This information is from 1996
Are you kidding me?
MEDICARE FRAUD
MAY 15, 1996
TRANSCRIPT
This week, the Department of Health & Human Services announced that a year-old pilot project to crack down on Medicare fraud is proving successful. Florida is one of five states included in that project. Fred De Sam Lazaro of KTCA-St. Paul-Minneapolis has the story.
FRED DE SAM LAZARO: More retired Americans live in Florida than any other state, so it's no surprised that health care, particularly Medicare, the program that insures all Americans over 65, is the biggest driver of the economy here. In the Miami area, doctors offices, nursing services, and home health agencies abound, serving an estimated 2 million Medicare beneficiaries in the area. South Florida is also a huge lucrative target of opportunity for rip-off artists according to U.S. Attorney Kendall Coffey.
KENDALL COFFEY, U.S. Attorney: South Florida has a rampant problem with Medicare fraud and really with health care fraud generally. It is spread all over the place. It is a problem that is perhaps as much as $2 billion or more when you include all the components of health care fraud. It is really the problem of the 90's, just as bank fraud and failures have been the big fraud challenge of the 80's. Criminals follow dollars and health care is where the dollars are.
FRED DE SAM LAZARO: The Medicare program is inviting to criminals because it is comprehensive. Medicare pays for all medical services a doctor deems reasonable and necessary. The FBI's George Clow says just what reasonable and necessary means has been stretched to new limits.
GEORGE CLOW, FBI: We've had some very unscrupulous licensed physicians have been, they've been utilized to prescribe things for people that they don't need. One of the more interesting ones that we had here in South Florida, this case that resulted in about $9 million worth of fraud being, being perpetrated on Medicare and the taxpayer, involves what's known as a nutritional milk. We had a group of people who were going to old folks homes and senior citizens complexes and telling these people that the government wants them to have this surplus milk, and they were bringing it in by the case, and all you need to do to participate in getting the surplus milk, this nutritional supplement, is to give us your Medicare number, which people did.
JOSE COMAS, Medicare Recipient: I received a phone call that afternoon. A gentleman asked me, "Have you heard about a new program from Medicare?".
FRED DE SAM LAZARO: Seventy-year-old retired airline mechanic Jose Comas readily volunteered his Medicare or Social Security number when a telephone solicitor offered him fruit juices which he was misled to believe were free under Medicare.
JOSE COMAS: Two days later, I find two cases of fruit juice on my porch. Very well, we drank it, very good. Next month we had another couple of cases. I didn't see anybody around. They always dropped it without saying anything or leaving any messages or notes until I got the Medicare statement at the end of a couple of months went buy, and I see January, February, $395 for nutrients and special fruit.
FRED DE SAM LAZARO: Medicare statements are merely notifications of benefits. Although there are some co-payments, beneficiaries rarely are asked to pay anything out of their own pocket in fraudulent schemes. It's one reason many do not complain. Although most elderly don't know they're being used in schemes, advocates say many, in fact, cooperate in them. Here at Miami's Little Havana Senior Center the average person lives on just $450 a month in Social Security benefits. Many don't speak English, making them especially vulnerable, according to psychologist Dr. Ariela Rodriguez.
DR. ARIELA RODRIGUEZ, Psychologist: These are folks that come out here because they don't have family at home, they don't have anything to do at home, except sit there and watch TV. So these folks are at risk for being, uh, poor, at risk for bribery, or at risk for accepting gifts because of their poverty. They are at risk to allow people to talk to them about these things because they're lonely, so anybody that comes knocking on their door, young person that is friendly to them, they will invite in and offer coffee to and entertain and please, try to please.
FRED DE SAM LAZARO: And Dr. Rodriguez says they're quite liable to turn over their Social Security numbers. That's the first of three simple steps it takes to bilk Medicare. The second is registering as a Medicare provider, obtaining an ID number. That takes one phone call to a Medicare office. Finally, with a collaborating doctor to sign prescriptions, these operators can begin sending bills to Medicare. Jose Comas got notifications that Medicare paid four different providers on his behalf over a two-year period.
JOSE COMAS: And I imagine Medicare provides them with a control numbers so they can collect their money when they send them a bill.
FRED DE SAM LAZARO: So you got a total of four different companies that supplied you with these?
JOSE COMAS: Four different companies supplying. That's right, over a period of over a year and I, I calculated more or less ten to fifteen thousand dollars.
FRED DE SAM LAZARO: Medicare is an open entitlement. It pays for all reasonable necessary medical care, but money to crack down on fraud comes from what are called discretionary federal funds, annual appropriations from Congress. They are limited and limiting, according to June Brown, inspector general at the Department of Health & Human Services.
JUNE BROWN, Department of Health and Human Services: (1995) This office brought back $8 billion last year to the government and reimbursed the programs that lost the money and the rest went to the U.S. Treasury, and yet, the budgets are being cut for the oversight effort. If you averaged people on the staff, they brought back $6.4 million each.
FRED DE SAM LAZARO: Medicare beneficiaries are being urged in mailings, through the media, and senior centers, to scrutinize their Medicare notifications. They are sent out each time a provider has been paid in their behalf. Recipients are urged to report bills for services they did not receive.
SPOKESPERSON: You do have a copy of the claim that you submitted?
FRED DE SAM LAZARO: The program has also taken several steps to make it more difficult for fraudulent operators. For example, it will no longer issue provider numbers to applicants who list post office boxes, instead of street addresses, a trademark of fly-by-night operators. Medicare's computerized billing system is also being streamlined so unusual billing activity will be red-flagged for further investigation according to Medicare's top administrator, Bruce Vladeck.
BRUCE VLADECK, Medicare Administrator: The long-term big effect is going to be, is going to be produced by significant changes in our systems, our computer systems, our payment systems, our systems for assigning new provider organizations to participate in the Medicare program. The front-end prevention and deterrence, of course, is where the greatest long-term pay-offs are, and that's a process that won't be going on over the next several years.
FRED DE SAM LAZARO: How much these measures will curtail abuse remains an open question to many experts. So too is the definition of abuse. The Florida Medical Association's Dr. Robert Goldberg says although some doctors have engaged in fraud, in many cases, the abuse is not overt or it may be well-intentioned.
DR. ROBERT GOLDBERG, Florida Medical Association: For example, a medical equipment, a durable medical equipment supplier may ask the physician to fill out or requisition, saying that a patient is there and requires a wheelchair or some other piece of medical equipment to, to do their activities in the home. The physician is not benefiting in that situation, and very often wants to do what's best for the patient. As practices have become busier and you're seeing larger numbers of patients, it's very difficult to check into every situation, so the doctors are vulnerable, coercible, into doing things that perhaps aren't always in the program's best interest.
FRED DE SAM LAZARO: Gail Wilensky, who ran the Medicare program during the Bush administration says the gray areas, possible but not clear abuse, far outstrip the out and out fraud in Medicare.
GAIL WILENSKY, Former Medicare Administrator: Thirty and forty percent of some kinds of procedures may well be in this gray area, not of zero benefit, and not of certain benefit either. Medicare tends to be delivered in an ala carte fee-for-service environment, and that means that the financial incentives are to do more, rather than less.
FRED DE SAM LAZARO: Wilensky says information measuring the effectiveness of some commonly used services, notably in cardiothorasic surgery, for example, is being gathered that will ultimately enable guidelines to better control costs. Meanwhile, law enforcement officials, who must go after the blatant abuse, say Medicare continues to attract crooks.
KENDALL COFFEY: My biggest frustration is that we have not yet reached the point of critical mass, and once friends are telling friends that they're going to get prosecuted, then we'll have hit critical mass, and then we'll be turning this thing around and in a dramatic way.
FRED DE SAM LAZARO: Do you see that happening?
KENDALL COFFEY: I think it's going to happen. I think it's starting to happen, but we're not there yet.
FRED DE SAM LAZARO: Coffey says part of the challenge is in making elderly Americans aware of how easily they are used in fraudulent Medicare schemes. In the meanwhile, under the Clinton administration anti-fraud program, his office is adding five new investigators to track down more of those schemes.
Friday, November 30, 2007
Thursday, November 29, 2007
Insurers and government fraud-fighters were slow to catch on to this scheme
By Dennis Jay on Wed Nov 28, 2007 at 6:23 PM EST
One of the most notorious medical scams recorded its first significant conviction today in California. Outpatient surgeon William Wilson Hampton, pictured here, was found guilty of one count of health care fraud. Dr. Hampton and two other surgeons from Unity Outpatient Surgery Center in Southern California are accused of masterminding a horrific plan to entice low-income people from around the country to travel to California to have unnecessary — and sometimes very risky — surgeries. All so the three could enrich themselves at the expense of insurance companies and health plans.
And this scheme seemed to work well. They hired runners who recruited “patients” from nearly every state, enticing them with cash and free vacations to California. By one account, the center performed more than 1,000 unnecessary surgeries and is part of a larger scam that has billed insurers for nearly $100 million. The FBI says its the biggest healthcare fraud scam it’s ever encountered. When the case broke in May, county DA Tony Rackauckas lamented:
“It is unfathomable that a doctor would treat patients as if they were bodies on a medical conveyor belt for a quick buck.'’
Insurers and government fraud-fighters were slow to catch on to this scheme. It flourished a long time before it was shut down. Hopefully fraud fighters will use this case to understand how others may be operating and develop red flags to increase detection.
Today’s conviction is far from a complete victory for prosecutors. Hampton was acquitted of one charge and jurors deadlocked on 10 others. Prosecutors say they’ll decide next week whether charges will be re-filed.
But at least the one that struck answers the question of guilt. The big question that remains, though, is why a seemingly intelligent person who has the gift to become a surgeon and a healer — and earn a great living — would jeopardize it all and cut people open for the sake of a few dollars. It’s baffling.
