2nd company founded by new Florida governor may be investigated for fraud.

madfloridian

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Fri Nov-05-10 12:44 PM
Original message

2nd company founded by new Florida governor may be investigated for fraud.

Edited on Fri Nov-05-10 01:04 PM by madfloridian

It may or may not be investigated for Medicare fraud and/or hiring discrimination. Right now the information is being passed around between various health agencies at state and federal level, and no one seems sure what to do. In fact if the company is investigated, Rick Scott as governor gets to pick the person to lead that investigation. Indeed I hope he would recuse himself, but the first article says he gets to appoint the head of the state's health care agency.

This would be the second company formerly run by new Florida governor, Rick Scott, to be the subject of investigation. His previous company, Columbia/HCA received one of the largest fines ever for Medicare fraud.

Scott has been deposed on the subject of Solantic, but he refuses to release the deposition. Says it is a private matter. I doubt that is true when you are running for governor, but that is what he said.

Scott would �recuse� himself if Solantic investigated

Republican governor candidate Rick Scott said, if elected, he will recuse himself from any decisions involving the potential investigation of Solantic, a chain of clinics he founded in 2001, other than appointing the head of the state�s health care agency. Scott is in a statistical tie with Democratic rival Alex Sink.

The Naples Daily News asked Scott how he would handle the situation if elected, after the paper attempted to determine the status of allegations raised by a former Solantic employee this summer, first reported in The Florida Independent. �I�d recuse myself from any involvement,� he told the News.

In a lengthy interview with the Independent, Randy Prokes alleged that while working at Solantic he discovered several instances in which Medicare was billed more than it should have been because the patient was seen by a nurse practitioner without a doctor on the premises, and without consulting the doctor. Prokes made other allegations of misconduct as well.

After the information became public, it was passed to various state and federal health care agencies, including the Office of the Inspector General at the U.S. Department of Health and Human Services, which handles Medicare investigations. None of the agencies will comment on whether they initiated investigations or what the status of those investigations might be.

The Florida blogger, The Reid Report, has the emails from Randy Prokes and more information.

EXCLUSIVE: Rick Scott and Solantic: the Randy Prokes email

Among the many allegations related to Medicare, Medicaid and Tri-Care fraud linked to Rick Scott, the Republican candidate for Florida governor, the one that produced a secret Scott deposition just days before he filed for governor, along with the most interesting moment of the campaign was the allegation that his new company, Solantic � the one he owned after leaving Columbia/HCA holding a $1.7 billion federal fine (plus a $300 million parting gift for Scott) � also committed fraud, this time, using doctors� licenses without their knowledge and billing Medicare improperly for patient care. Those allegations caused Scott to go ice cold when he was served a subpoena in the middle of a press conference about a week before the August 24 primary. Now, the Reid Report has obtained an email alleged to be the one Bill McCollum�s campaign referred to authorities for investigation. The email is from Dr. Randy Prokes

The Reid Report quotes from a Herald article which implies this was a campaign stunt by Bill McCollum. Campaign stunt or not, will an investigation follow now that he is governor?

I found this from August this year saying that the Florida Agency for Health Care Administration will not investigate. They sent the allegations to the federal Medicare officials.

AHCA won't investigate Scott clinics

The Florida Agency for Health Care Administration will not investigate politically explosive allegations against a clinic chain founded by Rick Scott, who is running for the Republican nomination for governor. But AHCA has sent the allegations to federal Medicare officials.

An AHCA statement released with the documents late Friday afternoon said it had determined that physician Randy Prokes' allegations of overbilling by Solantic dealt primarily with Medicare, not the state Medicaid program. Thus the matter has been turned over to the U.S. Department of Health and Human Services "for further review and possible investigation," the statement said.

Prokes, who worked for Solantic from 2004 until 2009, made numerous allegations against the Jacksonville-based chain, including allegations of improper billing. He contended, for example, that nurse practitioners sometimes provided care by themselves but the clinic billed at a higher rate that would be allowed if a physician was on the premises supervising. Recent reports in the Florida Independent about the Prokes allegations and a lawsuit involving another former Solantic physician, P. Mark Glencross, have caused an uproar in the closely contested race between Scott and Attorney General Bill McCollum for the Republican nomination for governor, to be decided in the primary Aug. 24.

It doesn't sound like the state agency is very forthcoming.

The records do not make clear how much time AHCA spent reviewing the allegations, though the agency inspector general stamped the date Aug. 6 on one document.

After learning about the complaint, Health News Florida made a public-records request for it on Wednesday. AHCA did not comply with the request until late Friday afternoon, after receiving a call from Health News Florida's attorney. No legal rationale for the delay was given, despite requests.

Salon did a two-part investigation back in September of last year. Briefly here is a summary of the Part One.

Rick Scott profits off the uninsured.

