Talk of The Villages Florida - View Single Post - Thought’s on Villages Health Chapter 11
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Old 07-04-2025, 12:01 PM
Stu from NYC Stu from NYC is offline
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Quote:
Originally Posted by OrangeBlossomBaby View Post
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.
If TVH was getting overpaid for hundreds of millions of dollars where did the money go? Had to go somewhere.

How did people not know how to code for billing purposes?

I smell fraud