALLOY: That’s – that’s your responsibility, the ultrasound?
TRINA THOMPSON: Yeah. Yes.
DR. MALLOY: Okay. You don’t bill?
TRINA THOMPSON: No.
DR. MALLOY: You don’t look at codes.
TRINA THOMPSON: No, I do not.
DR. MALLOY: Okay. What you do is the ultrasound and you follow the guidelines of the Women’s Right to Know - -
TRINA THOMPSON: Yes.
DR. MALLOY: - - and looking at fetal anatomy - -
TRINA THOMPSON: Yes.
DR. MALLOY: - - placental anatomy - -
TRINA THOMPSON: Yes.
DR. MALLOY: - - maternal anatomy - -
TRINA THOMPSON: Yes.
DR. MALLOY: - - because that is the requirement? And you’re also required, if the patient is to ask, to
give her any information about that?
TRINA THOMPSON: Yes.
DR. MALLOY: Okay. So patients that decide to stay - -
TRINA THOMPSON: Uh-huh?
DR. MALLOY: - - is it because we have made them stay?
TRINA THOMPSON: No.
DR. MALLOY: Have we coerced them to stay?
TRINA THOMPSON: No.
DR. MALLOY: They have the – do they have the opportunity to come back at another day?
TRINA THOMPSON: Oh, yeah.
DR. MALLOY: Do they have the opportunity to go someplace else?
TRINA THOMPSON: They do.
DR. MALLOY: And matter of fact, we don’t provide general anesthesia, do we?
TRINA THOMPSON: No, we do not.
DR. MALLOY: So we have patients who, because they don’t want to be done under local, will leave us - -
TRINA THOMPSON: Yeah.
DR. MALLOY: - - and go someplace else?
TRINA THOMPSON: Exactly.
DR. MALLOY: Um, but do we know whether or not
they indeed have the abortion?
TRINA THOMPSON: No, we do not.
DR. MALLOY: Okay. Even if they tell us they’re gonna have the abortion, we don’t know?
TRINA THOMPSON: No.
DR. MALLOY: Okay. So you’re performing the ultrasound and you’re doing what is required under the Woman’s(sic) Right to Know?
TRINA THOMPSON: Yes, sir.
DR. MALLOY: Okay. [Indistinct]
JUDGE TEATE: Cross-examination?
TARA DICKERSON: And you are a – is it a sonographer?
TRINA THOMPSON: Sonographer, yes, uh-huh. A Registered Diagnostic Medical Sonographer.
TARA DICKERSON: Okay. And with regard to that type of work, there are what we call 2D images and 3D images, correct?
TRINA THOMPSON: Yes, uh-huh. Yes, ma’am.
TARA DICKERSON: Now, at this facility over on Old National - -
TRINA THOMPSON: Yes?
TARA DICKERSON: - - what equipment do they have in place at that location?
TRINA THOMPSON: We have a 2D with vaginal and,
um, transabdominal.
TARA DICKERSON: So with regard to the 2D, you’d, uh, you said vaginal?
TRINA THOMPSON: Uh-huh. And transabdominal, uh-huh.
TARA DICKERSON: Okay. Vaginal is like a scope or something that takes the picture, right?
TRINA THOMPSON: No, the vaginal, you insert into the vagina.
TARA DICKERSON: Right.
TRINA THOMPSON: And the transabdominal, you do on top of the, uh, the abdomen.
TARA DICKERSON: So the one that we usually see on TV where they’re rubbing something around - -
TRINA THOMPSON: That’s the transabdominal, uh-huh.
TARA DICKERSON: - -that’s called the [overlapping conversation]?
TRINA THOMPSON: But that’s a 2D, yeah.
TARA DICKERSON: That’s 2D?
TRINA THOMPSON: Uh-huh.
TARA DICKERSON: Okay.
TRINA THOMPSON: Well, unless they’re doing a 3D. [Chuckling]
TARA DICKERSON: Okay.
TRINA THOMPSON: Uh-huh.
TARA DICKERSON: And then the 3D, are you saying that is the trans – the - -
TRINA THOMPSON: Well, with the 3D ultrasound, that – they do, um, they hand do it transvaginal when they’re looking for different, um, um, things that may – - could be wrong with the – with the woman’s fetal anat – - not fetal, but female – anatomy. Um, but usually the 3D that they do on the – on the tummy, they do on top. That’s what you see on TV. They don’t do the transabdo, uh, vaginal one on the TV.
TARA DICKERSON: So on the – just on the abdo – abdomen, you can do a T - -
TRINA THOMPSON: A 2D or a - -
TARA DICKERSON: - - 2D and a - -
TRINA THOMPSON: Uh-huh.
TARA DICKERSON: - - or a 3D?
TRINA THOMPSON: Yes, uh-huh.
TARA DICKERSON: Okay. Okay. So why would you need to do both?