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Posted in Medical fraud
One of the most notorious medical scams recorded its first significant conviction today in California. Outpatient surgeon William Wilson Hampton, pictured here, was found guilty of one count of health care fraud. Dr. Hampton and two other surgeons from Unity Outpatient Surgery Center in Southern California are accused of masterminding a horrific plan to entice low-income people from around the country to travel to California to have unnecessary — and sometimes very risky — surgeries. All so the three could enrich themselves at the expense of insurance companies and health plans.
And this scheme seemed to work well. They hired runners who recruited “patients” from nearly every state, enticing them with cash and free vacations to California. By one account, the center performed more than 1,000 unnecessary surgeries and is part of a larger scam that has billed insurers for nearly $100 million. The FBI says its the biggest healthcare fraud scam it’s ever encountered. When the case broke in May, county DA Tony Rackauckas lamented:
“It is unfathomable that a doctor would treat patients as if they were bodies on a medical conveyor belt for a quick buck.'’
Insurers and government fraud-fighters were slow to catch on to this scheme. It flourished a long time before it was shut down. Hopefully fraud fighters will use this case to understand how others may be operating and develop red flags to increase detection.
Today’s conviction is far from a complete victory for prosecutors. Hampton was acquitted of one charge and jurors deadlocked on 10 others. Prosecutors say they’ll decide next week whether charges will be re-filed.
But at least the one that struck answers the question of guilt. The big question that remains, though, is why a seemingly intelligent person who has the gift to become a surgeon and a healer — and earn a great living — would jeopardize it all and cut people open for the sake of a few dollars. It’s baffling.
-->
Posted in Medical fraud
Wednesday, November 28, 2007
Bankruptcy Cases....maybe we should ask the Queen of Bankruptcy...
Remember, Darla Moore......RICHARD RAINWATER's wife!!! She was on the cover of FORTUNE MAGAZINE. Title: Queen of Bankrutpcy.
Are Bankruptcy Cases the Future of Legal Malpractice?
Here is a post from NY Lawyer:
In April 2003, Steven Garfinkel, the chief financial officer of DVI Inc., wrote a memo to chief executive officer Michael O'Hanlon about the crushing liquidity crisis facing the health-care finance company and its implications for a pending stock float. The CFO urged his boss to talk as soon as possible to the company's main outside lawyer, John Healy, a partner in the New York office of Clifford Chance.
As for Clifford Chance, it is now facing two lawsuits in federal court in Philadelphia charging that it participated in the fraud at the company. One is the familiar shareholder class action, which is also targeting Merrill Lynch and Deloitte & Touche. The other suit, however, is by DVI itself, or, rather, the bankruptcy trustee overseeing the fallen company's estate. Trustee Dennis J. Buckley requested $2 billion in damages from the London-based law firm in a complaint filed in March 2006.
Though they garner fewer headlines, such bankruptcy trustee suits have largely replaced shareholder class actions in the nightmares of law firm managing partners. These suits are often better-funded, better-lawyered and, with the U.S. Supreme Court likely to further limit third-party liability in securities fraud cases, they may soon have a distinct legal edge as well.
"These are the lawsuits firms are most worried about now," said Michael Carlinsky, a partner at Quinn Emanuel Urquhart Oliver & Hedges who is representing Marc S. Kirschner, the bankruptcy trustee of failed commodities brokerage Refco Inc. in a $2 billion suit against the company's former lawyers at Mayer, Brown, Rowe & Maw, among others.
Indeed, the journey of Enron Corp. law firm Vinson & Elkins illustrates the shifting landscape of law firm liability. The Houston-based firm vigorously fought the high-profile securities fraud suit brought against it by former class action king William S. Lerach, getting off scot-free with a voluntary dismissal in January 2007. But last year Vinson & Elkins quietly paid $30 million to Enron's bankruptcy trustee, who never formally filed suit against the firm.
Law Firms as Targets
While securities class actions are brought on behalf of shareholders, bankruptcy trustee suits are brought for the benefit of creditors, the biggest of which are usually banks and investment funds. These creditors have grown more aggressive about recouping losses, lawyers say, with trustees acting accordingly. "
Are Bankruptcy Cases the Future of Legal Malpractice?
Here is a post from NY Lawyer:
In April 2003, Steven Garfinkel, the chief financial officer of DVI Inc., wrote a memo to chief executive officer Michael O'Hanlon about the crushing liquidity crisis facing the health-care finance company and its implications for a pending stock float. The CFO urged his boss to talk as soon as possible to the company's main outside lawyer, John Healy, a partner in the New York office of Clifford Chance.
As for Clifford Chance, it is now facing two lawsuits in federal court in Philadelphia charging that it participated in the fraud at the company. One is the familiar shareholder class action, which is also targeting Merrill Lynch and Deloitte & Touche. The other suit, however, is by DVI itself, or, rather, the bankruptcy trustee overseeing the fallen company's estate. Trustee Dennis J. Buckley requested $2 billion in damages from the London-based law firm in a complaint filed in March 2006.
Though they garner fewer headlines, such bankruptcy trustee suits have largely replaced shareholder class actions in the nightmares of law firm managing partners. These suits are often better-funded, better-lawyered and, with the U.S. Supreme Court likely to further limit third-party liability in securities fraud cases, they may soon have a distinct legal edge as well.
"These are the lawsuits firms are most worried about now," said Michael Carlinsky, a partner at Quinn Emanuel Urquhart Oliver & Hedges who is representing Marc S. Kirschner, the bankruptcy trustee of failed commodities brokerage Refco Inc. in a $2 billion suit against the company's former lawyers at Mayer, Brown, Rowe & Maw, among others.
Indeed, the journey of Enron Corp. law firm Vinson & Elkins illustrates the shifting landscape of law firm liability. The Houston-based firm vigorously fought the high-profile securities fraud suit brought against it by former class action king William S. Lerach, getting off scot-free with a voluntary dismissal in January 2007. But last year Vinson & Elkins quietly paid $30 million to Enron's bankruptcy trustee, who never formally filed suit against the firm.
Law Firms as Targets
While securities class actions are brought on behalf of shareholders, bankruptcy trustee suits are brought for the benefit of creditors, the biggest of which are usually banks and investment funds. These creditors have grown more aggressive about recouping losses, lawyers say, with trustees acting accordingly. "
US Attorney,,,,,,Minnesota.....MORE GARBAGE!
Has anyone inquired about the Health Care Fraud prosecuted in Minnesota under this BUSH APPOINTEE during her tenure? Is there even one case? Please educate me!
Tuesday, November 27, 2007
U.S. Attorney for Minnesota resigns; reassigned to Justice Dept. in Washington
Rachel K. Paulose, 34, a Minnesota native, who was nominated by President Bush as U.S. Attorney for the District of Minnesota, has resigned from her post. Her resignation comes after months of controversy over her handling the Minnesota office and staff and in the backdrop of former Attorney General Alberto Gonzalez' alleged politically selective hiring and firing of nine U.S. Attorney's nationwide.
Paulose has been reassigned as Counselor to the Assistant Attorney General for Legal Policy, a branch that handles Justice Department and Veterans Administration nominees to the Federal Bench.
Born in Kerala and raised in Minnesota, Paulose got a J.D. from Yale Law School after graduating summa cum laude from the University of Minnesota. Her father Joseph Paulose of Eagan, Minnesota, is an administrator at Hopkins public schools.
She is the first woman and the first Asian American to ever head the Minnesota U.S.
Attorney's office. She was confirmed by the U.S.
Senate last year in one of its last acts December 9, 2006, before it went on recess and before the Democrats took the leadership reins. Senator Norm Coleman (R-Minn) who was her main supporter back in 2006, in a statement issued recently, said he wanted incoming Attorney General Michael Mukasey to investigate the workings of the Minnesota office. This followed on the heels of complaints from employees in the office and the seemingly controversial changes Paulose pushed through after her appointment and resignations by a slew of prosecuting attorneys there. In a formal statement issued Nov. 19, Rep. Coleman said: - "I support Rachel Paulose's decision today to step down from her duties as Minnesota's U.S. Attorney. I have made it clear that I have had concerns about the office of the U.S. Attorney under her watch, and I believe this decision will allow the office to move forward." (Text of full statement below).
But in December when the Senate unanimously voted her through, Coleman, who took the credit for that, saying, "It would have been a shame to see such a capable, experienced nominee fail to get a chance for confirmation, and I am very excited we were able to get her nomination through the Senate before adjournment."
Before taking up her post in Minnesota, Paulose was Senior Counsel to Acting Deputy Attorney General Paul J. McNulty, and she was also the Department's Special Counsel for Health Care Fraud. She is a former prosecutor who served as an Assistant United States Attorney for the District of Minnesota from 1999-2002, where she prosecuted both criminal and civil cases for the federal government, including violent crime, health care fraud, and white collar crime. She previously served in the Justice Department as an Attorney General's Honors Program trial attorney for the Civil Rights Division. She was in private practice from 2002-2006.
To read the complete article click here..To read the complete epaper click here: www.newsindia-times.comimage and article source:News India TimesArticle taken from the issue:30 November, 2007
Tuesday, November 27, 2007
U.S. Attorney for Minnesota resigns; reassigned to Justice Dept. in Washington
Rachel K. Paulose, 34, a Minnesota native, who was nominated by President Bush as U.S. Attorney for the District of Minnesota, has resigned from her post. Her resignation comes after months of controversy over her handling the Minnesota office and staff and in the backdrop of former Attorney General Alberto Gonzalez' alleged politically selective hiring and firing of nine U.S. Attorney's nationwide.
