Talk of The Villages Florida - View Single Post - UHC under federal investigation for Medicare Fraud
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Old 07-25-2025, 07:54 AM
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Originally Posted by CoachKandSportsguy View Post
which would make sense in that the acquiring company's due diligence is always to validate and forecast the future revenue stream. And if the acquiring company found issues with the current revenue stream, like improper coding, upcoding etc, which was raised somewhere, then the wheels fell off the cart.
Exactly. (Hypothetically), neither TVH's internal audit nor their paid outside consultants found the error/discrepancy/misinterpretation in coding. It was Humana performing their due diligence prior to an acquisition/merger that disagreed with TVH coding, which is why it went on for years and accumulated so many millions in repayment/penalties. If not for the sale negotiations and another perspective from Humana, it would be continuing right now