Sen. Rick Scott talks Medicare fraud; no, not his ex-company’s Medicare fraud

By Dan Christensen, FloridaBulldog.org

U.S. Sen. Rick Scott, R-FL, knows a thing or two about Medicare fraud.

He built and ran Columbia/HCA, the huge hospital company that’s become synonymous with mega-healthcare fraud since it was forced to pay $1.7 billion in criminal fines and civil restitution in the early 2000s.

So it’s not without a heavy dose of irony that Florida’s junior senator is today sounding an alarm about an increase in Medicare fraud.

Richard L. Scott was no longer Columbia/HCA’s CEO when those penalties were assessed. He’d quit under pressure on July 25, 1997, eight days after the FBI and Department of Health and Human Services agents raided nearly three dozen company hospitals in six states, including Florida. To cushion his departure, Scott raked in a reported severance of $17 million.

Scott has denied any knowledge of criminality and later went to the Florida governor’s mansion instead of prison. And despite the extent of the fraud, he wasn’t charged with a crime, or even officially questioned by federal authorities, according to Politifact. Four lesser Columbia/HCA executives were indicted for Medicare fraud; two were convicted, but their convictions were overturned on appeal.  Dozens of other senior executives reportedly took the Fifth Amendment and refused to give evidence. Nobody went to jail.

Years later, in July 2000, Scott himself cited the Fifth Amendment 75 times in declining to answer questions during a deposition in a civil lawsuit against Columbia/HCA. Politifact reported in 2014 that Scott declined, citing his lawyer’s advice, because criminal investigations were ongoing at the time.

RICH MEANS NEVER HAVING TO WORRY ABOUT MEDICAL BILLS

Columbia/HCA, now known as HCA Healthcare, and some of its subsidiaries pleaded guilty to bilking Medicare by submitting inflated bills, pumping up diagnoses to increase reimbursements, paying kickbacks to doctors for patient referrals and other crimes. But unlike the human beings that concocted those schemes, corporate defendants couldn’t be packed off to prison.

Scott, 71, the richest U.S. senator with a net worth now likely in excess of $300 million, and his loved ones won’t ever have to worry about paying a medical bill. So in 2022 when Scott proposed his “Rescue America” plan that would have ended all federal programs after five years unless Congress voted to reauthorize them, it caught a lot of negative attention from both parties and he eventually backed down – altering his sunsetting plan to exclude Medicare and Social Security.

So it’s disconcerting that a guy like Scott, with a partisan penchant for calling out “wasteful spending” by Democrats, is making it his business to keep a watchful eye on our Medicare dollars.

Nevertheless, along with Sen. Mike Braun, R-IND, and Sen. JD Vance, R-OH, all minority members of the Senate’s Special Committee on Aging, Scott signed a March 12 letter to the Comptroller General of the U.S. Government Accountability Office “regarding the alarming increase in Medicare fraud.”

The senators cite a GAO estimate that “improper payments cost Medicare $47 billion, while other estimates put Medicare fraud at over $60 billion annually. In fiscal year 2022, only $1.7 billion was reclaimed from Medicare fraud, representing a mere 2.8 percent recovery rate. This fraud poses a substantial financial threat to the nation’s older Americans, undermines our healthcare system’s integrity, and contributes to the nation’s $34 trillion deficit.” [The senators should have said national debt, not deficit.]

“Medicare has increasingly become a target for highly sophisticated fraud schemes, including online phishing, data breaches and international fraud rings,” Scott, Braun and Vance wrote. “A striking example with which these frauds are carried out was provided by a Miami individual involved in Medicare theft, who stated, ‘It’s just so easy. It’s unbelievable.’”

RICK SCOTT ON MEDICARE’S ‘FRAUDULENT ACTORS’

The senators’ letter says a 2022 GAO report offered four recommendations to the Centers for Medicare and Medicaid Services to tighten safeguards. “The alarming new fraud data, however, raises questions regarding the extent to which CMS’s safeguards are working to prevent fraud.”

The senators asked the GAO for a “comprehensive assessment” of the Centers for Medicare and Medicaid Service’s fraud prevention measures as well as the effectiveness of the Justice Department-led Medicare Fraud Strike Force. The first interagency strike force was established in Miami in 2007. Today, strike forces that rely heavily on data analysis to uncover large frauds exist in Los Angeles; Detroit; Houston; Brooklyn; the Gulf Coast (New Orleans, Baton Rouge, Gulfport); Tampa; Orlando; Chicago; Newark; Philadelphia; Dallas; the Appalachian Region (Kentucky, Tennessee, Ohio, Virginia, West Virginia, Alabama); the New England Region (New Hampshire, Maine and Vermont); and Washington, DC (National Rapid Response Strike Force).

The letter from Scott and the others posed several questions they’d like the GAO to answer. Some are rich, like: “How is HHS OIG [Health and Human Services’ Office of Inspector General] prioritizing the investigation of fraudulent actors instead of legitimate providers?”

Then there’s this gem of an observation about Sen. Scott’s concern for Accountable Care Organizations (ACOs), healthcare providers that work together to prevent duplicative services and medical errors:

“This leads to savings for Medicare. However, ACOs can lose their hard-earned savings and face penalties from Medicare when bad actors bill for unnecessary medical supplies.”