Debbie Mucarsel-Powell taking on Fraudster Rick Scott 2024

Don’t be crazy man. I never said it was ok.
I don’t care for baby ass Trump either.
The pubs are not anti women.
It may just take the cons one more cycle to get a good candidate. Sad, but true.

 

I have experience in this. Decades ago I ran a multi specialty medical clinic. I saw the potential for fraud when they changed how you determine cpt codes from time based to complexity based. I would look over a doctors billing and say your diagnosis doesn’t support that level of service. One doctor hired a specialist who determined in writing that this doctor was super efficient and could bill out higher levels of services. All the doctors then hired the same analyst to evaluate them. They all came back with the same analysis. I think all the doctors who used the analyst ended up paying back money and some even did jail time.

 

The religious wrong is a major part of the Republican Party. The anti abortion crap they support is truly evil writ large.

 

Awesome experience right there and thanks for sharing.
The old days are rife with interesting stories and not everyone can resist the temptation of making more money.

 

"probably no saint"....lol, talk about "naive".
One of my oldest clients and now a coworker started out in the HCA environment. Guy is brilliant, has forgotten more than I will ever know. He ran Rev Cycle for several HCA facilities early in his career (it was called Patient Acct Mgmt back then) including N Fl Reg in Gville while he got his masters. Over his 35 years he has worked with and/or for countless provider systems as an employee or vendor. He couldn't get away from HCA fast enough. Not sure why you continue to try and equate others to what happened at HCA but it is incorrect.

 

The religious include some turds but I tend to think their are still plenty of wonderful religious people.
You gotta let it go man.

 

It seems personal to you.
Whatever man. There’s usually more than one way to view a situation. I really don’t care that much.

 

His company was warned, said they wouldn’t do it any longer, but did.

 

Rick Scott is just an astute businessman. So he defrauded the American taxpayer out of a few 10s (100s? 1,000s?) of millions of dollars. It's not like he used food stamps to buy a Coke and a bag of Doritos. Get some perspective people!

 

Only personal in that he has been elected to represent me in multiple elections and I find that both appalling and baffling

 

When Scott managed to unseat a relatively moderate long-term incumbent senator, and Florida has only turned redder since that time, I’ve got a tough time seeing a gun control lobbyist with no name recognition, who has run in three elections in her life and lost two of them, as a huge threat.

I think Scott is far from a great candidate, but just looking at this from a very high level she would seem like the weakest opponent he’ll have faced in any of his gubernatorial or senatorial races.

 

She does check a few key boxes tho and Scott has plenty of baggage, most of his peers dont even like him. I'm not sure how good she is on the campaign trail or in a debate, but the Dems have to start somewhere. Her losses were in a Republican district and she did beat the incumbent Carlos Curbelo.

A major factor in Scott beating Nelson was Nelsons age and lack of charisma. Scott is now almost 71 and also has no charisma which will now work against him as his opponent is in her early 50s. Still I won't believe a Dem can win in FL till it actually happens.

 

Since we are giving personal anecdotes, I was once the finance guy for a managed care company that ran several Humana facilities in SFla. . I neither saw nor heard of anything similar to what HCA was convicted of. There is a big difference between aggressiveness with cpt codes and outright fraud. Btw, fraudulent billing wasn't the only thing Scotts company was convicted of.

 

So I work in healthcare finance, and can answer your question.

Healthcare regulation in general, especially as it relates to medical billing practices, is often very grey, which can be understandable, as we're all (government and medical providers) trying to establish fixed guidelines of what should be done in myriad medical circumstances while also allowing highly trained doctors the necessary autonomy to make independent decisions on care needed for individual patients.

One of the impacts of that landscape is that certain possible healthcare decisions fall into those grey areas, and even queries to regulatory bodies will be answered with, "We don't really know the concrete answer. Use your best judgment." Then, sometimes many years later, a regulatory audit committee with DOJ authority will come in and say, "We disagree with your medical decisions and deemed that care unnecessary. You've defrauded CMS." The details of how that circus sometimes operates is too far off tangent for what I think is necessary explanation of the issue at hand, i.e. HCA's medical settlements under Rick Scott's leadership.

Below is a link to the actual settlement by HCA.

#386: 06-26-03 LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION

Some of the things that HCA ultimately was fined for and settled for fall into this space, and your (imo) accurate answer that many hospital systems (both for-profit and NFP) find themselves on the wrong side of. For example, they were fined for services rendered by OP wound care centers that were retroactively deemed unnecessary, but that's an area where I can completely see physicians erring on a cautious side and hitting complex wounds with a plethora of treatment types to save patients' limbs, etc., where some of the treatments may not have met a strict criteria for "medically necessary."

However, HCA also engaged in other actions which are 100% irrefutable fraud, that I suspect almost no other hospital systems were/are doing.

• Hospitals report annual "Cost Reports" to CMS on what different services cost to operate. Those cost reports impact Medicare reimbursement. HCA was caught in multiple ways just straight up lying about what their services cost to operate, including things like inflating what they paid for patient transports and including home office costs to claim those expenses. Those are not grey areas to anyone working in healthcare billing.
  
• Even more egregious, IMO, they made illegal payments to physicians and physician groups in direct exchange for patient referrals, a legal violation that honestly should have ended with someone(s) in prison, based on the Stark Law and Medicare Antikickback Statute.

 

As you follow the thread along you will see that I used to place the people who did the cost reports inside acute hospitals.
I was mostly using the info they passed along to me in this thread.
I believe Healthsouth rehab had some issues in the past related to this topic.
They have changed names since I believe.

 

I read the thread, but replied to your initial comment because it had the most succinct question I wanted to answer. And to be equally succinct, the answer is "no."

A lot of healthcare systems were certainly stretching limits where they could to recoup more reimbursement, but there's a big difference between operating in the grey areas of billing compliance vs. straight up lying about expenses on cost reports and paying vast amounts in kickbacks to generate business.

 

To further clarify, if you helped place people to do cost reports, then you're probably aware that there is a specific process that exists for keeping a cost report "open" if you have expenses that you think should qualify, and then you can work with CMS to argue for those costs being included and receive a settlement payment for the additional reimbursement owed.

 

Exactly my point being religious gives you absolutely no clues as to whether you are dealing with a person of morals. All I know is anybody who has a bible verse on their business cards is not someone I am going to trust without more data.

 

I actually agree with you I don’t like it when people use Christianity to sell their business.
But I won’t throw the baby out with the bath water.