[QUOTE=mtdjed;2446779]
Quote:
Originally Posted by dadspet
The Villages Health (TVH) filed for Chapter 11 bankruptcy on July 3, 2025, due to significant Medicare billing discrepancies, with a reported liability of $361 million to the U.S. government.
I have a problem understanding TVH's role and how they have billing discrepancies with the US Government.
I understand that Medicare Advantage Programs (MA) have agreements with the US Government and get paid by number of subscribers. I also understand that there are adjustments that MA programs may have with the USG to adjust their payment from the USG based upon severity of their subscriber health.
MA programs have their network of providers which likely invoice the MA Program (Not the USG).
How does TVH get involved with the USG? What do they bill that would lead them to be charged with Billing discrepancies? How could it grow to $361M. Was it mistake, fraud, and where was government audit?
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So the chain of events that unfolded. Biden administration starts holding office 2021. Villages Health started mis billing Medicare ( which is the government) They racked up $361 million of overpayment. DOGE started audits of Medicare Jan 2025. Overpayment sited to Villages Health 2025 under the Trump administration. Re-payment demanded. So bankruptcy ensues due to the $$ are gone. So how does an established business Villages Health, thru yearly audits not wonder where the new found $$ are coming from? They knew, they distributed it to their share holders. We honest working stiffs call that theft.