Paulose has been reassigned as Counselor to the Assistant Attorney General for Legal Policy, a branch that handles Justice Department and Veterans Administration nominees to the Federal Bench.
Born in Kerala and raised in Minnesota, Paulose got a J.D. from Yale Law School after graduating summa cum laude from the University of Minnesota. Her father Joseph Paulose of Eagan, Minnesota, is an administrator at Hopkins public schools.
She is the first woman and the first Asian American to ever head the Minnesota U.S.
Attorney's office. She was confirmed by the U.S.
Senate last year in one of its last acts December 9, 2006, before it went on recess and before the Democrats took the leadership reins. Senator Norm Coleman (R-Minn) who was her main supporter back in 2006, in a statement issued recently, said he wanted incoming Attorney General Michael Mukasey to investigate the workings of the Minnesota office. This followed on the heels of complaints from employees in the office and the seemingly controversial changes Paulose pushed through after her appointment and resignations by a slew of prosecuting attorneys there. In a formal statement issued Nov. 19, Rep. Coleman said: - "I support Rachel Paulose's decision today to step down from her duties as Minnesota's U.S. Attorney. I have made it clear that I have had concerns about the office of the U.S. Attorney under her watch, and I believe this decision will allow the office to move forward." (Text of full statement below).
But in December when the Senate unanimously voted her through, Coleman, who took the credit for that, saying, "It would have been a shame to see such a capable, experienced nominee fail to get a chance for confirmation, and I am very excited we were able to get her nomination through the Senate before adjournment."
Before taking up her post in Minnesota, Paulose was Senior Counsel to Acting Deputy Attorney General Paul J. McNulty, and she was also the Department's Special Counsel for Health Care Fraud. She is a former prosecutor who served as an Assistant United States Attorney for the District of Minnesota from 1999-2002, where she prosecuted both criminal and civil cases for the federal government, including violent crime, health care fraud, and white collar crime. She previously served in the Justice Department as an Attorney General's Honors Program trial attorney for the Civil Rights Division. She was in private practice from 2002-2006.
To read the complete article click here..To read the complete epaper click here: www.newsindia-times.comimage and article source:News India TimesArticle taken from the issue:30 November, 2007
GOLDMAN SACHS, RAINWATER, HALIBURTON
Amazing, 17 years later, here we are with RAINWATER, HALIBURTON, GOLDMAN SACHS and the good ole boys!
Once again, Bush's ex-partner, you know the dummy sideline partner of the Texas Rangers......
March 2, 1990
COMPANY NEWS; Simmering Battle on Penrod Begins to Boil
By THOMAS C. HAYES, SPECIAL TO THE NEW YORK TIMES
LEAD: A simmering battle for control of the world's largest offshore oil-drilling company, the Penrod Drilling Corporation, has pitted several of its big bankers against a group of investors headed by Richard E. Rainwater, an influential investor from Fort Worth.
A simmering battle for control of the world's largest offshore oil-drilling company, the Penrod Drilling Corporation, has pitted several of its big bankers against a group of investors headed by Richard E. Rainwater, an influential investor from Fort Worth.
The outcome of the struggle, which shows signs of escalating into financial and legal warfare, will determine who owns 39 percent of the world's most modern and efficient offshore drilling rigs at a time when lease rates and offshore drilling activity are rising smartly.
Penrod, organized more than 50 years ago by the legendary wildcatter and billionaire H. L. Hunt, also owns 47 land rigs. Industry analysts said offers for the company had been rumored at more than $500 million. Shearson Lehman Hutton Inc. estimated in a report in December that the Penrod rigs have a replacement value of $1.2 billion.
''There is no question that this is the biggest deal'' in the offshore industry since oil prices and drilling rates collapsed in 1986, said Thomas A. Escott, senior vice president at Rauscher, Pierce, Refsnes, a Dallas brokerage. ''With the Hunt brothers going bust, it has taken on a proportion that is larger than life.''
In the early 1980's, with one of Mr. Hunt's sons, W. Herbert Hunt, at the helm, Penrod borrowed heavily from a dozen leading commercial banks, headed by Manufacturers Hanover and First Chicago, to expand its fleet aggressively.
After oil prices collapsed, Herbert Hunt and two brothers, Nelson Bunker and Lamar, battled creditors in court for more than three years in a vain attempt to keep control of Penrod plus other assets once valued in the billions of dollars. Herbert and Bunker Hunt agreed to liquidate their trusts in December.
The Hunts' control over Penrod diminished in 1988 when the banks agreed to write off $250 million of Penrod's debt in exchange for an equal voice with the Hunts in the company's business affairs.
Weeks before the December agreement, Penrod's trustees had rejected an unsolicited offer of $325 million for the drilling contractor from the Rowan Companies, a competing driller. At the time, a group headed by Mr. Rainwater, who was once a key strategist for another famous family of Texas investors, the Bass brothers of Fort Worth, had bought small amounts of Penrod debt and equity at a discount from some of the banks.
Meanwhile, another family of investors, the Tisches of New York, offered $450 million to acquire all of Penrod, people familiar with the bid said. The Penrod trustees have not ruled on the Tisch offer.
The unsolicited bids persuaded Penrod's banks that they could reclaim most of their $530 million in unrecovered loans and interest if the entire company is auctioned, say investment bankers in the oilfield service business.
Meanwhile, Mr. Rainwater is raising his stake in Penrod. On Wednesday, the Energy Service Company, a contract driller in Houston that he controls, said a partnership including the Fort Worth investor; Goldman, Sachs, and others had raised their holdings of Penrod debt to 27.1 percent and their equity to 13.6 percent.
The Rainwater announcement came after Penrod's creditors, including banks and representatives from the Rainwater group, could not agree on the driller's fate, said an investment banker who asked not to be identified.
C. Christopher Gaut, chief financial officer at Energy Service, said today that the Rainwater group wants Penrod to remain independent.
''We have had discussions with the company about a recapitalization,'' he said. ''We believe that is the route that offers the best value for all the holders.''
Several analysts said Mr. Rainwater's goal might not be to keep Penrod independent or gain control, but to force bidders to pay a premium.
That happened two years ago, when a Rainwater group delayed Halliburton Inc.'s acquisition of Gearhart Industries for several months. Halliburton finally completed the deal after it agreed to pay $67 million for subordinated debt in Gearhart that the Rainwater group had bought for $33 million seven months earlier.
In its statement Wednesday, Energy Service said the Rainwater-Goldman, Sachs group had spent $44.4 million to acquire its current Penrod holdings.
Correction: March 5, 1990, Monday, Late Edition - Final
An article in Business Day on Friday about the Penrod Drilling Corporation misstated the extent of the company's ownership of offshore drilling rigs. Penrod owns 39 modern drilling rigs, not 39 percent of the world's total.
Once again, Bush's ex-partner, you know the dummy sideline partner of the Texas Rangers......
March 2, 1990
COMPANY NEWS; Simmering Battle on Penrod Begins to Boil
By THOMAS C. HAYES, SPECIAL TO THE NEW YORK TIMES
LEAD: A simmering battle for control of the world's largest offshore oil-drilling company, the Penrod Drilling Corporation, has pitted several of its big bankers against a group of investors headed by Richard E. Rainwater, an influential investor from Fort Worth.
A simmering battle for control of the world's largest offshore oil-drilling company, the Penrod Drilling Corporation, has pitted several of its big bankers against a group of investors headed by Richard E. Rainwater, an influential investor from Fort Worth.
The outcome of the struggle, which shows signs of escalating into financial and legal warfare, will determine who owns 39 percent of the world's most modern and efficient offshore drilling rigs at a time when lease rates and offshore drilling activity are rising smartly.
Penrod, organized more than 50 years ago by the legendary wildcatter and billionaire H. L. Hunt, also owns 47 land rigs. Industry analysts said offers for the company had been rumored at more than $500 million. Shearson Lehman Hutton Inc. estimated in a report in December that the Penrod rigs have a replacement value of $1.2 billion.
''There is no question that this is the biggest deal'' in the offshore industry since oil prices and drilling rates collapsed in 1986, said Thomas A. Escott, senior vice president at Rauscher, Pierce, Refsnes, a Dallas brokerage. ''With the Hunt brothers going bust, it has taken on a proportion that is larger than life.''
In the early 1980's, with one of Mr. Hunt's sons, W. Herbert Hunt, at the helm, Penrod borrowed heavily from a dozen leading commercial banks, headed by Manufacturers Hanover and First Chicago, to expand its fleet aggressively.
After oil prices collapsed, Herbert Hunt and two brothers, Nelson Bunker and Lamar, battled creditors in court for more than three years in a vain attempt to keep control of Penrod plus other assets once valued in the billions of dollars. Herbert and Bunker Hunt agreed to liquidate their trusts in December.
The Hunts' control over Penrod diminished in 1988 when the banks agreed to write off $250 million of Penrod's debt in exchange for an equal voice with the Hunts in the company's business affairs.
Weeks before the December agreement, Penrod's trustees had rejected an unsolicited offer of $325 million for the drilling contractor from the Rowan Companies, a competing driller. At the time, a group headed by Mr. Rainwater, who was once a key strategist for another famous family of Texas investors, the Bass brothers of Fort Worth, had bought small amounts of Penrod debt and equity at a discount from some of the banks.
Meanwhile, another family of investors, the Tisches of New York, offered $450 million to acquire all of Penrod, people familiar with the bid said. The Penrod trustees have not ruled on the Tisch offer.
The unsolicited bids persuaded Penrod's banks that they could reclaim most of their $530 million in unrecovered loans and interest if the entire company is auctioned, say investment bankers in the oilfield service business.
