(PEU) owners, who now occupied the majority of seats on HCA’s board, contributed only about $1.2 billion apiece in equity outlay from funds they oversaw
The NYT piece highlighted HCA's recent aggressive coding and billing practices, which produced a financial windfall for its PEU owners. To my ears it rang a virtual echo of the Scott years.
HCA's PEU owners bled $4.25 billion in special dividends from the company prior to its IPO. NYT shed a bit of light on HCA's ER coding:
HCA was still operating under a corporate integrity agreement resulting from its (Scott years) Medicare fraud settlement, and an independent reviewer was scrutinizing its billing. By late 2008, however, just as the agreement with federal regulators was ending, HCA introduced a new coding system for its emergency rooms.HCA informed investors and the SEC of their planned change in 2010:
Approximately 81% of our admissions of uninsured patients occurred through our emergency rooms.We are taking proactive measures to reduce our provision for doubtful accounts by, among other things: screening all patients, including the uninsured, through our emergency screening protocol, to determine the appropriate care setting in light of their condition, while reducing the potential for bad debt and increasing up-front collections from patients subject to co-pay and deductible requirements and uninsured patients.This week's news revealed the impact of such changes in an article titled "EMTALA lacks anti-patient dumping enforcement." It stated:
Even under health reform, uninsured Americans are still at risk for being turned away from the emergency room or transferred to another facility, known as patient dumping.
For more than two decades, it's been illegal to turn away uninsured patients who need emergency care. EMTALA requires hospitals to screen and stabilize patients regardless of their ability to pay. However, study authors, like the Government Accountability Office and the Office of Inspector General, criticized the U.S. Department of Health & Human Services for lax oversight, specifically over a lack of a public reporting system in which people could report potential violations.