[golfing eagles]

Originally Posted by Nucky

Hello, my Friend. I've checked in several times on this particular thread, started reading through, and got discouraged, so I clicked off. Is there any possibility for old times' sake that you could wrap up the future status of my beloved healthcare, and is it possible that it will stay as it is? Hope you are doing well.

The rumors of my recent demise are incorrect. We sure did have a whole lot of fun on here in the old days. Did you ever collect your LOBSTER?

No, Barefoot has successfully welshed on our bet for almost 9 years now. And despite her home in Canada where cold water lobster abounds, I remain devoid of seafood

I wish I could tell you the future of healthcare in TV, but I don't think anyone knows yet. I only know a few things that others don't, but very little and nothing that would indicate the future prospects for TVH. I do think that TVH will continue in one form or another, I doubt it will just close its doors on 50,000 patients. Right now it appears, but only from what others have posted on social media, that they need some emergency funding to continue in the short term.
Most likely they will get it. I also think this will be in court and negotiations for a while. My bigger fear is that the older docs will simply retire and the younger ones head to greener pastures before this all settles out. But don't be discouraged---I don't think there has ever been a situation where a community of 150,000 suddenly loses most of its healthcare at the hands of an overzealous bureaucracy. The term "bailout" comes to mind.

[Rainger99]

This is a document from the bankruptcy filing. It appears to be getting nasty.

Check out paragraph 1 which states that the debtor (TVH) erroneously sought and received about $350 million “chiefly from UHC.”

Who paid out the money for the errors? UHC, Medicare, or someone else?

https://cases.stretto.com/public/x45...0000000001.pdf

[margaretmattson]

///

[tophcfa]

Originally Posted by Rainger99

This is a document from the bankruptcy filing. It appears to be getting nasty.

Check out paragraph 1 which states that the debtor (TVH) erroneously sought and received about $350 million “chiefly from UHC.”

Who paid out the money for the errors? UHC, Medicare, or someone else?

https://cases.stretto.com/public/x45...0000000001.pdf

Yikes, just read the above posted bankruptcy court filing. Looks like two very powerful parties got into bed together and things ultimately turned out very nasty between them. It appears that in this case, the dirty laundry is not going to get swept under the bed since neither of the parties will back down because of the fear of a long and expensive legal battle. This could get very messy and not be a good thing. And if the message being portrayed in this filing is accurate, it goes a long way toward answering the ongoing question of where did the money go. Sincerely hoping this doesn’t turn into a real life tale of success turning into power and greed that ultimately leads to corruption?

[BrianL99]

Originally Posted by margaretmattson

This is a bankruptcy filing..... It seems court documents filed are questioning the bankruptcy. Does this business truly have more debt than assets? Should the Morse family be required to liquidate assets associated with this business to pay some of the debt? This is what the court will decide.

Please, identify just one sentence in the entire filing, that suggests that TVH is not bankrupt?

[BrianL99]

Originally Posted by Rainger99

This is a document from the bankruptcy filing. It appears to be getting nasty.

Check out paragraph 1 which states that the debtor (TVH) erroneously sought and received about $350 million “chiefly from UHC.”

Who paid out the money for the errors? UHC, Medicare, or someone else?

https://cases.stretto.com/public/x45...0000000001.pdf

The Motion in Opposition, accuses TVH of disbursing cash to the Morse family, to hide it from the Bankruptcy Court and creditors. This seems to be a new accusation.

The Motion also identifies a purported strategy to limit the Morse Family & TVH's liability for the Medicare overpayments.

I thought Paragraph 27 & 28 sort of summed everything up.

[Rainger99]

Interesting filing.

The monthly operating report for TVH for July.


https://cases.stretto.com/public/x45...0000000078.pdf

[Rainger99]

Now Florida Blue (FB) is objecting to portions of the bankruptcy.

One of the more interesting comments from Florida Blue is the following:

This “problem” turned out to be a four years’ long scheme to add diagnostic codes to patient files that resulted in overpayments by Florida Blue to the Debtor of approximately $25 million.

I am not a lawyer but it seems that TVH wants to pay FB $0 and FB thinks they are entitled to $25 million.

The entire document is only 8 pages long.

https://cases.stretto.com/public/x45...0000000132.pdf

[golfing eagles]

Originally Posted by Rainger99

Now Florida Blue (FB) is objecting to portions of the bankruptcy.

One of the more interesting comments from Florida Blue is the following:

This “problem” turned out to be a four years’ long scheme to add diagnostic codes to patient files that resulted in overpayments by Florida Blue to the Debtor of approximately $25 million.

I am not a lawyer but it seems that TVH wants to pay FB $0 and FB thins they are entitled to $25 million.