Meanwhile, Mr. Rainwater is raising his stake in Penrod. On Wednesday, the Energy Service Company, a contract driller in Houston that he controls, said a partnership including the Fort Worth investor; Goldman, Sachs, and others had raised their holdings of Penrod debt to 27.1 percent and their equity to 13.6 percent.
The Rainwater announcement came after Penrod's creditors, including banks and representatives from the Rainwater group, could not agree on the driller's fate, said an investment banker who asked not to be identified.
C. Christopher Gaut, chief financial officer at Energy Service, said today that the Rainwater group wants Penrod to remain independent.
''We have had discussions with the company about a recapitalization,'' he said. ''We believe that is the route that offers the best value for all the holders.''
Several analysts said Mr. Rainwater's goal might not be to keep Penrod independent or gain control, but to force bidders to pay a premium.
That happened two years ago, when a Rainwater group delayed Halliburton Inc.'s acquisition of Gearhart Industries for several months. Halliburton finally completed the deal after it agreed to pay $67 million for subordinated debt in Gearhart that the Rainwater group had bought for $33 million seven months earlier.
In its statement Wednesday, Energy Service said the Rainwater-Goldman, Sachs group had spent $44.4 million to acquire its current Penrod holdings.
Correction: March 5, 1990, Monday, Late Edition - Final
An article in Business Day on Friday about the Penrod Drilling Corporation misstated the extent of the company's ownership of offshore drilling rigs. Penrod owns 39 modern drilling rigs, not 39 percent of the world's total.
Monday, November 26, 2007
RAINWATER; CRAWFORD; Want some more dots....
By BARRY MEIER
Published: February 16, 2000
The nation's largest chain of psychiatric hospitals lies in tatters. More than half of the roughly 90 hospitals and treatment centers operated by Charter Behavioral Health Systems will soon be closed and the company is expected to announce as early as today that it is seeking bankruptcy protection.
Three years ago, officials of a real estate investment trust headed by Richard E. Rainwater, the financier based in Fort Worth, announced a $400 million investment that they said would breathe new life into Charter. But rather than revitalizing the chain, the deal contributed to its collapse, according to many former Charter officials, undermining patient care in the process.
The company says that Charter's woes were caused by insurance cutbacks, not by the 1997 plan, and that patient care was not affected. The 1997 plan, though, saddled Charter Behavioral, a unit of Magellan Health Services Inc., with some $125 million in franchise fees and rapidly escalating rents. The chain's former chief executive said he warned that the costs would cause financial chaos. Those pressures, coupled with industrywide insurance cutbacks, were soon felt in psychiatric wards, former company officials said.
Hospital directors and workers, overworked and faced with repeated salary freezes, quit. Wards had too few employees, federal and state reports show. Training programs were eliminated, former company officials said. Broken chairs and walls were not repaired. ''It felt like they were strip-mining this place,'' said Dr. Hashim Hafez, the medical director at a Charter unit in Nashua, N.H., until he quit last year.
Charter Behavioral, which once had units in 27 states caring for more than 8,000 patients, many of them children, had long had a troubled past. But after 1997, patient care failed even at well-run hospitals, according to regulators and former company executives.
''Charter was never a great company,'' said Cindy Musikantow, who once ran a treatment center for adolescents that the company managed in Naperville, Ill. ''But it disintegrated to the degree that decisions were being made without regard for patients.''
The deal was a complex one that was intended to benefit both Mr. Rainwater's real estate trust, the Crescent Real Estate Equities Company, and Magellan Health. Under the plan, the trust received income from lease payments and Magellan received franchise fees.
In addition, Mr. Rainwater, as the largest shareholder in Magellan Health at the time, stood to profit because the sale of the ailing chain raised Magellan's stock price.
Magellan Health's top executive also got a large bonus, according to filings with the Securities and Exchange Commission. Additionally, the plan enabled Magellan, the nation's largest behavioral health company, to leave the hospital business for managed health care, a more lucrative field.
The deal split ownership of Charter Behavioral between Magellan Health and an affiliate of Crescent Real Estate. The psychiatric chain's buildings were sold to Crescent Real Estate, which leased them back at a healthy profit.
Both Mr. Rainwater -- a former business associate of Gov. George W. Bush Jr. of Texas -- and Mac Crawford, the chief executive of Magellan Health at the time of the deal, declined to be interviewed. In written responses, their spokesmen said that Charter Behavioral's financial woes were caused by insurance cutbacks, not by the 1997 plan. They said patient care was not affected.
''Sure, we had falling resources,'' said Dr. Gary M. Henschen, the chief medical officer of Charter Behavioral, which is based in Alpharetta, Ga. ''But we have done the best we can.''
In late 1995, Mr. Rainwater and his wife, Darla Moore, paid $69.7 million for a 12.3 percent stake in Magellan Health. The following year, he approached Mr. Crawford about a deal for Magellan to sell Charter Behavioral's buildings to Crescent. Companies that operate nursing homes had engaged in similar ''sale lease-backs'' to raise cash.
In the 1997 deal, Crescent Real Estate paid $400 million to acquire a half-stake in Charter Behavioral and buy its buildings. Because federal tax laws bar real estate investment trusts, or REIT's, from operating companies, Mr. Rainwater and his associates formed a publicly traded company, Crescent Operating Inc., to hold the half-stake.
Under the deal, Charter Behavioral was required to pay Crescent Real Estate $41.5 million in rent, a return of about 11 percent. Gerald Haddock, a Crescent executive, described the lease returns as ''exceptional.'' The rent, which took precedence over franchise fees to Magellan Health, escalated 5 percent annually.
Magellan Health, which is based in Columbia, Md., retained a 50 percent stake in Charter Behavioral, which was to pay it $78 million annually in franchise fees. Magellan, which used cash from the sale to finance managed care acquisitions, said that those payments could decline if industrywide insurance cuts continued.
At the time, most analysts applauded the plan. But John Lutzius, an analyst with Green Street Advisors in Newport Beach, Calif., said shortly after that the new payments left Charter Behavioral with little cash to weather any problems.
''Between the franchise fees and the rent, Magellan and Crescent were effectively sweeping all the cash flow from Charter,'' Mr. Lutzius said recently.
Mr. Rainwater's bet on the psychiatric industry proved to be wrong. In 1997, some within Charter Behavioral had sounded warnings about the deal's consequences for the company.
In separate interviews, two former top Charter officials said John M. DeStefanis, Charter's top executive, told Mr. Crawford of Magellan Health that the franchise fee and rent payments would financially devastate the psychiatric hospitals. Not long after the deal closed, Mr. DeStefanis resigned, those former officials said.
''John went nose to nose with them and that's why he was forced out of the company,'' said one former executive who spoke on the condition of anonymity.
Asked about that account, Mr. DeStefanis confirmed it but declined further comment, citing a confidentiality agreement. In his statement, Mr. Crawford disputed this version of events, saying that Mr. DeStefanis supported the deal. Mr. DeStefanis's departure was unrelated to the deal, he said.
Magellan officials declined to comment on discussions with Mr. DeStefanis. ''In the course of negotiating any transaction, differing viewpoints are always expressed, and, in a good organization, are even encouraged,'' the company said in a statement.
Magellan Health executives said the deal would benefit Charter Behavioral; Magellan's top official also profited. Mr. Crawford, whose salary in fiscal 1996 was $712,500, received a $2.48 million bonus for closing the deal, according to Magellan Health's 1997 proxy statement.
In his statement, Mr. Crawford described his cash payment as a ''retention bonus.'' One company director, A. D. Frazier Jr., said that he supported the payment to Mr. Crawford because the 1997 deal moved Magellan toward managed care and away from hospitals.
A month after the deal closed in June 1997, the federal government further cut hospital reimbursements. That December, Magellan told shareholders in its annual report the move would cut the $78 million due in franchise fees from Charter Behavioral in fiscal 1998 by a range of $10 million to $15 million.
Mr. DeStefanis's projections, however, proved far more accurate. Charter Behavioral managed to pay only $32 million in fees that fiscal year. In January 1998, seven months after the deal and 45 days after Magellan issued its annual report, the chain made its last franchise payment.
Charter Behavioral had had a troubled record of patient care, including settlements of government charges involving fraudulent billing. Regulators said, however, that some units provided good care.
In early 1997, for example, Dr. Ronald Davidson, a hospital consultant for the State of Illinois, declared he would not hesitate to use a company center in Brown Deer, Wis., for his own child. But by early 1998, conditions there and at other well-run units worsened as the weakening chain imposed repeated salary freezes, staff cutbacks and other cost-cutting measures, said former executives, including Ms. Musikantow, the former head of the Chicago-area unit.
At Charter's flagship hospital in Nashua, N.H., resources shrank and staff levels fell, said Dr. Philip Santora, a former associate medical director at the unit. When experienced nurses and therapists quit, they were replaced by fresh graduates, he said.
In 1998 and 1999 reports, federal and New Hampshire regulators found unsupervised children engaging in sex or hurting themselves at the Nashua unit. Wards persistently had too few employees. Suicide attempts were not recorded, and children were improperly restrained.
Dr. Santora, who quit in August, said that while insurance cutbacks played a role, the 1997 deal resulted in a pattern of neglect.
''You can chip away and chip away and sooner or later you reach a critical mass and a point of no return,'' he said.
As its hospitals veered out of control, Charter Behavioral's governing board -- which was comprised of two executives from Magellan Health and two associates of Mr. Rainwater -- had little response.
Dr. Clarissa Marques, Magellan Health's chief clinical officer, joined the board in August 1998 and found it had never received or asked for patient care reports. She said that in 1998 it did not meet until late October.
John C. Goff, one of Mr. Rainwater's closest associates, who headed the board then, declined to comment.
