Amedisys (Nasdaq:AMED), a provider of home health care nursing services, said on June 30 that it has "received notice of a formal investigation from the Securities and Exchange Commission ... pertaining to the company, and received a subpoena for documents relating to the matters under review by the Senate Finance Committee."
Amedisys, which is run out of Baton Rouge, La., also said that it will cooperate with the investigation.
Back in April, the Wall Street Journal ran a story that strongly suggested abuse of the Medicare reimbursement system by Amedisys, the largest company in the sector.
Sam Antar makes the case that the WSJ report wasn't as hard-hitting as it could have been.
Going back a bit, I should note that in September 2009, the president and chief operating officer of Amedisys, Larry Graham, resigned those posts suddenly. So did Alice Ann Schwartz its Chief Information Officer.
The company didn't give any reason for these departures. Not even their desire to spend more time with their families. Just a bald, "...to pursue other interests." That sort of thing is always ominous.
The U.S. Senate Finance Committee investigation to which the company referred in its statement involved four companies in the field. In addition to Amedisys, the Senate was curious about Almost Family Inc., Gentiva Health Services Inc., and the LHC Group, and their "internal policies and guidelines regarding the number of visits provided to each patient...."
Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Monday, July 12, 2010
Sunday, April 25, 2010
WellCare Health
The story about WellCare Health seems to have been rather buried in the weekend edition of The Wall Street Journal. But it's there if you look. Furthermore, if you do find it on page B6 you might skip right by it because the headline is misleadingly anodyne.
The headline is "Director Resigns at Wellcare Health," -- which sounds as if the story is a mere personnel matter, not a significant accusation. The subhead doesn't help much. It says "Head of Audit Committee Raises Questions About Company's Accounting." She did more than raise questions. She made statements. And they weren't about "accounting." This isn't an issue concerning, say, mark-to-market versus mark-to-model. This has to to with overcharges, and potentially it seems with fraud.
Here's a link to the resignation letter, dated April 21.
Regina Herzlinger, the head of the audit committee of the board of directors at WellCare, has resigned from the board and has made significant accusations on her way out the door. She says internal audits have found that WellCare overbilled Medicaid program of the state of Illinois by $1 million in 2009 and potentially overcharged states by almost half a million dollars more in connection with maternity care.
Nor does she regard this sort of thinbg as the result of honest mistakes. She also writes, after all, of "facially credible evidence of an unlawful agreement among at least Chairman Chuck Berg, Director Chris Michalik, and Lead Director Hickey to seize control of the Board regardless of the best interests of shareholders."
WellCare has a history. Back in the fall of 2007, 200 state and federal agents raided company headquarters in a dispute that led to the restatement of three years of earnings, and the firing of three of the entity's top executives. Last year, Georgia's Dept. of Community Health fined WellCare $610,000 in connection with the company's failure to account for each patient visit in which it paid providers.
The headline is "Director Resigns at Wellcare Health," -- which sounds as if the story is a mere personnel matter, not a significant accusation. The subhead doesn't help much. It says "Head of Audit Committee Raises Questions About Company's Accounting." She did more than raise questions. She made statements. And they weren't about "accounting." This isn't an issue concerning, say, mark-to-market versus mark-to-model. This has to to with overcharges, and potentially it seems with fraud.
Here's a link to the resignation letter, dated April 21.
Regina Herzlinger, the head of the audit committee of the board of directors at WellCare, has resigned from the board and has made significant accusations on her way out the door. She says internal audits have found that WellCare overbilled Medicaid program of the state of Illinois by $1 million in 2009 and potentially overcharged states by almost half a million dollars more in connection with maternity care.
Nor does she regard this sort of thinbg as the result of honest mistakes. She also writes, after all, of "facially credible evidence of an unlawful agreement among at least Chairman Chuck Berg, Director Chris Michalik, and Lead Director Hickey to seize control of the Board regardless of the best interests of shareholders."
WellCare has a history. Back in the fall of 2007, 200 state and federal agents raided company headquarters in a dispute that led to the restatement of three years of earnings, and the firing of three of the entity's top executives. Last year, Georgia's Dept. of Community Health fined WellCare $610,000 in connection with the company's failure to account for each patient visit in which it paid providers.
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