[OrangeBlossomBaby]

Originally Posted by elevatorman

This is the site for Centerwell Health that is closest to The Villages. It is about 6 miles from UF Health Spanish Plains (The Villages Hospital). You may get a feel for what to expect if the sale is approved.

The Villages, FL | CenterWell Senior Primary Care

It's not 6 miles from the hospital. It's on the same campus, they share a parking lot. It's behind the Sharon Morse Medical Center.

[justjim]

Originally Posted by OrangeBlossomBaby

TVH caught the mistakes and reported it to Medicare. The miscoding was not intentional - if it was, then yeah it'd be fraud, and TVH would be under criminal investigation. Medicare acknowledged that this was a mistake. A HUGE mistake, but a mistake nonetheless.

TVH auditors likely caught it. Their lawyers advised them to file bankruptcy and sell. And that is exactly what they did. People go to prison for a lot less but money to have an army of lawyers can certainly lesson the impact and claim just a honest mistake. It’s the golden rule. Those that have the gold rule. Having “political power” doesn’t hurt either. Occasionally a bone with little meat on it is thrown to us in the middle class. That keeps most of us reasonably happy. Fore.

[Rainger99]

Originally Posted by OrangeBlossomBaby

2. Medicare has already acknowledged that it was an error, not fraud.

Where did they acknowledge that? Do you have a statement or press release from Medicare?

[drducat]

Originally Posted by golfing eagles

Take another whiff, it was a computer error that went unnoticed for a long time. Once TVH noticed it they immediately notified CMS. NO FRAUD

The DOJ is involved and looking into HCC up billing due to the amount of overpayment...the amount is too high to be an error..at any rate TVH is going to be on the hook to CMS for the $361 million after Humana owned co takes over...of course the amount is negotiable however the gov is being very aggressive.

[BrianL99]

Originally Posted by justjim

TVH auditors likely caught it. Their lawyers advised them to file bankruptcy and sell.

So you think it's only coincidence that the "computer glitch" was found, after TV Health started merger talks with CenterWell?

Why do you suppose TVH Auditors missed it every year, for the 1st 4 years it was going on?

[OrangeBlossomBaby]

Originally Posted by kingofbeer

Where is the document that says it was not Medicare fraud?

Heck if I know, it was in the news at the end of last year, and patients got the e-mail from TVH. I'm a patient, I got the e-mail. I read it, and deleted it, just like I do with any other e-mails that I don't need to save for any reason.

Seriously - this is not news. TVH reported the error, it was acknowledged. The sale of TVH is the "news" part of this whole thing.

[Blueblaze]

It sounds like good news to me. I was going to try Centerwell this year, anyway. Maybe they'll finally take my Humana Advantage PPO and hire some doctors.

It's always been a crime to see those beautiful facilities go to waste, just because The Villages had some corrupt deal with United. We tried it the first couple of years after we moved here and got tired of being sent to some glorified nurse every time. It took 3 months to schedule a visit with your actual doctor. When we left, they even refused to release our medical records.

What concerns me is the possibility of the government going after The Villages for that money, and bankrupting the development company. We might be about to discover how much of that "free golf", "free entertainment", and everything else we supposedly pay for with our CDD fees, is actually subsidized by new houses and phony medicare bills.

[Moderator]

Please stay on Topic - Villages Health Chapter 11.

[tophcfa]

- TVH (The Villages health) problems began in late 2024, when Medicare auditors flagged $250 million in billing overpayments, a sum that could balloon with penalties
- Centerwell (CW) was negotiating to purchase TVH (The Village’s Health) last fall when they discovered the billing and coding issues and backed out, about the same time TVH reportedly self reported the issue
- Filing for chapter 11 allowed TVH to restructure its debt while continuing its operations, but it liabilities remain a ticking time bomb
- The deal TVH reached with CW is designed to allow CW to acquire the assets, but sidestep the TVH’s looming liabilities. CW has entered into a “ stalking horse” purchase agreement to purchase TVH assets at a minimum floor price, but the sale will ultimately go through an auction process. The purchase agreement gives CW an advantage over other bidders as they have the option to match other bidders price and are now privy to information to do their due diligence. The court will oversee the sale process
- It’s not entirely clear whether Chapter 11 protects TVH from its Medicare related government liabilities, chapter 11 does not protect from TAXES owed to the government
- An ultimate sale to CW is by no means a done deal at this point, they have simply entered into a stalking horse asset purchase agreement
- Court fillings indicate Villages Health Holding Company has a 66.3% Equity interest in TVH.
- Stay tuned, this will most definitely get more interesting as facts are leaked out or become public information

