Quote:
Originally Posted by OrangeBlossomBaby
It wasn't fraud. It was a really huge, significant flaw that TVH discovered, and reported. They were being overpaid for quite awhile. At some point, someone found what the problem was and said "hey boss - this is totally not right." And the boss said "OMG holy crap" and reported it to Medicare, and told Medicare "hey youz guyz - you've been sending us too much money! How do we give it back to you?" And Medicare said "oh golly gee let's figure this out" and they did.
Unfortunately, imposed penalties for overpayment don't get absorbed by the people who were doing the overpayment (Medicare) but by the entity that receives it (TVH). So they're on the hook for the millions in the government's overpayments, AND for penalties. Which - they can't afford.
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I will say that they have not been very transparent on the overbilling issue. I think they should provide a very detailed explanation. When did it start? Was it one code? A hundred codes? A thousand codes? Were there any audits during the overbilling?
What caused it? And was it a programming error? Did the money go to the doctors or to the owners of the company?