In mid-1998, Mr. Crawford left Magellan Health to become chief executive of Caremark Rx of Birmingham, Ala. About that time, in an S.E.C. filing, Crescent Operating -- which along with Magellan had lent some money to Charter -- acknowledged that Charter's operating losses were growing because of insurance cutbacks and the rents and fees the 1997 deal required.
In November 1998, Mr. Goff resigned from Charter Behavioral's board. A month later, the chain's accountants questioned its ability to continue, according to an S.E.C. filing.
Last April, the television news magazine ''60 Minutes II'' broadcast the results of an undercover investigation at several Charter Behavioral units. Secretly recorded footage showed ill-trained employees crudely restraining teenagers and filling in medical records for patients who apparently had not been examined.
Several company hospitals were already under government scrutiny. After the broadcast, federal officials announced a broad investigation of Charter Behavioral for Medicaid fraud and patient abuse. Magellan Health is also part of the inquiry.
That investigation involves activities both before and after the 1997 deal and is not focused on its financial aspects. (There is also a Federal investigation into billing fraud at the Columbia/HCA Corporation, a hospital chain that Mr. Rainwater helped found. Mr. Rainwater has not been accused of any wrongdoing.)
Vowing to improve patient care, Charter Behavioral hired outside consultants. Regulators shut some units and the company closed others.
By last August, Charter Behavioral could no longer make lease payments. The next month, Magellan Health transferred most of its remaining stake in Charter to Crescent Operating. Magellan and Charter agreed to indemnify each other in the face of the investigations. In December, Charter said it would reorganize and sell some 50 units.
Magellan Health officials said yesterday that the troubled chain could announce a bankruptcy filing as early as today. Michael French, Charter Behavioral's chief executive, and associates of Mr. Rainwater said they believed that following a reorganization, Charter Behavioral would be stronger.
On a recent day at the New Hampshire facility, a sign on the door instructed employees to turn in their keys during exit interviews. The keys would not work anyway. The locks had been changed. The last patient had been transferred.
''It all fell apart so fast,'' said Dr. Hafez, the former medical director. ''It was like the Kremlin. Everyone knew it was falling apart. But when it fell apart, it fell apart so quickly because there was no foundation.''
Published: February 16, 2000
The nation's largest chain of psychiatric hospitals lies in tatters. More than half of the roughly 90 hospitals and treatment centers operated by Charter Behavioral Health Systems will soon be closed and the company is expected to announce as early as today that it is seeking bankruptcy protection.
Three years ago, officials of a real estate investment trust headed by Richard E. Rainwater, the financier based in Fort Worth, announced a $400 million investment that they said would breathe new life into Charter. But rather than revitalizing the chain, the deal contributed to its collapse, according to many former Charter officials, undermining patient care in the process.
The company says that Charter's woes were caused by insurance cutbacks, not by the 1997 plan, and that patient care was not affected. The 1997 plan, though, saddled Charter Behavioral, a unit of Magellan Health Services Inc., with some $125 million in franchise fees and rapidly escalating rents. The chain's former chief executive said he warned that the costs would cause financial chaos. Those pressures, coupled with industrywide insurance cutbacks, were soon felt in psychiatric wards, former company officials said.
Hospital directors and workers, overworked and faced with repeated salary freezes, quit. Wards had too few employees, federal and state reports show. Training programs were eliminated, former company officials said. Broken chairs and walls were not repaired. ''It felt like they were strip-mining this place,'' said Dr. Hashim Hafez, the medical director at a Charter unit in Nashua, N.H., until he quit last year.
Charter Behavioral, which once had units in 27 states caring for more than 8,000 patients, many of them children, had long had a troubled past. But after 1997, patient care failed even at well-run hospitals, according to regulators and former company executives.
''Charter was never a great company,'' said Cindy Musikantow, who once ran a treatment center for adolescents that the company managed in Naperville, Ill. ''But it disintegrated to the degree that decisions were being made without regard for patients.''
The deal was a complex one that was intended to benefit both Mr. Rainwater's real estate trust, the Crescent Real Estate Equities Company, and Magellan Health. Under the plan, the trust received income from lease payments and Magellan received franchise fees.
In addition, Mr. Rainwater, as the largest shareholder in Magellan Health at the time, stood to profit because the sale of the ailing chain raised Magellan's stock price.
Magellan Health's top executive also got a large bonus, according to filings with the Securities and Exchange Commission. Additionally, the plan enabled Magellan, the nation's largest behavioral health company, to leave the hospital business for managed health care, a more lucrative field.
The deal split ownership of Charter Behavioral between Magellan Health and an affiliate of Crescent Real Estate. The psychiatric chain's buildings were sold to Crescent Real Estate, which leased them back at a healthy profit.
Both Mr. Rainwater -- a former business associate of Gov. George W. Bush Jr. of Texas -- and Mac Crawford, the chief executive of Magellan Health at the time of the deal, declined to be interviewed. In written responses, their spokesmen said that Charter Behavioral's financial woes were caused by insurance cutbacks, not by the 1997 plan. They said patient care was not affected.
''Sure, we had falling resources,'' said Dr. Gary M. Henschen, the chief medical officer of Charter Behavioral, which is based in Alpharetta, Ga. ''But we have done the best we can.''
In late 1995, Mr. Rainwater and his wife, Darla Moore, paid $69.7 million for a 12.3 percent stake in Magellan Health. The following year, he approached Mr. Crawford about a deal for Magellan to sell Charter Behavioral's buildings to Crescent. Companies that operate nursing homes had engaged in similar ''sale lease-backs'' to raise cash.
In the 1997 deal, Crescent Real Estate paid $400 million to acquire a half-stake in Charter Behavioral and buy its buildings. Because federal tax laws bar real estate investment trusts, or REIT's, from operating companies, Mr. Rainwater and his associates formed a publicly traded company, Crescent Operating Inc., to hold the half-stake.
Under the deal, Charter Behavioral was required to pay Crescent Real Estate $41.5 million in rent, a return of about 11 percent. Gerald Haddock, a Crescent executive, described the lease returns as ''exceptional.'' The rent, which took precedence over franchise fees to Magellan Health, escalated 5 percent annually.
Magellan Health, which is based in Columbia, Md., retained a 50 percent stake in Charter Behavioral, which was to pay it $78 million annually in franchise fees. Magellan, which used cash from the sale to finance managed care acquisitions, said that those payments could decline if industrywide insurance cuts continued.
At the time, most analysts applauded the plan. But John Lutzius, an analyst with Green Street Advisors in Newport Beach, Calif., said shortly after that the new payments left Charter Behavioral with little cash to weather any problems.
''Between the franchise fees and the rent, Magellan and Crescent were effectively sweeping all the cash flow from Charter,'' Mr. Lutzius said recently.
Mr. Rainwater's bet on the psychiatric industry proved to be wrong. In 1997, some within Charter Behavioral had sounded warnings about the deal's consequences for the company.
In separate interviews, two former top Charter officials said John M. DeStefanis, Charter's top executive, told Mr. Crawford of Magellan Health that the franchise fee and rent payments would financially devastate the psychiatric hospitals. Not long after the deal closed, Mr. DeStefanis resigned, those former officials said.
''John went nose to nose with them and that's why he was forced out of the company,'' said one former executive who spoke on the condition of anonymity.
Asked about that account, Mr. DeStefanis confirmed it but declined further comment, citing a confidentiality agreement. In his statement, Mr. Crawford disputed this version of events, saying that Mr. DeStefanis supported the deal. Mr. DeStefanis's departure was unrelated to the deal, he said.
Magellan officials declined to comment on discussions with Mr. DeStefanis. ''In the course of negotiating any transaction, differing viewpoints are always expressed, and, in a good organization, are even encouraged,'' the company said in a statement.
Magellan Health executives said the deal would benefit Charter Behavioral; Magellan's top official also profited. Mr. Crawford, whose salary in fiscal 1996 was $712,500, received a $2.48 million bonus for closing the deal, according to Magellan Health's 1997 proxy statement.
In his statement, Mr. Crawford described his cash payment as a ''retention bonus.'' One company director, A. D. Frazier Jr., said that he supported the payment to Mr. Crawford because the 1997 deal moved Magellan toward managed care and away from hospitals.
A month after the deal closed in June 1997, the federal government further cut hospital reimbursements. That December, Magellan told shareholders in its annual report the move would cut the $78 million due in franchise fees from Charter Behavioral in fiscal 1998 by a range of $10 million to $15 million.
Mr. DeStefanis's projections, however, proved far more accurate. Charter Behavioral managed to pay only $32 million in fees that fiscal year. In January 1998, seven months after the deal and 45 days after Magellan issued its annual report, the chain made its last franchise payment.
Charter Behavioral had had a troubled record of patient care, including settlements of government charges involving fraudulent billing. Regulators said, however, that some units provided good care.
In early 1997, for example, Dr. Ronald Davidson, a hospital consultant for the State of Illinois, declared he would not hesitate to use a company center in Brown Deer, Wis., for his own child. But by early 1998, conditions there and at other well-run units worsened as the weakening chain imposed repeated salary freezes, staff cutbacks and other cost-cutting measures, said former executives, including Ms. Musikantow, the former head of the Chicago-area unit.
At Charter's flagship hospital in Nashua, N.H., resources shrank and staff levels fell, said Dr. Philip Santora, a former associate medical director at the unit. When experienced nurses and therapists quit, they were replaced by fresh graduates, he said.
In 1998 and 1999 reports, federal and New Hampshire regulators found unsupervised children engaging in sex or hurting themselves at the Nashua unit. Wards persistently had too few employees. Suicide attempts were not recorded, and children were improperly restrained.
Dr. Santora, who quit in August, said that while insurance cutbacks played a role, the 1997 deal resulted in a pattern of neglect.
