[Joecooool]

Originally Posted by Worldseries27

Mistakes are not crimes.

LOL, they sure can be. Have you never heard of "Ignorantia juris non excusat"?

This Latin phrase translates to "Ignorance of the law is no excuse". It means that individuals cannot escape legal responsibility just because they were unaware of the law. Whether intentional or not, violations of laws can still lead to consequences, especially in highly regulated sectors like healthcare.

Ignorantia juris non excusat - Wikipedia

In order to run a Medicare Advantage plan, strict compliance with federal regulations is required, especially in areas like coding and billing. The government mandates that professionals employed in these roles are properly trained and certified by recognized, independent agencies. Certifications like the Certified Professional Coder (CPC), awarded by the American Academy of Professional Coders (AAPC), or the Certified Coding Specialist (CCS) offered by the American Health Information Management Association (AHIMA), are crucial for ensuring compliance with Medicare's complex rules.

Individuals working in healthcare billing and compliance must also hold certifications like Certified in Healthcare Compliance (CHC) from the Compliance Certification Board. These certifications ensure accuracy and legitimacy in billing processes, specifically to mitigate the risk of errors that could lead to legal or financial penalties.

This is not just a matter of following protocol, it's a legal requirement. The Medicare program is under constant oversight by agencies like CMS (Centers for Medicare & Medicaid Services), and any failure to comply with the established rules, even if accidental, can result in significant repercussions. Mistakes in coding, billing, or compliance, even if unintentional, can lead to fraud charges, fines, and even criminal liability.

So mistakes can be criminal if they lead to fraudulent claims, improper reimbursements, or violations of federal standards.

[Snowbirdtobe]

In my post Villages Health where did all the money go back on July 12 I said.
"I noticed that the rent was paid to TV. The rent looks to be 1,135,000 per month, but no rent is forecast for October, Nov, or Dec in the pro-forma DIP budget."
I''ll bet most companies stiff the landlord as part of the effort to conserve cash especially when the landlord is part of the "family". I'll bet there are other issues that an audit will show up.
Sucking money out of a bankrupt company before filing might be an issue.
Many people in the past have said they were experts and I didn't know about healthcare or Medicare.
here is what I posted on July 14.
"If the money was spent on making the Brownwood facility a wonderful place or burned in the parking lot that should have no effect on the ability for the new owner of serve the patients."
Follow the money.

[vintageogauge]

Originally Posted by Angelhug52

So, do we all start looking for new doctors?

Most of their doctors already retired once and are/were working part time. The PA's are the ones that will get hurt the most from this.

[Snowbirdtobe]

The patients, in my opinion, will be hurt the most. If you have incorrect medical information in your file it may STOP you from transferring to a Medicare Supplement Plan.
For example BCBS said if you take more than 50 units a day of insulin a day they will not take you.
Transfer to a MA plan is possible despite your health history.

[Tobys Dad]

[QUOTE=Worldseries27;2449307]i agree. Too many hanging judges in the world. Mistakes are not crimes. If it can be saved, do so, if not, replace with better options. Let the courts decide the merits later. Patients need help not turmoil[/QUOT
You say ‘’mistakes”, possible, but outright theft may be more appropriate. IMHO

[Ruger2506]

Originally Posted by ROCKETMAN

The words used by the person in put in charge of villages health system. He said they need to borrow 24 million to sustain operations, which I assume to pay employees and leases on 10 buildings. By his comments the only way out of this situation is to be taken over by Humana, but I assume the bankruptcy judge would have to approve this. Still not clear on the overbilling. Does that mean Medicare was over billed but the money was never actually paid. Going back as long as it has, I would think they received some of that $350 billion.

I think it’s safe to say The Villages healthcare was stealing government monies. Not sure how it was laundered or whatever but I’m pretty sure it was stolen. They knew exactly what they were doing.

[ROCKETMAN]

Unfortunately we won’t have any source other than villages news to know what is going on. Daily sun had one article and I doubt until situation resolved, won’t see any more. If we didn’t have village news we wouldn’t know that Mr. Luria is getting $150,000 a month to oversee the bankruptcy and possible Humana takeover. Don’t think united health care will let this go without a fight.

[golfing eagles]

Originally Posted by Ruger2506

I think it’s safe to say The Villages healthcare was stealing government monies. Not sure how it was laundered or whatever but I’m pretty sure it was stolen. They knew exactly what they were doing.

"Safe" to say that???? "Stole monies"???? "Laundered it"????

Well, in sporting competitions it is best to be confident

So, I suppose that degree of confidence is advantageous in the "TOTV jump to conclusions even though I have no idea what I'm talking about" Olympics.

[Stu from NYC]

Originally Posted by golfing eagles

"Safe" to say that???? "Stole monies"???? "Laundered it"????

Well, in sporting competitions it is best to be confident

So, I suppose that degree of confidence is advantageous in the "TOTV jump to conclusions even though I have no idea what I'm talking about" Olympics.

Time will tell but would think that these large medical practices will benchmark their results with other practices and notice their profit margins are much higher and wonder why.

[golfing eagles]

Originally Posted by Stu from NYC

Time will tell but would think that these large medical practices will benchmark their results with other practices and notice their profit margins are much higher and wonder why.

The "why" will probably be economy of scale, but time will tell.