Billions in questionable payments disappeared down California's Medicaid hole

Jan 2014
14,658
3,602
California
#1
Billions In ‘Questionable Payments’ Went To California’s Medicaid Insurers And Providers

"In one case, the state paid a managed-care plan $383,635 to care for a person in Los Angeles County who had been dead for more than four years, according to California State Auditor Elaine Howle."

"In February, a federal watchdog estimated that California had signed up 450,000 people under Medicaid expansion who may not have been eligible for coverage."

"By year’s end, she said she expects the federal government to recoup about $9.5 billion from California’s Medicaid program, covering overpayments from 2014 to 2016."

But luckily for us California taxpayers, Gavin Newson promises to expand Medical to cover illegals. What could go wrong?
 
Jul 2015
31,026
22,334
Florida
#3
Some conservative has figured out how rip off the state medicare fund!
You mean like the FLORIDA SENATOR half of my dumbass electorate is trying to send to WASHINGTON?? Rick Scott as head of Hospital Corporation of America conducted the biggest 'heist' in US history of Medicare and Medicaid and I believe VA monies as well. His company was penalized the largest federal fine in US HISTORY at that time. He sold out his stock and walked away with about $200,000,000.


Rick Scott 'oversaw the largest Medicare fraud' in U.S. history, Florida Democratic Party says
By Amy Sherman on Monday, March 3rd, 2014 at 4:38 p.m.

First, Gov. Rick Scott scared the bejesus out of seniors with an online ad claiming that Medicare rate cuts would lead them to lose access to their doctors, hospitals and preventive care.Then, the Florida Democratic Party fired back at Scott, issuing a press release that called Scott "the ultimate Medicare thief."

The Democrats were referring to Scott’s prior tenure as CEO of Columbia/HCA about a decade ago, when the hospital company was fined $1.7 billion for Medicare fraud.
"Rick Scott is saying Democrats are committing Medicare robbery, when in fact he's the ultimate Medicare thief. He lost the right to accuse Democrats of raiding Medicare when he oversaw the largest Medicare fraud in the nation's history. Rick Scott's company stole money that should have gone to health care for seniors," said Florida Democratic Party spokesman Joshua Karp in the Feb. 25 press release.

Separately, we have fact-checked Scott’s claim "we are seeing dramatic rate cuts" to Medicare that will affect people's choice of doctor, hospital and preventive care. We concluded that Scott had failed to say that the rate cut only applies to Medicare Advantage, and thus only affects a fraction of all Medicare beneficiaries. Also, it could be several months before we know the actual impact of the cut which could vary county by county. We rated Scott's claim Mostly False.

Here, we’ll fact-check the Democratic counter-attack that Scott "oversaw the largest Medicare fraud in the nation’s history."

Scott’s tenure at Columbia/HCA

During Scott’s 2010 race for governor, PolitiFact fact-checked multiple claimsrelated to his tenure at Columbia/HCA. Now, we’ll recap some of our earlier discussion of the investigation and fine.

Scott started what was first Columbia in 1987, purchasing two El Paso, Texas, hospitals. Over the next decade he would add hundreds of hospitals, surgery centers and home health locations. In 1994, Scott’s Columbia purchased Tennessee-headquartered HCA and its 100 hospitals, and merged the companies.

In 1997, federal agents went public with an investigation into the company, first seizing records from four El Paso-area hospitals and then expanding across the country. The investigation focused on whether Columbia/HCA had committed Medicare and Medicaid fraud.

Scott resigned as CEO in July 1997, less than four months after the inquiry became public. Company executives said had Scott remained CEO, the entire chain could have been in jeopardy.

During his 2010 race, the Miami Herald reported that Scott had said he would have immediately stopped his company from committing fraud -- if only "somebody told me something was wrong." But there were such warnings in the company’s annual public reports to stockholders -- which Scott had to sign as president and CEO.
Scott wanted to fight the accusations, but the corporate board of the publicly traded company wanted to settle.

In December 2000, the U.S. Justice Department announced that Columbia/HCA agreed to pay $840 million in criminal fines, civil damages and penalties.
Among the revelations from the 2000 settlement:

• Columbia billed Medicare, Medicaid, and other federal programs for tests that were not necessary or had not been ordered by physicians;

• The company attached false diagnosis codes to patient records to increase reimbursement to the hospitals;

• The company illegally claimed non-reimbursable marketing and advertising costs as community education;

• Columbia billed the government for home health care visits for patients who did not qualify to receive them.

The government settled a second series of similar claims with Columbia/HCA in 2002 for an additional $881 million. The total for the two fines was $1.7 billion.
On Scott’s 2010 campaign website, he admitted to the $1.7 billion fine, though the link is no longer on the site.
 
Jul 2014
30,342
7,736
midwest
#4
California leads the nation in illegals.

Only logical that they would lead in Medicaid fraud, too.

And lots of other taxpayer rip offs...
 
Jan 2014
14,658
3,602
California
#5
You mean like the FLORIDA SENATOR half of my dumbass electorate is trying to send to WASHINGTON?? Rick Scott as head of Hospital Corporation of America conducted the biggest 'heist' in US history of Medicare and Medicaid and I believe VA monies as well. His company was penalized the largest federal fine in US HISTORY at that time. He sold out his stock and walked away with about $200,000,000.