''You can chip away and chip away and sooner or later you reach a critical mass and a point of no return,'' he said.
As its hospitals veered out of control, Charter Behavioral's governing board -- which was comprised of two executives from Magellan Health and two associates of Mr. Rainwater -- had little response.
Dr. Clarissa Marques, Magellan Health's chief clinical officer, joined the board in August 1998 and found it had never received or asked for patient care reports. She said that in 1998 it did not meet until late October.
John C. Goff, one of Mr. Rainwater's closest associates, who headed the board then, declined to comment.
In mid-1998, Mr. Crawford left Magellan Health to become chief executive of Caremark Rx of Birmingham, Ala. About that time, in an S.E.C. filing, Crescent Operating -- which along with Magellan had lent some money to Charter -- acknowledged that Charter's operating losses were growing because of insurance cutbacks and the rents and fees the 1997 deal required.
In November 1998, Mr. Goff resigned from Charter Behavioral's board. A month later, the chain's accountants questioned its ability to continue, according to an S.E.C. filing.
Last April, the television news magazine ''60 Minutes II'' broadcast the results of an undercover investigation at several Charter Behavioral units. Secretly recorded footage showed ill-trained employees crudely restraining teenagers and filling in medical records for patients who apparently had not been examined.
Several company hospitals were already under government scrutiny. After the broadcast, federal officials announced a broad investigation of Charter Behavioral for Medicaid fraud and patient abuse. Magellan Health is also part of the inquiry.
That investigation involves activities both before and after the 1997 deal and is not focused on its financial aspects. (There is also a Federal investigation into billing fraud at the Columbia/HCA Corporation, a hospital chain that Mr. Rainwater helped found. Mr. Rainwater has not been accused of any wrongdoing.)
Vowing to improve patient care, Charter Behavioral hired outside consultants. Regulators shut some units and the company closed others.
By last August, Charter Behavioral could no longer make lease payments. The next month, Magellan Health transferred most of its remaining stake in Charter to Crescent Operating. Magellan and Charter agreed to indemnify each other in the face of the investigations. In December, Charter said it would reorganize and sell some 50 units.
Magellan Health officials said yesterday that the troubled chain could announce a bankruptcy filing as early as today. Michael French, Charter Behavioral's chief executive, and associates of Mr. Rainwater said they believed that following a reorganization, Charter Behavioral would be stronger.
On a recent day at the New Hampshire facility, a sign on the door instructed employees to turn in their keys during exit interviews. The keys would not work anyway. The locks had been changed. The last patient had been transferred.
''It all fell apart so fast,'' said Dr. Hafez, the former medical director. ''It was like the Kremlin. Everyone knew it was falling apart. But when it fell apart, it fell apart so quickly because there was no foundation.''
nation's biggest operator of psychiatric hospitals and treatment centers ...and you thought he was all about OIL!
Charter Behavioral Health Systems, the nation's biggest operator of psychiatric hospitals and treatment centers which has gone into a financial free fall, filed for Chapter 11 bankruptcy protection from creditors yesterday.
Charter, which is 90 percent owned by Crescent Operating Inc., a company led by Richard E. Rainwater, the financier from Fort Worth, said it made the filing to ''ensure continued services to patients'' in its units.
Charter listed less than $50 million in assets and more than $100 million in debts in filings yesterday at the United States Bankruptcy Court in Wilmington, Del.
The Crescent Real Estate Equities Company, a real estate investment trust also led by Mr. Rainwater, already owns the buildings used by Charter's hospitals and treatment centers.
Three years ago, Charter ran roughly 90 psychiatric hospitals and treatment centers for more than 8,000 patients, many of them children. Operations have now dwindled to 37 units with a capacity of 2,000 patients.
Since last year, the Justice Department and the Department of Health and Human Services have been investigating Charter and Magellan Health Services Inc., which once owned the chain, for Medicaid billing fraud and patient abuse.
In 1997, Magellan Health entered into a complex $400 million deal in which it sold Charter's buildings to Crescent Real Estate and a 50 percent stake in the chain to Crescent Operating, an affiliate of Crescent Real Estate. Because real estate investment trusts cannot operate companies, Crescent Operating was formed by Mr. Rainwater and his associates to hold the Charter stake.
The 1997 deal came as the industry faced cutbacks by insurers on treatment payments. Many former officials of the chain have said that the plan -- which saddled Charter with some $125 million annually in new franchise fees and rapidly escalating rents -- contributed to Charter's financial collapse, undermining patient care in the process.
Officials of Magellan Health, Crescent Operating and Charter Behavioral have said that the chain's problems were caused by the insurance cutbacks, and that the 1997 plan did not affect patient care.
Last year, Magellan Health, the nation's largest behavioral health care company, transferred all but 10 percent of Charter to Crescent Operating.
Yesterday's filing comes a month after Charter said it would close and sell about 35 hospitals and centers. Former employees at some units have filed lawsuits contending that Charter violated federal law by failing to give them sufficient notice of the unit's closings and paying them severance benefits.
Mary E. Olson, a lawyer in Mobile, Ala., representing former Charter employees in three of those actions, estimated that about 5,000 former workers at the chain had been affected by the recent closings.
Karen Keiser-Jenkins, a spokeswoman for Charter, which is based in Alpharetta, Ga., declined to comment on the lawsuits. But in a news release, Charter said it was ''unable to fully fund all benefits'' to staff members dismissed before yesterday's filing.
In a release, Crescent Operating said that Mr. Rainwater would guarantee a bank loan that Crescent Operating plans to use to buy the reorganized company. Mr. Rainwater would be compensated for that guarantee, the company said. He is the largest shareholder in both companies and was the biggest stakeholder in Magellan Health at the time of the 1997 deal.
Last Friday, Jeffrey L. Stevens, an official of Crescent Operating and an associate of Mr. Rainwater, told Charter executives that the chain had $60 million in debts, according to a former Charter official who was informed about that meeting.
Ms. Keiser-Jenkins said that she was not aware of the meeting. Mr. Stevens did not return calls in recent days seeking comment.
Under a proposed plan, Crescent Real Estate would initially lease the 30 Charter facilities it owns to Crescent Operating for $20.3 million, a 13.3 percent annual return, the company said. That rate would rise by 5 percent annually.
Crescent Real Estate would also receive the proceeds of any sales of buildings once used by Charter.
Charter, which is 90 percent owned by Crescent Operating Inc., a company led by Richard E. Rainwater, the financier from Fort Worth, said it made the filing to ''ensure continued services to patients'' in its units.
Charter listed less than $50 million in assets and more than $100 million in debts in filings yesterday at the United States Bankruptcy Court in Wilmington, Del.
The Crescent Real Estate Equities Company, a real estate investment trust also led by Mr. Rainwater, already owns the buildings used by Charter's hospitals and treatment centers.
Three years ago, Charter ran roughly 90 psychiatric hospitals and treatment centers for more than 8,000 patients, many of them children. Operations have now dwindled to 37 units with a capacity of 2,000 patients.
Since last year, the Justice Department and the Department of Health and Human Services have been investigating Charter and Magellan Health Services Inc., which once owned the chain, for Medicaid billing fraud and patient abuse.
In 1997, Magellan Health entered into a complex $400 million deal in which it sold Charter's buildings to Crescent Real Estate and a 50 percent stake in the chain to Crescent Operating, an affiliate of Crescent Real Estate. Because real estate investment trusts cannot operate companies, Crescent Operating was formed by Mr. Rainwater and his associates to hold the Charter stake.
The 1997 deal came as the industry faced cutbacks by insurers on treatment payments. Many former officials of the chain have said that the plan -- which saddled Charter with some $125 million annually in new franchise fees and rapidly escalating rents -- contributed to Charter's financial collapse, undermining patient care in the process.
Officials of Magellan Health, Crescent Operating and Charter Behavioral have said that the chain's problems were caused by the insurance cutbacks, and that the 1997 plan did not affect patient care.
Last year, Magellan Health, the nation's largest behavioral health care company, transferred all but 10 percent of Charter to Crescent Operating.
Yesterday's filing comes a month after Charter said it would close and sell about 35 hospitals and centers. Former employees at some units have filed lawsuits contending that Charter violated federal law by failing to give them sufficient notice of the unit's closings and paying them severance benefits.
Mary E. Olson, a lawyer in Mobile, Ala., representing former Charter employees in three of those actions, estimated that about 5,000 former workers at the chain had been affected by the recent closings.
Karen Keiser-Jenkins, a spokeswoman for Charter, which is based in Alpharetta, Ga., declined to comment on the lawsuits. But in a news release, Charter said it was ''unable to fully fund all benefits'' to staff members dismissed before yesterday's filing.
In a release, Crescent Operating said that Mr. Rainwater would guarantee a bank loan that Crescent Operating plans to use to buy the reorganized company. Mr. Rainwater would be compensated for that guarantee, the company said. He is the largest shareholder in both companies and was the biggest stakeholder in Magellan Health at the time of the 1997 deal.
Last Friday, Jeffrey L. Stevens, an official of Crescent Operating and an associate of Mr. Rainwater, told Charter executives that the chain had $60 million in debts, according to a former Charter official who was informed about that meeting.
Ms. Keiser-Jenkins said that she was not aware of the meeting. Mr. Stevens did not return calls in recent days seeking comment.
Under a proposed plan, Crescent Real Estate would initially lease the 30 Charter facilities it owns to Crescent Operating for $20.3 million, a 13.3 percent annual return, the company said. That rate would rise by 5 percent annually.
Crescent Real Estate would also receive the proceeds of any sales of buildings once used by Charter.