For months now multimillionaire healthcare entrepreneur Rick Scott has been at the center of the aggressive campaign to derail healthcare reform in Washington, D.C. Reprising the role he played nearly 20 years ago, when as the head of a national hospital chain he helped kill Clintoncare, the former hospital-chain executive founded the group Conservatives for Patients' Rights, raising $20 million to fight Obamacare, including $5 million of his own money. The tall, lean Scott, whose shiny bald head swivels in exasperation at the idea of government involvement in healthcare, even stars in its nationwide ad campaign comparing Democratic proposals to socialized medicine. Through this group, he has fomented the conservative strategy to disrupt town hall-style healthcare meetings around the country by shouting down elected officials. (CPR sent schedules of the meetings to so-called Tea Party activists.) He can justifiably claim some of the credit for the Senate Finance Committee's two votes Tuesday against a public option. But in Rick Scott the right has found a frontman whose baggage threatens to overwhelm his message.

A linchpin of Scott's 2009 campaign has been the use of anecdotes from abroad -- horror stories from Britain and Canada meant to illustrate how government-controlled healthcare systems "clearly kill people" by controlling their access to care, as he told Fox's Sean Hannity in June. He even funded a documentary titled "Faces of Government Healthcare" cataloging the horror stories of British and Canadian patients who were purportedly denied medical attention for life-threatening illnesses until it was too late.

Yet even as Scott makes the rounds of Congress and talk-show green rooms, a wrongful death lawsuit has been working its way through the Florida courts against a doctor employed by the chain of walk-in clinics Scott founded. Scott has repeatedly bragged that the 27-clinic, Florida-based company, Solantic, is an example of the free-market ingenuity needed to fix our ailing medical infrastructure. The lawsuit, however, alleges a Solantic doctor misdiagnosed a patient's deep-vein thrombosis as a sprained ankle, leading to a pulmonary embolism and death. That same doctor was reprimanded by the state for misdiagnosing deep-vein thrombosis in a patient who died two years earlier. It's the kind of anecdote you'd expect to hear in Scott's documentary -- except that it condemns a free-market system where profit and patient volume may take precedence over care.

Long article, but this one sentence really rings true.

"Solantic's very existence is an implicit acknowledgment that healthcare costs have not been reined in by free-market forces."

Here is some from Part Two of the Salon investigation.

After six months and lots of money, Scott, founder of Conservatives for Patients' Rights (and an ally of McKalip), has finally seen the fruits of his multimillion-dollar campaign against reform. Scott, a millionaire healthcare entrepreneur, predicted that when Congress reconvened this September the public option would be dead. "While Victory is near, we must not rest," Scott crowed on CPR's Web site. Scott himself never rested. He met with lawmakers, coordinated conference calls with conservative activists, wrote opinion pieces and spoke to the faithful about the evils of socialized medicine. Conservatives for Patients' Rights targeted elected officials in 11 states with TV ads hoping constituents would pressure the lawmakers to oppose proposed changes....

....""One of the first things we needed was an R.N. to help oversee the clinical part with me," Yarian recalls. "There was this great young individual who had a lot of experience with clinic start-ups. She interviewed with me, and then with Karen. We both loved her. When I got on the phone with Rick, the first thing he says is, 'What does she look like?'"

Yarian says he began describing her to Scott, at one point mentioning that "She's a little bit overweight."

"Immediately Rick says to me, 'Fat people can't work at our centers.' And that sort of set the trend," Yarian says. "I'd be interviewing someone and his first concern was what they looked like. He was always sending e-mails that people had to be fit and attractive. And no one was hired without his approval."

Here is more on the alleged discrimination.

Scott formed Solantic with partner Karen Bowling, aiming to cater to the under- and uninsured, among others. They hired David Yarian as the company�s first medical director. He lasted four months. In that time, Yarian claims, Scott told him not to hire overweight women as a rule, and specifically prohibited him from hiring a qualified nurse because she was slightly overweight; told him not hire anyone of Middle Eastern descent after 9/11 because they might scare away customers; and prohibited Yarian from hiring a Hispanic male nurse candidate who had an accent because he was not �mainstream American.� Later, Yarian says, Scott repeated that directive. �He said in a meeting with all the other staff that the people we hire for our centers have to be mainstream American,� Yarian recalls.

A spokesperson for The Equal Employment Opportunity Commission, without commenting on Solantic specifically, notes that the agency has seen words like �mainstream� and �clean-cut� used as code to discriminate on the basis of race and national origin before.

Yarian, who is married to an African-American woman, says he complained in an email to Scott that the hiring procedures could be considered discriminatory. He says he was told not to communicate with Scott anymore, and was fired a short time later. Yarian sued the company over his severance payout, and included his allegations in the lawsuit. Solantic settled with him for about $80,000 in 2002.

Florida Independent

It is to Florida's shame that the man whose previous company has already been investigated for Medicare fraud, whose latest company may be investigated, and who paid for the town hall riots that disrupted the health care debate is now our governor.