Saturday, February 27, 2021

$48 million False Claims Act settlement by proposed donee of $786,305 in county corporate welfare -- Encompass Health, 3/2/2021 consent agenda #13

 



 Giant multi-billion dollar ENCOMPASS HEALTH has a big payday on the St. Johns County Commission Consent Agenda for March 2, 2021.  Formerly known as HEALTH SOUTH, ENCOMPASS wants some $786,305  to build a rehabilitation facility in St. Johns County,  


It's our money.

Here's my request to County Commissioners to drop the oyster and leave the wharf," as my grandmother would say, enclosing the 2019 USDOJ press release on the $48,000,000 fraud settlement:


-----Original Message-----
From: Ed Slavin <easlavin@aol.com>
....
Sent: Sat, Feb 27, 2021 1:31 pm
Subject: Re: Request No. 2021-31: $48 million False Claims Act settlement by proposed donee of $786,305 corporate welfare -- Encompass Health, 3/2/2021 consent agenda #13

Dear Chairman Blocker, Vice Chairman Dean, Commissioners Smith, Waldron and Whitehurst, and Messrs. McCormack and Conrad:

1. Please send me the requested documents and answer my questions (below). No response yet.  Why?

2. What background investigation and research, if any, did St. Johns County Board of County Commissioners staff do on this applicant for $786,305 in corporate welfare?

3. Would you please be so kind was to table, or delete item 13 from 3/2 Consent Agenda?  Will you kindly reject the proposed wasteful subsidy of $786,305 to a multi-billion dollar health care oligopolist, one that just settled a $48 million False Claims Act with the Justice Department?  It's our money.

4.  Here is the USDOJ press release on $48 million False Claims Act settlement with ENCOMPASS HEALTH, proposed recipient of $786,305 in St. Johns County corporate welfare:    

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Friday, June 28, 2019

Encompass Health Agrees to Pay $48 Million to Resolve False Claims Act Allegations Relating to its Inpatient Rehabilitation Facilities

Encompass Health Corporation (formerly known as HealthSouth Corporation), the nation’s largest operator of inpatient rehabilitation facilities (IRFs), has agreed to pay $48 million to resolve allegations that some of its IRFs provided inaccurate information to Medicare to maintain their status as an IRF and to earn a higher rate of reimbursement, and that some admissions to its IRFs were not medically necessary.
“This settlement demonstrates our commitment to ensuring that those who participate in federal healthcare programs follow the rules,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division. “Medicare and Medicaid providers who seek to profit inappropriately at the expense of taxpayers will be held accountable.”
Medicare and Medicaid use information about patients’ diagnoses to determine whether a facility is properly classified as an IRF, and to determine the level of reimbursement the facility is awarded for specific patients. The government alleged that beginning in 2007, in order to insure compliance with Medicare’s rules regarding classification as an IRF, and to increase Medicare reimbursement, some Encompass IRFs falsely diagnosed patients with what they referred to as “disuse myopathy” when there was no clinical evidence for this diagnosis. Additionally, Encompass IRFs allegedly admitted patients who were not eligible for admission to an IRF because they were too sick or disabled to participate in or benefit from intensive inpatient therapy.
“This important civil settlement concludes a lengthy, comprehensive investigation that brought to light a nationwide scheme that the government contends was intended to defraud our fragile public health programs,” said U.S. Attorney Maria Chapa Lopez. “In doing so, we confirm our commitment to civil health care fraud enforcement as a key component of the mission of our office.”
The settlements resolve allegations raised in three lawsuits filed by Dr. Emese Simon M.D., a former contract physician employed at an Encompass inpatient rehabilitation facility in Sarasota, Florida; Melissa Higgins the former Director of Therapy Operations at Encompass’s inpatient rehabilitation facility in Arlington, Texas; and Dr. Darius Clarke M.D. the former Medical Director at Encompass’s inpatient rehabilitation facility in Richmond, Virginia, and his company, Restorative Health & Wellness P.L.L.C. The lawsuits were filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims and to share in any recovery. Here, the whistleblowers collective share of the settlement will be $12.4 million.
The settlement was the result of a coordinated effort by the Civil Division of the Department of Justice, the Unite States Attorney’s Office for the Middle District of Florida, and the U.S. Department of Health and Human Services Office of Inspector General.        
The three cases are captioned United States ex rel. Simon, et al. v. HealthSouth Corp., et al.; Case No. 08-CV-236 (M.D. Fla.); United States ex rel. Higgins v. HealthSouth Corp.; Case No. 3:12 CV 2496 (N.D. Tex.); and United States ex rel. Clarke et al. v. HealthSouth Corp.; Case No. 1:12 CV 853 (E.D. Va.). The claims resolved by the settlement are allegations only, and there has been no determination of liability. 
Topic(s): 
False Claims Act
Component(s): 

With kindest regards, I am,
Sincerely yours,
Ed Slavin
904-377-4998
www.cleanupcityofstaugustine.blogspot.com
www.edslavin.com



-----Original Message-----
From: Ed Slavin <easlavin@aol.com>
...
Sent: Thu, Feb 25, 2021 6:39 am
Subject: Request No. 2021-31: $786,305 corporate welfare for Encompass Health, 3/2/2021 consent agenda #13

Dear Ms. Zuberer and Messrs. McCormack and Conrad:
A. Would you please be so kind as to send me today:
  1. the Encompass Health grant application? 
  2. all communications with Encompass Health?
  3. meeting minutes?
  4. business cards of Encompass Health or its lobbyists 
  5. telephone call notes and readouts? 
  6. e-mails?
  7. gift reports? 
  8. any background investigations of, or research on, Encompass Health, formerly known as HealthSouth? 
  9. letters of recommendation for Encompass Health?
  10. Communications with FBI or FDLE? 
B. Why is this item on the consent agenda? What role in the consent agenda process, if any, was performed by the County Administrator, the County Attorney and the BCC Chair?
https://stjohnsclerk.com/minrec/agendas/2021/030221cd/03-02-21CON13.pdf
C. Why is there no non-discrimination clause in contract?
D. Who wrote, and who approved, this contract?  Please provide all drafts and counter-drafts, including research memos and e-mails on contract formation process.
E. Please send all records today. 
Thank you.
With kindest regards, I am,
Sincerely yours,
Ed Slavin
904-377-4998
www.cleanupcityofstaugustine.blogspot.com
www.edslavin.com

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