Rick Scott 'oversaw the largest Medicare fraud' in U.S. history, Florida Democratic Party says
By Amy Sherman on Monday, March 3rd, 2014 at 4:38 p.m.

First, Gov. Rick Scott scared the bejesus out of seniors with an online ad claiming that Medicare rate cuts would lead them to lose access to their doctors, hospitals and preventive care.Then, the Florida Democratic Party fired back at Scott, issuing a press release that called Scott "the ultimate Medicare thief."

The Democrats were referring to Scott’s prior tenure as CEO of Columbia/HCA about a decade ago, when the hospital company was fined $1.7 billion for Medicare fraud.
"Rick Scott is saying Democrats are committing Medicare robbery, when in fact he's the ultimate Medicare thief. He lost the right to accuse Democrats of raiding Medicare when he oversaw the largest Medicare fraud in the nation's history. Rick Scott's company stole money that should have gone to health care for seniors," said Florida Democratic Party spokesman Joshua Karp in the Feb. 25 press release.

Separately, we have fact-checked Scott’s claim "we are seeing dramatic rate cuts" to Medicare that will affect people's choice of doctor, hospital and preventive care. We concluded that Scott had failed to say that the rate cut only applies to Medicare Advantage, and thus only affects a fraction of all Medicare beneficiaries. Also, it could be several months before we know the actual impact of the cut which could vary county by county. We rated Scott's claim Mostly False.

Here, we’ll fact-check the Democratic counter-attack that Scott "oversaw the largest Medicare fraud in the nation’s history."

Scott’s tenure at Columbia/HCA

During Scott’s 2010 race for governor, PolitiFact fact-checked multiple claimsrelated to his tenure at Columbia/HCA. Now, we’ll recap some of our earlier discussion of the investigation and fine.

Scott started what was first Columbia in 1987, purchasing two El Paso, Texas, hospitals. Over the next decade he would add hundreds of hospitals, surgery centers and home health locations. In 1994, Scott’s Columbia purchased Tennessee-headquartered HCA and its 100 hospitals, and merged the companies.

In 1997, federal agents went public with an investigation into the company, first seizing records from four El Paso-area hospitals and then expanding across the country. The investigation focused on whether Columbia/HCA had committed Medicare and Medicaid fraud.

Scott resigned as CEO in July 1997, less than four months after the inquiry became public. Company executives said had Scott remained CEO, the entire chain could have been in jeopardy.

During his 2010 race, the Miami Herald reported that Scott had said he would have immediately stopped his company from committing fraud -- if only "somebody told me something was wrong." But there were such warnings in the company’s annual public reports to stockholders -- which Scott had to sign as president and CEO.
Scott wanted to fight the accusations, but the corporate board of the publicly traded company wanted to settle.

In December 2000, the U.S. Justice Department announced that Columbia/HCA agreed to pay $840 million in criminal fines, civil damages and penalties.
Among the revelations from the 2000 settlement:

• Columbia billed Medicare, Medicaid, and other federal programs for tests that were not necessary or had not been ordered by physicians;

• The company attached false diagnosis codes to patient records to increase reimbursement to the hospitals;

• The company illegally claimed non-reimbursable marketing and advertising costs as community education;

• Columbia billed the government for home health care visits for patients who did not qualify to receive them.

The government settled a second series of similar claims with Columbia/HCA in 2002 for an additional $881 million. The total for the two fines was $1.7 billion.
On Scott’s 2010 campaign website, he admitted to the $1.7 billion fine, though the link is no longer on the site.
Mr. Picturetaker,

Could you at least try and stay on subject. We are talking about the Medicaid fraud associated with the ACA, especially in California.
 
May 2016
3,016
706
california
#6
I'd suspect the hospitals are getting the money, illegals get the free care (which doesn't sound bad except when you're skimping to pay for your own medical care).
 
Jan 2014
14,658
3,602
California
#7
I'd suspect the hospitals are getting the money, illegals get the free care (which doesn't sound bad except when you're skimping to pay for your own medical care).
Mr. OlGuy,

It was going to providers because California signed up 450,000 people who weren't eligible, costing cash strapped California $9B. I imagine there was fraud, as in the first case, but in the general case, the providers were assuming they were treating valid patients, so I can see that the State can recover much of that $9B. Add to that, California will have to pay for the illegal's healthcare themselves because the Federal Government will not reimburse them.
 
Jul 2015
31,026
22,334
Florida
#8
Mr. Picturetaker,

Could you at least try and stay on subject. We are talking about the Medicaid fraud associated with the ACA, especially in California.
So when HCA was ripping of MEDICARE, MEDICAID and TriCare during the Reagan, Bush1 and Clinton years, MISSING BILLIONS didn't COUNT? It only matters when it is from the ACA subsidies? WOW, how do you do that? You must be a fantastic contortionist.


PS Guess who was RICK SCOTT'S business partners were back then? David Frist and his brother Bill Frist, Senator, TN and SEN Majority Leader.

