December 10, 1998
AMERIPATH PREVAILS ON MEDICARE REIMBURSEMENT ISSUE
Riviera Beach, Florida, December 10, 1998 - AmeriPath,
Inc. (Nasdaq: PATH) announced today that Medicare (Florida)
Program Safeguards ("MPS") has advised the Company that
after consideration of the additional information provided
by the Company, it has determined "not to hold . AmeriPath
Florida Inc. liable for refunding our previously assessed
overpayment" of $2.95 million. Moreover, MPS, in its
letter to the Company, acknowledged that this matter
did "not involve fraud or intentional abuse" of the Medicare
program.
As previously disclosed, following an onsite review
in April 1997 by an Operation Restore Trust Team of the
Company's 1996 Medicare billing practices at its Ft.
Lauderdale laboratory facility, MPS determined that the
Company was liable for, and sought recoupment of, alleged
$2.95 million in Medicare overpayments. MPS's determination
was based on their finding at that time that the AmeriPath
facility accepted payment for services that either were
billed using an improper procedure code (88305 vs. 88304)
or were not adequately documented.
Upon receiving the MPS overpayment determination, the
Company mounted a vigorous protest and defense, consistently
taking the position that MPS's determination, regarding
improper CPT coding, was completely erroneous and inconsistent
with accepted CPT code assignment guidelines that have
been in effect since 1992. As support for its position,
the Company provided MPS with reports of two reputable,
independent CPT coding experts, retained as consultants
by the Company's healthcare counsel. These experts independently
concluded, based on their review of the services reviewed
by MPS, that all such services were properly coded and
properly billed by AmeriPath under CPT Code 88305, in
conformity with accepted CPT code assignment guidelines.
The only claim which MPS has determined to continue
to pursue is related to an alleged lack of documentation
on 12 services, resulting in overpayments in the total
amount of $204.05. Although the Company believes that
it can provide adequate documentation supporting the
billing for these clinical laboratory services, the Company
will pay the $204.05 in the interest of bringing closure
to this matter.
The MPS letter also states that it has requested an
interpretation from the CPT coding panel on the future
use of CPT codes 88304 and 88305 by AmeriPath and all
other providers. MPS also acknowledged that no action
will be taken for the periods 1996 or thereafter. Once
MPS receives information from the CPT coding panel, they
will issue clarifying instruction through their normal
publication process. AmeriPath believes that CPT coding
panel will confirm the correctness of AmeriPath's use
of CPT code 88305 for skin biopsies.
Separately, the Company announced that it will vigorously
defend and seek expeditious withdrawal or dismissal of
the class action lawsuits that have been filed against
it. The Company has been served with summonses in what
purport to be five securities class action claims filed
in the U. S. District Court for the Southern District
of Florida. The Company is aware that other similar lawsuits,
all arising as a result of the recent significant drop
in the Company's stock price (which in turn followed
the Company's initial announcement regarding MPS's $2.95
million overpayment determination), are being filed or
pursued. Again, the Company believes all such suits are
without merit and will seek immediate withdrawal or dismissal.
James C. New, AmeriPath's President and CEO, stated: "From
the outset, we were confident that we had a strong position
in this matter, and were determined to vigorously defend
our rights. We are gratified that MPS has determined
to drop its refund request, and we can now move forward
with 'business as usual' in managing and operating our
business in the best interests of our stockholders, employees
and the physicians and patients whom we serve. Many people
have stood by us, and supported us, during this difficult
time, and for that we are extremely grateful. However,
it is most unfortunate that the Company and our management
team's reputation and billing integrity were ever called
into question in the first place."
AmeriPath, Inc. is the nation's leading physician practice
management company focused on providing anatomic pathology
services to physicians, patients, hospitals, national
clinical laboratories and managed care organizations.
The Company presently operates in ten states and employs
226 pathologists who provide medical services through
outpatient pathology laboratories, hospital inpatient
laboratories and outpatient surgery centers.
....................................................................................................................
This release contains certain forward-looking statements
regarding AmeriPath, including its operations and prospects.
Past performance is not necessarily indicative of future
results. In addition, AmeriPath's actual results could
differ materially from the results anticipated in these
forward-looking statements as a result of uncertainties,
including risks relating to demand, pricing, government
regulation, payments and reimbursements, dependence upon
contracts and pathologists, acquisitions, integration
of acquired practices, the market for pathology services,
competition, and other factors identified in AmeriPath's
filings with theSecurities and Exchange Commission.