TRINA THOMPSON: Well, we don’t do 3D’s - -
TARA DICKERSON: Okay.
TRINA THOMPSON: - - at – at Old National. Three-D is a more – a lot of, um, pregnant mommies want 3D’s to see what, you know, to try to get a look
at – look at the baby.
TARA DICKERSON: [Indistinct] okay.
TRINA THOMPSON: Not [overlapping conversation].
TARA DICKERSON: A better picture?
TRINA THOMPSON: Well, yeah, because that gives them a with a 3D it – it – it lights it up, it gives it in color, and it gives you all the actual – you can see the features of the baby. You can almost see what the baby looks like. Most of the time you can. Um, it’s, you know, and you have to be a certain amount of weeks to do a 3D, which is about like 25 weeks. They say like 25 to like 32. Uh, when I do ‘em at the – at, um, at our other office, um, that’s what we’ll do. But that’s for, you know, that’s a different type of ultrasound.
TARA DICKERSON: Oh, okay.
TRINA THOMPSON: Yeah.
TARA DICKERSON: And so with regard to this location, since the maximum that you are gonna be looking at anyway is 14 weeks - -
TRINA THOMPSON: Yes.
TARA DICKERSON: - -then you do what’s considered what, the 2D? Is that - -
TRINA THOMPSON: Two-D, yes.
TARA DICKERSON: Okay.
TRINA THOMPSON: Uh-huh.
TARA DICKERSON: And so you’re billing for a – do you know what they’re billing for, whether they’re billing for 2D or 3D or what?
TRINA THOMPSON: Well, it would be – it would have to be 2D because we don’t do 3D.
TARA DICKERSON: Okay.
TRINA THOMPSON: Uh-huh, yes.
TARA DICKERSON: Okay. All right. No other questions.
JUDGE TEATE: Any other questions?
DR. MALLOY: Just one – one last question, Your Honor. Again, I just want to make sure that it’s clear. We can only do 14 weeks in a private doctor’s office, but the ultrasound may be of any gestational age?
TRINA THOMPSON: Yes, yes.
TARA DICKERSON: Right.
TRINA THOMPSON: Yes.
DR. MALLOY: Okay. I just wanted to - -
TRINA THOMPSON: Yeah, and we have ladies that come in – um, private pay or whatever – that want to get an ultrasound in our office, and we do that there, too, for them. The 2D one.
DR. MALLOY: Okay. Um, and which brings up the
question. So we do have patients who come to the facility just to have an ultra - -
TRINA THOMPSON: Just to have an ultrasound, yes. Just to see [clearing throat] how far they are and to see what the sex of their baby is.
DR. MALLOY: And we also do ultrasounds for patients who have GYN issues?
TRINA THOMPSON: Oh, yeah. They come for that, yes, as well.
DR. MALLOY: Such as pelvic pain?
TRINA THOMPSON: Yes. Why they’re not having a period.
DR. MALLOY: Okay. Bleeding?
TRINA THOMPSON: Bleeding. Abnormal bleeding, yes.
DR. MALLOY: History of fibroids?
TRINA THOMPSON: Yes, and pelvic pain, yeah.
DR. MALLOY: Thank you.
JUDGE TEATE: Anything else?
TARA DICKERSON: Nothing else.
JUDGE TEATE: Thank you for coming in.
TRINA THOMPSON: [Indistinct]
JUDGE TEATE: Dr. Malloy, your next witness?
DR. MALLOY: The next witness will be Ms. – Ms.
Sarah Holmes.
JUDGE TEATE: Ms. Holmes, if you’ll come up here beside me in the upper chair?
SARAH HOLMES: Okay.
JUDGE TEATE: And before you take a seat, if you would please raise your right hand? Do you solemnly affirm the testimony you’re about to give is the whole truth and nothing but the truth, so help you God?
SARAH HOLMES: I affirm.
JUDGE TEATE: All right. Uh, please take a seat and state your name for the record.
SARAH HOLMES: Sarah, S-A-R-AH, Holmes, H-O-L-M-E-S.
JUDGE TEATE: All right. Thank you, ma’am. All right, Dr. Malloy.
DR. MALLOY: Ms. Holmes, uh, you’re the last one, so [indistinct] save you for last, but it’s okay to be last.
SARAH HOLMES: [Chuckling]
DR. MALLOY: Um, uh, Ms. Holmes, uh, explain to the Court your relationship and, um, with my practices.
SARAH HOLMES: Um, I’m the [indistinct] Executive Administrator for your practices, um, for 27 years, um, overseeing, um, the things that you ask me to
oversee.
DR. MALLOY: Good. And how many – how many offices, um, am I currently affiliated with?
SARAH HOLMES: Um, do I include surgi?
DR. MALLOY: [Indistinct] name – name every office I’m affiliated with.
SARAH HOLMES: Okay. Um, Old National Gynecology.
DR. MALLOY: Uh-huh.