Charter Behavioral Health Systems, the largest operator of privately run psychiatric hospitals and clinics, said yesterday that it planned to sell 53 of the 96 centers it operates.
Charter Behavioral, which is a unit of the Crescent Real Estate Equities Company, a Fort Worth-based company headed by the billionaire investor Richard E. Rainwater, had said that it was losing money at many of its psychiatric hospitals.
But federal officials are continuing to investigate the hospital chain for patient abuse and Medicaid fraud. Company officials, who have announced the closing of several Charter Behavioral hospitals in recent months, have said that those closings are unrelated to the federal inquiry.
Yesterday's announcement was a setback for Mr. Rainwater, who invested $400 million in 1997 to purchase a 50 percent stake in Charter Behavioral from Magellan Health Services Inc. That deal was structured to provide $50 million annually in rental income from the psychiatric hospitals to Crescent Real Estate, a real estate investment trust.
As part of that deal, the psychiatric hospital company was also supposed to pay some $80 million annually in franchise fees to Magellan, a health care company of which Mr. Rainwater is the largest single shareholder.
The psychiatric chain soon fell behind on its franchise fee payments and Magellan Health exercised an option in 1997 to cut the hospital chain's operating budget.
Ad for Crescent Real Estate, it said yesterday that its third-quarter earnings fell 38 percent, to $57.2 million, or 43 cents a share, from $91.7 million, or 62 cents a share, in the period a year earlier. The results reflect a $30.8 million charge to reflect the canceling of booked rent from the Charter hospitals.
Shares of Crescent Real Estate Equities rose 43.75 cents, to $16.875. Because of federal tax laws governing real estate investment trusts, Crescent Real Estate could not operate the Charter facilities without jeopardizing its favorable tax status. As a result, Mr. Rainwater and his associates created a separate public company, Crescent Operating Inc. whose shares fell 6.25 cents yesterday, to $3.9375.
Charter Behavioral, which is a unit of the Crescent Real Estate Equities Company, a Fort Worth-based company headed by the billionaire investor Richard E. Rainwater, had said that it was losing money at many of its psychiatric hospitals.
But federal officials are continuing to investigate the hospital chain for patient abuse and Medicaid fraud. Company officials, who have announced the closing of several Charter Behavioral hospitals in recent months, have said that those closings are unrelated to the federal inquiry.
Yesterday's announcement was a setback for Mr. Rainwater, who invested $400 million in 1997 to purchase a 50 percent stake in Charter Behavioral from Magellan Health Services Inc. That deal was structured to provide $50 million annually in rental income from the psychiatric hospitals to Crescent Real Estate, a real estate investment trust.
As part of that deal, the psychiatric hospital company was also supposed to pay some $80 million annually in franchise fees to Magellan, a health care company of which Mr. Rainwater is the largest single shareholder.
The psychiatric chain soon fell behind on its franchise fee payments and Magellan Health exercised an option in 1997 to cut the hospital chain's operating budget.
Ad for Crescent Real Estate, it said yesterday that its third-quarter earnings fell 38 percent, to $57.2 million, or 43 cents a share, from $91.7 million, or 62 cents a share, in the period a year earlier. The results reflect a $30.8 million charge to reflect the canceling of booked rent from the Charter hospitals.
Shares of Crescent Real Estate Equities rose 43.75 cents, to $16.875. Because of federal tax laws governing real estate investment trusts, Crescent Real Estate could not operate the Charter facilities without jeopardizing its favorable tax status. As a result, Mr. Rainwater and his associates created a separate public company, Crescent Operating Inc. whose shares fell 6.25 cents yesterday, to $3.9375.
A Chapter 11 Filing by Charter Behavioral
Charter Behavioral
Make sure you look at the year 1997......remember when his wife, Darla Moore fired Richard Scott. You know the same Richard Scott involved with Columbia and Columbia/HCA and God only knows who or what else!
By BARRY MEIER
Published: February 17, 2000
Charter Behavioral Health Systems, the nation's biggest operator of psychiatric hospitals and treatment centers which has gone into a financial free fall, filed for Chapter 11 bankruptcy protection from creditors yesterday.
Charter, which is 90 percent owned by Crescent Operating Inc., a company led by Richard E. Rainwater, the financier from Fort Worth, said it made the filing to ''ensure continued services to patients'' in its units.
Charter listed less than $50 million in assets and more than $100 million in debts in filings yesterday at the United States Bankruptcy Court in Wilmington, Del.
The Crescent Real Estate Equities Company, a real estate investment trust also led by Mr. Rainwater, already owns the buildings used by Charter's hospitals and treatment centers.
Three years ago, Charter ran roughly 90 psychiatric hospitals and treatment centers for more than 8,000 patients, many of them children. Operations have now dwindled to 37 units with a capacity of 2,000 patients.
Since last year, the Justice Department and the Department of Health and Human Services have been investigating Charter and Magellan Health Services Inc., which once owned the chain, for Medicaid billing fraud and patient abuse.
In 1997, Magellan Health entered into a complex $400 million deal in which it sold Charter's buildings to Crescent Real Estate and a 50 percent stake in the chain to Crescent Operating, an affiliate of Crescent Real Estate. Because real estate investment trusts cannot operate companies, Crescent Operating was formed by Mr. Rainwater and his associates to hold the Charter stake.
The 1997 deal came as the industry faced cutbacks by insurers on treatment payments. Many former officials of the chain have said that the plan -- which saddled Charter with some $125 million annually in new franchise fees and rapidly escalating rents -- contributed to Charter's financial collapse, undermining patient care in the process.
Officials of Magellan Health, Crescent Operating and Charter Behavioral have said that the chain's problems were caused by the insurance cutbacks, and that the 1997 plan did not affect patient care.
Last year, Magellan Health, the nation's largest behavioral health care company, transferred all but 10 percent of Charter to Crescent Operating.
Yesterday's filing comes a month after Charter said it would close and sell about 35 hospitals and centers. Former employees at some units have filed lawsuits contending that Charter violated federal law by failing to give them sufficient notice of the unit's closings and paying them severance benefits.
Mary E. Olson, a lawyer in Mobile, Ala., representing former Charter employees in three of those actions, estimated that about 5,000 former workers at the chain had been affected by the recent closings.
Karen Keiser-Jenkins, a spokeswoman for Charter, which is based in Alpharetta, Ga., declined to comment on the lawsuits. But in a news release, Charter said it was ''unable to fully fund all benefits'' to staff members dismissed before yesterday's filing.
In a release, Crescent Operating said that Mr. Rainwater would guarantee a bank loan that Crescent Operating plans to use to buy the reorganized company. Mr. Rainwater would be compensated for that guarantee, the company said. He is the largest shareholder in both companies and was the biggest stakeholder in Magellan Health at the time of the 1997 deal.
Last Friday, Jeffrey L. Stevens, an official of Crescent Operating and an associate of Mr. Rainwater, told Charter executives that the chain had $60 million in debts, according to a former Charter official who was informed about that meeting.
Ms. Keiser-Jenkins said that she was not aware of the meeting. Mr. Stevens did not return calls in recent days seeking comment.
Under a proposed plan, Crescent Real Estate would initially lease the 30 Charter facilities it owns to Crescent Operating for $20.3 million, a 13.3 percent annual return, the company said. That rate would rise by 5 percent annually.
Crescent Real Estate would also receive the proceeds of any sales of buildings once used by Charter.
Make sure you look at the year 1997......remember when his wife, Darla Moore fired Richard Scott. You know the same Richard Scott involved with Columbia and Columbia/HCA and God only knows who or what else!
By BARRY MEIER
Published: February 17, 2000
Charter Behavioral Health Systems, the nation's biggest operator of psychiatric hospitals and treatment centers which has gone into a financial free fall, filed for Chapter 11 bankruptcy protection from creditors yesterday.
Charter, which is 90 percent owned by Crescent Operating Inc., a company led by Richard E. Rainwater, the financier from Fort Worth, said it made the filing to ''ensure continued services to patients'' in its units.
Charter listed less than $50 million in assets and more than $100 million in debts in filings yesterday at the United States Bankruptcy Court in Wilmington, Del.
The Crescent Real Estate Equities Company, a real estate investment trust also led by Mr. Rainwater, already owns the buildings used by Charter's hospitals and treatment centers.
Three years ago, Charter ran roughly 90 psychiatric hospitals and treatment centers for more than 8,000 patients, many of them children. Operations have now dwindled to 37 units with a capacity of 2,000 patients.
Since last year, the Justice Department and the Department of Health and Human Services have been investigating Charter and Magellan Health Services Inc., which once owned the chain, for Medicaid billing fraud and patient abuse.
In 1997, Magellan Health entered into a complex $400 million deal in which it sold Charter's buildings to Crescent Real Estate and a 50 percent stake in the chain to Crescent Operating, an affiliate of Crescent Real Estate. Because real estate investment trusts cannot operate companies, Crescent Operating was formed by Mr. Rainwater and his associates to hold the Charter stake.
The 1997 deal came as the industry faced cutbacks by insurers on treatment payments. Many former officials of the chain have said that the plan -- which saddled Charter with some $125 million annually in new franchise fees and rapidly escalating rents -- contributed to Charter's financial collapse, undermining patient care in the process.
Officials of Magellan Health, Crescent Operating and Charter Behavioral have said that the chain's problems were caused by the insurance cutbacks, and that the 1997 plan did not affect patient care.
Last year, Magellan Health, the nation's largest behavioral health care company, transferred all but 10 percent of Charter to Crescent Operating.
Yesterday's filing comes a month after Charter said it would close and sell about 35 hospitals and centers. Former employees at some units have filed lawsuits contending that Charter violated federal law by failing to give them sufficient notice of the unit's closings and paying them severance benefits.
