[birdawg]

What’s your thoughts on Villages Health filing chapter 11

[Laurawilcox]

With owing millions from the Medicare over billing it may be the only option. Really want them to be successful as we need all of the medical options we can get here. It was interesting the Sun article indicated that all insurance will be accepted during the realignment hope that is true. Beautiful facilities were limited for Medicare patients to only Medicare advantage, hope that changes. May increase their success.

[OrangeBlossomBaby]

Originally Posted by Laurawilcox

With owing millions from the Medicare over billing it may be the only option. Really want them to be successful as we need all of the medical options we can get here. It was interesting the Sun article indicated that all insurance will be accepted during the realignment hope that is true. Beautiful facilities were limited for Medicare patients to only Medicare advantage, hope that changes. May increase their success.

I hope that changes, too. Next year is Medicare time for me, and I wasn't sure I wanted to go the Advantage route. But I worried about having to find a new doctor since I am a TVH patient with normal non-Medicare mundane Marketplace insurance.

If they start accepting regular Medicare plans, I'll have more options, and still be able to keep my own doctors.

[Altavia]

https://news.bloomberglaw.com/bankru...-to-centerwell

Villages Health Files Chapter 11, to Sell Assets to CenterWell


The Villages Health says it has filed for Chapter 11 bankruptcy in the Middle District of Florida court as part of a strategic restructuring, according to a statement.

Estimated liabilities of $100m-$500m and estimated assets of $50m-$100m, a separate court filing shows Humana Inc’s CenterWell Senior Primary Care entered into a “stalking horse” asset purchase agreement with TVH

Deal provides for CenterWell to acquire TVH’s assets as a going concern, including eight primary care centers and two specialty care centers

TVH will continue to fully operate its business and manage its affairs without interruption during the sale process
TVH ...

[Snowbirdtobe]

In a case like this the court has issued an order to continue the business unchanged. The plan and disclosure statements are due by 10/31/2025 but that is likely to change. So payroll will continue, utilities are prohibited from turning out the lights, everything is likely to remain unchanged for a while.

The Villages Health will have many issues because of the large liabilities outstanding. Who do they stiff and walk away from?
What sort of payments were made before the filing?

[KarenBrake]

Wondering… if this Medicare fraud will lead to some arrest.

[Stu from NYC]

Originally Posted by KarenBrake

Wondering… if this Medicare fraud will lead to some arrest.

I would sure hope so. How can this happen?

Would think there would be at least some oversight but apparently not.

[tophcfa]

Interesting, but not surprising. The fact that they only accepted certain Advantage plans, and no Medigap plans, for primary care immediately raised the hair on the back of my neck that something fishy was going on. As far as I’m aware, they were the only large health care operation in the country serving a predominantly senior citizen population that wouldn’t accept traditional Medicare. My intuitive suspicions aren’t always correct, but apparently it was this time.

[kingofbeer]

Originally Posted by birdawg

What’s your thoughts on Villages Health filing chapter 11

I was shocked when I read it in the Daily Sun today. I received an urgent text message from Villages Health. The link for that did not work. Maybe they need to pay back money to Medicare which they do not have.

Based on the bankruptcy filing it looks like Morse family no longer wants to finance this unprofitable entity. I had always assumed that Morse family would keep on funding entity which allows them to sell more homes to Medicare eligible people.

"The Villages Health says it has filed for Chapter 11 bankruptcy in the Middle District of Florida court as part of a strategic restructuring, according to a statement.
Estimated liabilities of $100m-$500m and estimated assets of $50m-$100m, a separate court filing shows
Humana Inc’s CenterWell Senior Primary Care entered into a “stalking horse” asset purchase agreement with TVH
Deal provides for CenterWell to acquire TVH’s assets as a going concern, including eight primary care centers and two specialty care centers
TVH will continue to fully operate its business and manage its affairs without interruption during the sale process."

[Rainger99]

Does anyone know who actually owns Villages Health?

The Villages Health System, LLC is owned by The Villages Health Holding Company, LLC, which is part of the Holding Company of The Villages, Inc.

The Holding Company of The Villages, Inc. is a privately-held company, and specific ownership details are not fully disclosed in public records.

[OrangeBlossomBaby]

Originally Posted by KarenBrake

Wondering… if this Medicare fraud will lead to some arrest.

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.

[Bjeanj]

Did I read the Daily Sun article correctly that The Villages Health incorrectly billed Medicare for hundreds of millions of dollars? If so, how does that happen? It seems like no one is that incompetent? Intentional? Over what time period? The article indicated that The Villages Health was proactive in reporting the overbillings.

[OrangeBlossomBaby]

Originally Posted by Bjeanj

Did I read the Daily Sun article correctly that The Villages Health incorrectly billed Medicare for hundreds of millions of dollars? If so, how does that happen? It seems like no one is that incompetent? Intentional? Over what time period? The article indicated that The Villages Health was proactive in reporting the overbillings.

Yes if I remember it was some kind of computer error. And Medicare just paid it, over and over again, without once questioning it. It was never flagged. When TVH realized what was happening they immediately reported the error and cooperated with Medicare to repay the overpayments.

[justjim]

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.

TVH was apparently “coding”
many procedures wrong. I don’t know who caught the overpayments. Generally auditors are the ones that first spot such a pattern of overpayments. The best money governments can spend is on more monitors and auditors. Sometimes it’s honest mistakes and sometimes not so much the case.

[Rainger99]

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.

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?