|Did you know?
- Rick Scott was never indicted or arrested. Simply, he was never charged with any crime.
- Prosecutors never attempted to depose Scott nor found evidence he was directly involved in the fraud:
Peter Chatfield, who spent seven years working on a Columbia-HCA civil case brought by two whistleblowers, said that deposing Scott was not a high priority for the case. “His e-mails were mostly motivational.” “After sifting through years of discovery documents, Chatfield said he never had a feel for whether Scott knew of any wrongdoing.”
- The convictions were tossed out for the only 2 individuals initially convicted of wrongdoing at Columbia/HCA.
- On 7/25/97, Rick Scott along with 2 other executives resigned.
- Rick Scott wanted to challenge how regulations are interpreted, but the board of directors wanted to settle: Scott “took the position that the courts ultimately did, which was that there could be honest disagreement over how the regulations were interpreted,” Scott campaign spokeswoman Jennifer Baker said.
- In 2000, three years after Scott left the company, HCA agreed to settle and pay $840 million in criminal fines and civil damages and penalties. In 2002, HCA agreed to pay an additional $881 million.
- The $1.7 billion fines in context: Columbia/HCA was the largest hospital company in the nation and world in 1997. Columbia/HCA operated 343 hospitals, so a $1.7 billion fine is equivalent to approx. $4.9 million per hospital.
- Whistleblowers were offered 25% of the settlement
- Janet Reno was the Attorney General (DOJ press release of Dec. 14, 2000)
- Did Scott take the 5th Amendment 75 times? Read here.
Rick Scott Fought Against HillaryCare in the 1990s
- Rick Scott, then-CEO of Columbia/HCA, coordinated private health providers to fight HillaryCare during the Clinton Administration.
- Rick Scott won. HillaryCare was defeated.
- After HillaryCare was defeated, the Clinton Administration decided to give a hard time to every health care group that had opposed them. They pushed for stricter interpretation of Medicare regulations which consisted of well over 100,000 pages.
Clintons’ Witch Hunt: Simple mistakes became fraud
The Clintons targeted many health providers in addition to Rick Scott’s Columbia/HCA.
It’s almost a manhunt. [In 1998] As of March 375 FBI agents work exclusively on health care fraud, up from about 100 in 1992…Health & Human Services and its Inspector General’s office boast a medical fraud staff of 1,143, up a third from 1996.
With that many cops out there, they’ve got to justify their keep.
More and more, simple mistakes and misunderstandings are being labeled as fraud. [...]
“The whole [focus] on infringement as opposed to flagrant violation means everybody’s guilty…So you violate something on page 44,391 — and you’re guilty. Full compliance is not feasible. The regulations are Byzantine.”
It seems pretty clear that the real aim of this game of gotcha is not law enforcement, but revenue. In all, the federal government collected more than $1 billion in fines and settlements last year. [...]
It hasn’t been a hoot at Hospice of the Florida Suncoast, a $48 million (annual revenues) facility in Largo, Fla. The Inspector General’s office audited five years of patient records at the hospice in early 1996 and determined that 176 of its 15,426 dying patients were ineligible for hospice coverage. Why? They lived longer than six months.
Medicare rules say hospice patients must be terminally ill, defined as being within six months of death.
Suncoast was fined $8.9 million — equal to about five years of operating profits.
Clinton administration created a myriad of ambiguous Medicare regulations
- In 1992, there were just ~600 Medicare investigations
- By 1996, there were ~2,200 Medicare investigations (4x increase)
- In 1997, there were over 100,000 pages of Medicare Regulations
- By 1998, the government announced a program to assist hospitals in fraud prevention
- The government was criticized in the media for classifying simple mistakes as “fraud.”
- Dozens of prestigious health care institutions paid millions in fines, including Yale Hospital, Duke University Hospital, Harvard University Hospitals, University of Chicago Hospitals, Johns Hopkins, and industry giants Tenet and Columbia/HCA
Even the Courts agreed the Medicare regulations were ambiguous
The 11th Circuit Court of Appeals ruled that the regulations the Clintons put in place were so arcane and complex that reasonable people could disagree on their application and, consequently, dismissed cases filed against employees:
The 11th U.S. Circuit Court of Appeals overturned the convictions of [HCA's] Jay Jarrell and Robert Whiteside, saying government prosecutors had failed to prove that fraud had taken place. [...]
U.S. District Judge Susan Bucklew…said the government’s case was “not completely persuasive” and noted that even the government’s experts testified about the complexity of the Medicare reimbursement process.
In the decision filed late Friday, the appellate court agreed with Jarrell and Whiteside’s lawyers who argued that competing interpretations of the applicable law were reasonable and justified. “Reasonable people could differ,” the court said.
“This ruling should give the government pause before they charge someone with a crime when the regulations they are relying on are ambiguous,” said Peter George, Whiteside’s trial attorney. [...]
The appellate decision raised questions about how successful the government would have been in pursuing criminal charges against HCA if the company hadn’t agreed to pay $95-million in fines to avoid criminal trials.
“Things would be reviewed differently today,” [HCA spokesman Jeff] Prescott said. “But given our position and the potential consequences, settling the case was the best business decision to make at that time.”
Some of the charges were before Columbia/HCA acquire the hospitals
RedState: “Additionally, some of the issues being pinned on Scott originated before he entered the picture and some came from hospitals absorbed into Columbia/HCA through merger or acquisition”
[T]he U.S. Justice Department has revealed its belief that the roots of the wide-ranging Medicare billing fraud allegations against HCA-The Healthcare Co. extend to the pre-Columbia Hospital Corp. days of the original Hospital Corporation of America and its co-founder, Thomas Frist Jr., M.D.
PRNewswire: Another example:
The indictment related to reimbursements since 1986 at Columbia Fawcett Memorial Hospital, a Port Charlotte, Fla. hospital which was acquired by Columbia in 1992.
Bill McCollum Defended Rick Scott’s Company in the 1990s
In 1998, then-congressman Bill McCollum defended Columbia/HCA against the Clinton Administration’s witch hunt:
(Congressional Records: March 19, 1998; Page E434, or here.) St. Petersburg Times
“In our zeal to crack down on health care fraud and abuse, we must be careful not to throw our nets so wide that we ensnare honest providers who are making inadvertent billing mistakes,” McCollum said March 19, 1998, when he introduced his Health Care Claims Guidance Act in the U.S. House of Representatives. [...]
Columbia/HCA wasn’t the only hospital targeted by federal investigators. It was the most high-profile, however, because it was the largest private chain. The company controlled 340 hospitals, 135 surgery centers and 550 home health locations in 37 states.
With so many hospitals facing investigations during the Clinton administration, the American Hospital Association, which received major backing from Columbia/HCA, fought back in Congress with the legislation that McCollum helped sponsor.