SARAH HOLMES: Metropolitan Atlanta OB/GYN, Soapstone Center for Clinical Research and Atlanta Center for Women’s Choice.
DR. MALLOY: You left out one.
SARAH HOLMES: [Chuckling] Um - -
DR. MALLOY: [Indistinct]
SARAH HOLMES: Oh.
DR. MALLOY: [Indistinct]
SARAH HOLMES: I’m sorry? What did you say?
DR. MALLOY: [Indistinct]
SARAH HOLMES: Oh, Feminist. I’m sorry, Feminist Women’s Health Center.
DR. MALLOY: Okay. [Overlapping conversation]
SARAH HOLMES: Um, I apologize.
DR. MALLOY: Okay. Um, [indistinct] with that many practices, I can see possibly [indistinct]. Anyway, you have been my Executive Administrator for 27 years and, in the 27 years in that capacity – because you’ve been in that capacity [indistinct] – have I ever had a Medicaid audit?
SARAH HOLMES: No.
DR. MALLOY: Okay. Has Medicaid ever contacted you about any misrepresentation or fraudulent activity that I had done?
SARAH HOLMES: No.
DR. MALLOY: Um, and you have – give us some of your – your – your titles and – and your experience and your – your job descriptions, your duties.
SARAH HOLMES: Um, I have four certifications. I am a Certified Med, um, Medical Manager, a Certified Practice Manager. Um, I am a, um, Certified Health Care Compliance Officer. And I am a HIPAA Compliance Specialist. I also teach, uh, part-time at Clayton State, um, in the evenings, um, in the Medical Billing and Coding Department.
DR. MALLOY: Okay. So, suffice it to say, I’m fortunate to have you because you’re gonna keep me out of trouble?
SARAH HOLMES: I’m gonna try my best.
DR. MALLOY: Okay, thank you. All right. And – and your relationship with – with Old National, um,
please tell the Court your relationship there.
SARAH HOLMES: Well, I, um, oversee, um, the Officer Manager, Cathy, um, Ms. Warner. Um, I go over [clearing throat] at least once a week to make sure that she’s not having any issues that she can’t resolve, um, and just to make sure that things are running smoothly and as compliantly as possible.
DR. MALLOY: Okay. And you, Cathy(sic), um, did you have occasion to speak with Cathy, um, last year, uh, about firing an employee?
SARAH HOLMES: Yes, I did.
DR. MALLOY: Okay. And, as my Executive Director(sic), did you advise her how to handle that?
SARAH HOLMES: Yes, I did.
DR. MALLOY: Um, did she obtain your assistance with respect to any hearings that followed that?
SARAH HOLMES: Yes, she did.
DR. MALLOY: Okay. And, um, and it’s already been stated for the record, but the employee, um, title – their position over at Old National – was, what did they do?
SARAH HOLMES: They filed Medicaid billing.
DR. MALLOY: Okay. Um, when this happened about my – the audit, was I – did I even ask you – did I ask you, Have we ever been audited before?
SARAH HOLMES: I think you did ask me had we ever
been audited.
DR. MALLOY: And – and what was your answer?
SARAH HOLMES: No, we have not been audited before.
DR. MALLOY: Was I surprised - -
SARAH HOLMES: Yes, you were.
DR. MALLOY: - - about this audit?
SARAH HOLMES: As well as I.
DR. MALLOY: Okay. And so because we knew this Hearing was – was coming up, um, we, as – as my – as my Administrator, you wanted to make sure that I was, I would hope, in compliance?
SARAH HOLMES: Correct.
DR. MALLOY: And, in doing such, you [indistinct] tell me what – what did you do to make sure or to assure yourself that I had not and was not doing anything wrong?
SARAH HOLMES: I initiated [clearing throat] an email to, um, Medicaid, um, stipulating what our policy was. And I also submitted a copy of our form that we, um, have the patients sign when they come in, and I forwarded it on to, um, Medicaid – well, to the Georgia web portal which is the overseer of the Medicaid Program.
DR. MALLOY: And – and what – what did, um,
[indistinct; pages shuffling] – will you identify the form that you have in your hand?
SARAH HOLMES: Yes. This is the form that I sent to, um, to Medicaid.
DR. MALLOY: Could you please read, um, the form out loud for the Court?
SARAH HOLMES: Um, the highlighted areas?
DR. MALLOY: The high – yeah.
SARAH HOLMES: Okay. Thank you for contacting the CIC. We have received your inquiry. The provider’s office is in compliance with Medicaid’s policies, and the form is acceptable.
DR. MALLOY: Okay, keep going.
SARAH HOLMES: If you have any questions regarding this information, please do not hesitate to contact the ACS Provider Inquiry Unit Monday through Friday, 8 am. until 5 p.m., or use the Contact Us features on the web at www.dhp.ga.gov. Thank you for your participation in the Georgia Medicaid PeachCare for Kids Program.
DR. MALLOY: Okay.