Columbia/HCA became the target of a widespread fraud investigation in the late 1990s, which led to one of the largest Medicare settlements ever.
During that time, HCA was still operating under a corporate integrity agreement resulting from its Medicare fraud settlement, and an independent reviewer was scrutinizing its billing.
Scott's previous experience was running a health care company charged with the largest Medicare fraud settlement in history.
Two years ago, McCaskill tweeted a photo of herself enjoying a watermelon mojito at a vacation home she and her husband share with Rick DeStefane, a nursing home magnate embroiled in controversies including safety lapses tied to gruesome deaths and a federal Medicare fraud settlement (McCaskill's husband and DeStefane have been business partners).
Under the settlement, Medicare officials have until next January to straighten things out by notifying health care providers.
Because of an action by Congress and a recent court settlement, Medicare probably won't cut off Ms. Gorman's physical therapy again should her progress level off — as long as her doctor says it is medically necessary.
"Under this proposed settlement, Medicare policy would be clarified so that claims from providers will be reimbursed consistently and appropriately, which is always our aim," Ms. Shields Britt said via e-mail.
"Under this settlement, Medicare policy will be clarified to ensure that claims from providers are reimbursed consistently and appropriately and not denied solely based on a rule-of-thumb determination that a beneficiary's condition is not improving," said Fabien Levy, a spokesman for the U. S. Department of Health and Human Services, which includes the Medicare program.
The Justice Department announced just last week that Beverly Enterprises, the nation's largest nursing-home chain, had agreed to pay $175 million and relinquish 10 of its homes for defrauding Medicare, the biggest such settlement ever.
For seniors getting skilled services at home under a doctor's order, the settlement means Medicare's home health coverage has no time limit, Margaret Murphy told lawyers attending the annual meeting of the National Academy of Elder Law Attorneys in Washington, D. C., shortly after the then-tentative settlement was announced.