[Caymus]

Originally Posted by tophcfa

- TVH (The Villages health) problems began in late 2024, when Medicare auditors flagged $250 million in billing overpayments, a sum that could balloon with penalties
- Centerwell (CW) was negotiating to purchase TVH (The Village’s Health) last fall when they discovered the billing and coding issues and backed out, about the same time TVH reportedly self reported the issue
- Filing for chapter 11 allowed TVH to restructure its debt while continuing its operations, but it liabilities remain a ticking time bomb
- The deal TVH reached with CW is designed to allow CW to acquire the assets, but sidestep the TVH’s looming liabilities. CW has entered into a “ stalking horse” purchase agreement to purchase TVH assets at a minimum floor price, but the sale will ultimately go through an auction process. The purchase agreement gives CW an advantage over other bidders as they have the option to match other bidders price and are now privy to information to do their due diligence. The court will oversee the sale process
- It’s not entirely clear whether Chapter 11 protects TVH from its Medicare related government liabilities, chapter 11 does not protect from TAXES owed to the government
- An ultimate sale to CW is by no means a done deal at this point, they have simply entered into a stalking horse asset purchase agreement
- Court fillings indicate Villages Health Holding Company has a 66.3% Equity interest in TVH.
- Stay tuned, this will most definitely get more interesting as facts are leaked out or become public information

So, when it's all over who will be financially impacted? Whoever owns Village Health holding company? Bond Holders (if any)? The money lenders? US Government?

[Normal]

This is the same group who asked me 3 questions and called it a “WellnessCheck”. In turn they billed Medicare 160 bucks. I hope they get fried. Follow the money and bust them all!

[bmcgowan13]

Originally Posted by oneclickplus

They scammed the system (over billing Medicare HUNDREDS OF MILLIONS). This is the fraud and abuse that the current administration is trying to fix. Know that they have or will also over bill patients (you and me) also without even a pause to consider ethics.

Unfortunately, TVH is not alone. Remember Columbia Health care from 2003? Remember, TVH SELF-REPORTED this case unlike Columbia which was the result of whistleblowers exposing corrupt management...and nobody went to jail from Columbia.

Certainly TVH deserves a little credit here.

#386: 06-26-03 LARGEST HEALTH CARE FRAUD CASE IN U.S. HISTORY SETTLED HCA INVESTIGATION NETS RECORD TOTAL OF $1.7 BILLION

[Plinker]

Originally Posted by Normal

This is the same group who asked me 3 questions and called it a “WellnessCheck”. In turn they billed Medicare 160 bucks. I hope they get fried. Follow the money and bust them all!

Agree. I believe they up-coded to the tune of hundreds of millions of dollars. Up-coding is very common and often deliberate. How much of that money went to management as salary and bonuses instead of patient care? You live in a pollyannish world if you think the bankruptcy, overcharging and sale is all just a coincidence.
Blaming this on a computer error is ridiculous. Without these hundreds of millions of dollars in overcharges, would TVH not gone under long before now?

[Keninches]

We went with VH for a brief period when they first started. Never saw the doctor. When we received a letter stating “go with a Medicare Advantage or get thrown out,”. We left, no way were we changing to an Advantage Plan. Medicare Advantage is Not an Advantage.

[golfing eagles]

Originally Posted by drducat

The DOJ is involved and looking into HCC up billing due to the amount of overpayment...the amount is too high to be an error..at any rate TVH is going to be on the hook to CMS for the $361 million after Humana owned co takes over...of course the amount is negotiable however the gov is being very aggressive.

Investigating and being guilty are 2 different things. And where was it stated that the DOJ was investigating anyway????