Talk of The Villages Florida - Villages Health where did all the money go?

Quote:

Originally Posted by golfing eagles (Post 2446198)

You are assuming that coding/billing somehow "changed" in 2020. The statement is ONLY that a retrospective review started looking at billing from 2020 to the present, it does not address 2012-2020. If the same billing and coding practices were in place from 2012 to 2020, your whole premise falls apart. NO adjustment in budget. No doubling the revenue. Just business as usual.

Now here's a concept I haven't considered: Many posters are considering the $361 M as "extra" and want to know where the money went. What if (hypothetical) they only broke even and without the "overpayments" they would have been in $361M of debt, ie: bankrupt a long time ago?????

I read the bankruptcy documents and did not assume. They clearly say:

"1. An internal investigation, supported by Goodwin Procter and FTI Consulting, revealed that a retrospective chart review program initiated around 2020 was inconsistent with Medicare guidelines.
2. The program resulted in the submission of unsupported Hierarchical Condition Category (HCC) codes, which improperly inflated patient Risk Adjustment Factor (RAF) scores and, consequently, the capitated payments TVH received from Medicare Advantage plans"

Initiated, in my opinion means started. Started around 2020. That program, initiated in 2020 "resulted in the submission of unsupported Hierarchical" coding.... and so on. The chart review program initiated around 2020 also caught the attention of the buyer and caused them to pull out. I can't find an assumption. So nothing falls apart. We do know that the Chart review led to the 320 million in question. Those funds were not invested in physical assets that can now be sold or identified or they would be listed as such in the filing.