1199SEIU Releases Investigative Report On HCA Hospitals, Potential $1.1 Billion Medicare Fraud In FloridaFebruary 8, 2022
Media contact: Ed Gilhuly, 305-807-6906, firstname.lastname@example.org
MIAMI - A new investigative report on America’s largest for-profit hospital corporation, HCA Healthcare (NYSE: HCA), suggests the company may be engaging in widespread Medicare admissions fraud that may have cost taxpayers billions of dollars even before the COVID-19 public healthcare emergency began.
Research contained in the report from 1199SEIU United Healthcare Workers East, the nation’s largest union of healthcare workers, indicates that HCA may have netted nearly $2 billion in excess Medicare payments from 2008 through 2019 by routinely over-admitting emergency department patients for inpatient hospital stays regardless of medical need. More than $1.1 billion of that total came from HCA hospitals in Florida, according to the report.
And as the new report notes, HCA has a long and troubled history of Medicare fraud including being the subject of the largest Medicare fraud settlement in history at the time in the early 2000’s, with HCA agreeing to pay settlements totaling $1.7 billion.
“The findings in this report are truly disturbing, although sadly unsurprising,” said Dale Ewart, 1199SEIU Executive Vice President in Florida. “And the numbers come from even before the COVID-19 pandemic that overwhelmed emergency rooms and left patients, caregivers, communities and our entire healthcare system on the brink and in desperate need for resources.”
SEIU’s analysis finds that HCA’s average Medicare emergency department admission rate has been well above the national average and in Florida. In 2019, HCA’s Florida hospitals had an average Medicare emergency department admission rate of about 41% - compared to the statewide average that year of about 38%. Further, SEIU’s analysis suggests that many of these admissions at HCA’s Florida hospitals may have been unnecessary, leading to millions in potential overpayment from Medicare. SEIU estimates that HCA’s Florida hospitals may have received $100 million in overpayments from Medicare in 2019 for these potentially unnecessary admissions, and a total of more than $1.1 billion since 2008.
“As frontline caregivers, we’ve put our lives on the line for many years, and especially during the pandemic, to provide the very best care possible without enough staffing, pay or protections,” said Leora Stirrat, a certified monitor technician at HCA Blake Medical Center in Bradenton. “It’s a terrible thing to think there might be profiteering while our patients and caregivers suffer.”
With the COVID-19 Omicron variant surging and hospital beds in short demand across the country, unnecessary emergency admissions potentially can put tens of thousands of HCA patients at further risk, and exacerbating the dangerous bed shortage for COVID patients.
In addition to the data in the investigative report on potential Medicare fraud, a recent survey of HCA workers also shows 89% of respondents say unsafe staffing levels currently jeopardize patient care in their facilities. HCA’s hospital staffing levels, a key indicator of patient safety, lagged the national average by 30% before the pandemic.
Meanwhile, HCA reported $7 billion in profit just in 2021; has paid out more than $29 billion to investors since 2010; and the Frist family, HCA’s founders and largest shareholders, have more than doubled their wealth during the pandemic.
“The rich get richer while tens of thousands of exhausted frontline workers receive near-poverty wages, patients put in potential jeopardy and our tax dollars possibly scammed in a massive way,” Ewart said. “We all deserve better.”
About SEIU Healthcare: More than one million healthcare workers across hospitals, in-home care, and in nursing homes are united in SEIU, the nation's largest union of healthcare workers. SEIU is an organization of nearly 2 million members united by a belief in the dignity and worth of workers and the services they provide. SEIU is dedicated to improving the lives of workers, families, and communities to create a more just and humane society.