The entire document is only 8 pages long.

https://cases.stretto.com/public/x45...0000000132.pdf

I think that should read "The ACCUSATION...."

[Rainger99]

Originally Posted by golfing eagles

I think that should read "The ACCUSATION...."

I believe they took the word problem directly from the letter from TVH’s CEO.


https://thevillageshealth.com/wp-con...FINAL_1230.pdf

[tophcfa]

Originally Posted by Rainger99

Now Florida Blue (FB) is objecting to portions of the bankruptcy.

One of the more interesting comments from Florida Blue is the following:

This “problem” turned out to be a four years’ long scheme to add diagnostic codes to patient files that resulted in overpayments by Florida Blue to the Debtor of approximately $25 million.

I am not a lawyer but it seems that TVH wants to pay FB $0 and FB thins they are entitled to $25 million.

The entire document is only 8 pages long.

https://cases.stretto.com/public/x45...0000000132.pdf

Yikes, more bad news for TVH. Add Blue Cross and Blue Shield to the mix of Medicare Advantage Insurers objecting to the terms of the bankruptcy filing. They strongly imply that TVH engaged in a multiple year scheme to add diagnostic codes to patient files that resulted in overpayment by Florida Blue to TVH of approximately 25 million (not including 2025). Blue Cross is further claiming that TVH must repay these overpayments to Florida Blue, or they will object to the assignment of their Medicare Advantage contracts to any entity that acquires TVH. The bankruptcy filing by TVH claimed they don’t owe Florida Blue anything, which Blue Cross vehemently disagrees with. This obviously throws an additional monkey wrench into the whole process. Florida Blue wants to be reimbursed for overpayments resulting from miscoding by TVH. Without reimbursements, they want to void the assignment of their customers MA contracts, making TVH less attractive to any buyer. Furthermore, this very well might give CenterWell/Humana an opening to back out of the Stalking Horse agreement to purchase TVH because of a material change in value. And finally, this gives further evidence to the bankruptcy court that the bankruptcy filing by TVH includes questionable information that necessities more detailed legal discovery. It has become very clear that TVH wants this process expedited ASAP, with little to no discovery. Every time another bankruptcy court filing comes out this case gets more complicated, potentially extending the outcome and requiring a much deeper dive into TVH’s accounting activities and diagnostic coding practices. Not a good thing for TVH, it’s patients, and residents of the Villages in general.

[dewilson58]

"a multiple year scheme"...................click bait.

"the Debtor’s CEO disclosed to........................" first time I heard about the self admission.

[golfing eagles]

Originally Posted by Rainger99

Now Florida Blue (FB) is objecting to portions of the bankruptcy.

One of the more interesting comments from Florida Blue is the following:

This “problem” turned out to be a four years’ long scheme to add diagnostic codes to patient files that resulted in overpayments by Florida Blue to the Debtor of approximately $25 million.

I am not a lawyer but it seems that TVH wants to pay FB $0 and FB thinks they are entitled to $25 million.

The entire document is only 8 pages long.

https://cases.stretto.com/public/x45...0000000132.pdf

Originally Posted by golfing eagles

I think that should read "The ACCUSATION...."

Originally Posted by Rainger99

I believe they took the word problem directly from the letter from TVH’s CEO.


https://thevillageshealth.com/wp-con...FINAL_1230.pdf

OK, now for the facts:

The post I responded to:

This “problem” turned out to be a four years’ long scheme to add diagnostic codes to patient files that resulted in overpayments by Florida Blue to the Debtor of approximately $25 million.

And now the quote from the actual letter:

Upon discovering a potential problem with our Medicare billing this past Fall, TVH hired outside consultants to conduct an in-depth review of our coding and billing practices.

Does anyone think those two statements have the same meaning????

[drducat]

Florida Blue wants their $25 million back before they allow a contract transfer over to the new stalking horse owner or bidder that wins. This could cause an issue for the end of year care for those of us whom have that coverage.

[golfing eagles]

Originally Posted by drducat

Florida Blue wants their $25 million back before they allow a contract transfer over to the new stalking horse owner or bidder that wins. This could cause an issue for the end of year care for those of us whom have that coverage.

Perhaps, but not very likely.

TVH can't stop accepting UHC and Florida Blue, they'd have no patients left.

UHC and Florida Blue could drop TVH from their panel of providers, but the optics of dropping 50,000 covered lives in a small geographic area wouldn't look good, and probably garner the attention of our politicians and regulatory authorities.

Hopefully the dozens of lawyers involved won't get into a "p!$$!ng" contest at the expense of Villager's health care.

Besides, it's not yet clear that TVH owes FB anything and $25M is chump change to Blue Cross