BEYOND FEAR

The story of a lawsuit that highlighted bureaucratic errors in the health care field.

In his debut nonfiction book, Giovanis recounts his multiyear quest to get the federal government to correct a calculation issue involving hospital reimbursement rates that ended in a multimillion-dollar settlement in favor of the hospitals. The author, a hospital administrator–turned-consultant, opens the book with an overview of his personal history, then moves on to the central issue: He discovered an error in the formula being used to determine the amount of Medicare payments to hospitals, and when he notified Medicare administrators about the problem, they quietly updated the formula but refused to discuss making good on past miscalculations. Giovanis and his colleagues filed suit against the federal government and recruited hospitals to join the action, hoping to gather more than 100 plaintiffs; they ended up with more than 700 hospitals signing on, with Giovanis as the leader and decision-maker. As the lawsuit proceeded, the author’s wife, Jayne, was dying of cancer; this book is both a tribute to her and a celebration of a wrong righted. The author does a good job of highlighting the key elements of a complex, obscure topic with significant financial implications, providing calculation details for readers who may be interested but effectively aiming the majority of the text at a general audience. Although Giovanis is the hero of the narrative, he acknowledges the contributions of his colleagues; as a result, this is the story of a team effort rather than an individual crusade. The lawsuit’s outcome is evident from the book’s subtitle, but the author still manages to maintain tension throughout as he describes the many challenges and setbacks that the plaintiffs encountered. The book also offers some intriguing big-picture insights into the roles of career bureaucrats, the for-profit companies that make money from government programs, and the relationship between them. Overall, it’s a well-written story on a niche topic for an audience of nonspecialists and a compelling look at modern governance.

A solid account of a battle between government and industry.