The Bad Doctor
DOUG IRELAND | JANUARY 9, 2003 | 12:00AM

While TV gushed last week over the Republicans’ new Senate majority leader, Bill Frist, intervening in a traffic accident, portraying the former heart surgeon as a “Good Samaritan,” in truth the GOP has simply replaced a racist with a corporate crook.

Frist was born rich, and got richer -- thanks to massive criminal fraud by the family business. The basis of the Frist family fortune is HCA Inc. (Hospital Corporation of America), the largest for-profit hospital chain in the country, which was founded by Frist‘s father and brother. And, just as Karl Rove was engineering the scuttling of Trent Lott and the elevation of Frist, the Bush Justice Department suddenly ended a near-decadelong federal investigation into how HCA for years had defrauded Medicaid, Medicare and Tricare (the federal program that covers the military and their families), giving the greedy health-care behemoth’s executives a sweetheart settlement that kept them out of the can.

The government‘s case was that HCA kept two sets of books and fraudulently overbilled the government. The deal meant that HCA agreed to pay the government $631 million for its lucrative scams -- which, on top of previous fines, brought the total government penalties against the health-care conglomerate to a whopping $1.7 billion, the largest fraud settlement in history, breaking the old record set by Drexel Burnham.

The deal also meant that HCA can continue to participate in Medicare. And, as part of the Bushies’ deal shutting down what Deputy Assistant FBI Director Thomas Kubic called “one of the FBI‘s highest-priority white-collar crime investigations,” no criminal charges were brought against the top HCA execs who presided over the illegal bilking of federal programs designed to aid the poor -- and that includes Senator Frist’s brother, Thomas, HCA‘s former CEO (and current director), who’s been described by Forbes magazine as “one of the richest men in America,” with a personal fortune estimated at close to $2 billion.

What did HCA do? It inflated its expenses and billed the government for the overrun; it billed the government for services ineligible for reimbursement (like advertising and marketing costs). HCA violated both law and medical ethics when, as Forbes put it, “the company increased Medicare billings by exaggerating the seriousness of the illnesses they were treating. It also granted doctors partnerships in a company hospitals as a kickback for the doctors‘ referring patients to HCA. In addition, it gave doctors ’loans‘ that were never expected to be paid back, free rent, free office furniture -- and free drugs from hospital pharmacies.”
 
Jan 2014
14,658
3,602
California
#9
So when HCA was ripping of MEDICARE, MEDICAID and TriCare during the Reagan, Bush1 and Clinton years, MISSING BILLIONS didn't COUNT? It only matters when it is from the ACA subsidies? WOW, how do you do that? You must be a fantastic contortionist.


PS Guess who was RICK SCOTT'S business partners were back then? David Frist and his brother Bill Frist, Senator, TN and SEN Majority Leader.

The Bad Doctor
DOUG IRELAND | JANUARY 9, 2003 | 12:00AM

While TV gushed last week over the Republicans’ new Senate majority leader, Bill Frist, intervening in a traffic accident, portraying the former heart surgeon as a “Good Samaritan,” in truth the GOP has simply replaced a racist with a corporate crook.

Frist was born rich, and got richer -- thanks to massive criminal fraud by the family business. The basis of the Frist family fortune is HCA Inc. (Hospital Corporation of America), the largest for-profit hospital chain in the country, which was founded by Frist‘s father and brother. And, just as Karl Rove was engineering the scuttling of Trent Lott and the elevation of Frist, the Bush Justice Department suddenly ended a near-decadelong federal investigation into how HCA for years had defrauded Medicaid, Medicare and Tricare (the federal program that covers the military and their families), giving the greedy health-care behemoth’s executives a sweetheart settlement that kept them out of the can.

The government‘s case was that HCA kept two sets of books and fraudulently overbilled the government. The deal meant that HCA agreed to pay the government $631 million for its lucrative scams -- which, on top of previous fines, brought the total government penalties against the health-care conglomerate to a whopping $1.7 billion, the largest fraud settlement in history, breaking the old record set by Drexel Burnham.

The deal also meant that HCA can continue to participate in Medicare. And, as part of the Bushies’ deal shutting down what Deputy Assistant FBI Director Thomas Kubic called “one of the FBI‘s highest-priority white-collar crime investigations,” no criminal charges were brought against the top HCA execs who presided over the illegal bilking of federal programs designed to aid the poor -- and that includes Senator Frist’s brother, Thomas, HCA‘s former CEO (and current director), who’s been described by Forbes magazine as “one of the richest men in America,” with a personal fortune estimated at close to $2 billion.

What did HCA do? It inflated its expenses and billed the government for the overrun; it billed the government for services ineligible for reimbursement (like advertising and marketing costs). HCA violated both law and medical ethics when, as Forbes put it, “the company increased Medicare billings by exaggerating the seriousness of the illnesses they were treating. It also granted doctors partnerships in a company hospitals as a kickback for the doctors‘ referring patients to HCA. In addition, it gave doctors ’loans‘ that were never expected to be paid back, free rent, free office furniture -- and free drugs from hospital pharmacies.”
Mr. picturetaker,

If you want to change the subject, please start your own thread.