Mary E. Olson, a lawyer in Mobile, Ala., representing former Charter employees in three of those actions, estimated that about 5,000 former workers at the chain had been affected by the recent closings.
Karen Keiser-Jenkins, a spokeswoman for Charter, which is based in Alpharetta, Ga., declined to comment on the lawsuits. But in a news release, Charter said it was ''unable to fully fund all benefits'' to staff members dismissed before yesterday's filing.
In a release, Crescent Operating said that Mr. Rainwater would guarantee a bank loan that Crescent Operating plans to use to buy the reorganized company. Mr. Rainwater would be compensated for that guarantee, the company said. He is the largest shareholder in both companies and was the biggest stakeholder in Magellan Health at the time of the 1997 deal.
Last Friday, Jeffrey L. Stevens, an official of Crescent Operating and an associate of Mr. Rainwater, told Charter executives that the chain had $60 million in debts, according to a former Charter official who was informed about that meeting.
Ms. Keiser-Jenkins said that she was not aware of the meeting. Mr. Stevens did not return calls in recent days seeking comment.
Under a proposed plan, Crescent Real Estate would initially lease the 30 Charter facilities it owns to Crescent Operating for $20.3 million, a 13.3 percent annual return, the company said. That rate would rise by 5 percent annually.
Crescent Real Estate would also receive the proceeds of any sales of buildings once used by Charter.
Whistleblowers and Health care
Posted by David Kassel on November 25, 2007
Cynthia Fitzgerald filed one of the largest whistleblower lawsuits on record—a suit, which names companies such as Johnson & Johnson, Becton Dickinson, and Merck as participants in massive health care overcharges, The New York Times reports.
The suit was filed under the False Claims Act, which allows private citizens to sue on behalf of the federal government, if they believe fraud has occurred, and share in the financial recovery.
Like many whistleblowers, Fitzgerald lost her job after she complained to company higher-ups about sales practices she came to believe were draining millions of dollars out of public programs such as Medicare through overcharges and other unauthorized uses. Her subsequent suit alleges systematic fraud across a network of companies and more than 7,000 health care institutions.
Fitzgerald worked for a company called Novation, which helps hospitals, rehabilitation centers, home health agencies and doctors’ offices negotiate prices for medical supplies. Novation is the nation’s largest group purchasing organizations for hospitals, buying more than $25 billion in supplies and services each year.
Fitzgerald’s case points up the need for new legislation, including the Private Sector Whistleblower Protection Streamlining Act of 2007 (H.R. 4047), and a second bill that would close loopholes under the False Claims Act (S. 2041).
It’s one of many pieces of whistleblower-protection legislation that appear to be going nowhere in Congress, according to the National Whistleblower Legal Defense & Education Fund. One of these, which I’ve mentioned here before, is the Whistleblower Protection Enforcement Act of 2007 (H.R. 985), which would enhance protections for federal whistleblowers.
A spokesperson for Novation alleges that Fitzgerald:
…is rehashing old rumors and suspicions. These allegations have been examined in depth by a variety of different authorities, and no one has proven any of them to be true.
In other words, calm down everybody, there’s no such thing as health care fraud.
The Times reports that in 1998, a few months into her job at Novation, Fitzgerald and her boss attended a meeting with a Johnson & Johnson sales team seeking an exclusive three-year contract to sell $130 million worth of IV equipment to Novation’s clients. The bids for the contract had already been received, and Fitzgerald contends it was her understanding that she was not supposed to meet individually with any of the vying bidders. During the meeting, the Johnson & Johnson team allegedly sought inside information on how they could get the contract.
Fitzgerald says she brought the meeting to a halt and later notified her company’s legal department and the company president about the situation and got little satisfaction. The same dynamic happened with other companies. After she asked her supervisor to be taken off a contract in which a bidder had said he would “take care of her,” she was fired for nonperformance of duties.
When companies submitted bids to Novation, there were frequently offers thrown in for things such as shares of stock and sometimes even cash, Fitzgerald alleges. These “rewards” and rebates would get passed through to hospitals, which would then pass through the charges to Medicare, she contends.
The fact is that the existence of health care fraud is not a rumor or suspicion, but is an established fact. Fraud is a parasitic drain our health care system, and a recent survey by PricewaterhouseCoopers shows that whistleblowers are one of the most effective means of exposing it.
The cost and availability of health care has become a significant issue in the presidential campaign, and yet health care fraud and the protection of whistleblowers, in particular, don’t seem to be on the radar screen. Why?
This entry was posted on November 25, 2007 at 8:08 pm and is filed under Oversight, Private, Public. Tagged: Cynthia Fitzgerald, False Claims Act, fraud, health care, whistleblower. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Cynthia Fitzgerald filed one of the largest whistleblower lawsuits on record—a suit, which names companies such as Johnson & Johnson, Becton Dickinson, and Merck as participants in massive health care overcharges, The New York Times reports.
The suit was filed under the False Claims Act, which allows private citizens to sue on behalf of the federal government, if they believe fraud has occurred, and share in the financial recovery.
Like many whistleblowers, Fitzgerald lost her job after she complained to company higher-ups about sales practices she came to believe were draining millions of dollars out of public programs such as Medicare through overcharges and other unauthorized uses. Her subsequent suit alleges systematic fraud across a network of companies and more than 7,000 health care institutions.
Fitzgerald worked for a company called Novation, which helps hospitals, rehabilitation centers, home health agencies and doctors’ offices negotiate prices for medical supplies. Novation is the nation’s largest group purchasing organizations for hospitals, buying more than $25 billion in supplies and services each year.
Fitzgerald’s case points up the need for new legislation, including the Private Sector Whistleblower Protection Streamlining Act of 2007 (H.R. 4047), and a second bill that would close loopholes under the False Claims Act (S. 2041).
It’s one of many pieces of whistleblower-protection legislation that appear to be going nowhere in Congress, according to the National Whistleblower Legal Defense & Education Fund. One of these, which I’ve mentioned here before, is the Whistleblower Protection Enforcement Act of 2007 (H.R. 985), which would enhance protections for federal whistleblowers.
A spokesperson for Novation alleges that Fitzgerald:
…is rehashing old rumors and suspicions. These allegations have been examined in depth by a variety of different authorities, and no one has proven any of them to be true.
In other words, calm down everybody, there’s no such thing as health care fraud.
The Times reports that in 1998, a few months into her job at Novation, Fitzgerald and her boss attended a meeting with a Johnson & Johnson sales team seeking an exclusive three-year contract to sell $130 million worth of IV equipment to Novation’s clients. The bids for the contract had already been received, and Fitzgerald contends it was her understanding that she was not supposed to meet individually with any of the vying bidders. During the meeting, the Johnson & Johnson team allegedly sought inside information on how they could get the contract.
Fitzgerald says she brought the meeting to a halt and later notified her company’s legal department and the company president about the situation and got little satisfaction. The same dynamic happened with other companies. After she asked her supervisor to be taken off a contract in which a bidder had said he would “take care of her,” she was fired for nonperformance of duties.
When companies submitted bids to Novation, there were frequently offers thrown in for things such as shares of stock and sometimes even cash, Fitzgerald alleges. These “rewards” and rebates would get passed through to hospitals, which would then pass through the charges to Medicare, she contends.
The fact is that the existence of health care fraud is not a rumor or suspicion, but is an established fact. Fraud is a parasitic drain our health care system, and a recent survey by PricewaterhouseCoopers shows that whistleblowers are one of the most effective means of exposing it.
The cost and availability of health care has become a significant issue in the presidential campaign, and yet health care fraud and the protection of whistleblowers, in particular, don’t seem to be on the radar screen. Why?
This entry was posted on November 25, 2007 at 8:08 pm and is filed under Oversight, Private, Public. Tagged: Cynthia Fitzgerald, False Claims Act, fraud, health care, whistleblower. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Sunday, November 25, 2007
Deferred and non-prosecution agreements are fast becoming the accepted means for corporations to settle a range of criminal investigations....
November 24, 2007
Deferred Prosecutions Article
FROM: White Collar Crime Prof Blog
A Member of the Law Professor Blogs Network
Deferred and non-prosecution agreements are fast becoming the accepted means for corporations to settle a range of criminal investigations, from FCPA violations to healthcare fraud to accounting problems. What little law there is in the area has developed haphazardly, and there has not been much attention paid to these agreements in academia. Stetson law professors Candace Zierdt and Ellen Podgor, co-editor of this blog, have contributed to the discussion with their new article, Corporate Deferred Prosecutions Through the Looking Glass of Contract Policing. From the abstract:
This article examines deferred and non-prosecution agreements entered into between corporations and the Department of Justice (DOJ) through the lens of contract policing theory. It adds a new dimension to the contractual law now applicable to plea bargains and proffer agreements by suggesting key provisions that should be prohibited in deferred prosecution agreements. Three provisions common to many deferred prosecution agreements, or used by the government as leverage to secure a deferred prosecution agreement, are of particular interest here. These are: (1) the requirement of a corporation to waive its attorney-client privilege; (2) the determination of a breach of the agreement being within the sole province of the government; and (3) the provision that corporations not abide by previously negotiated contract terms that allow the corporation to pay the attorney fees of corporate employees. Specifically, this article examines the viability of specific provisions within these agreements when matched up against contract policing principles such as duress and unconscionability. This article concludes that corporations are deprived of basic contract rights as a result of the over-powering prosecutorial power used in reaching these agreements.
The article is available to download on SSRN (here). (ph)
Deferred Prosecutions Article
FROM: White Collar Crime Prof Blog
A Member of the Law Professor Blogs Network
Deferred and non-prosecution agreements are fast becoming the accepted means for corporations to settle a range of criminal investigations, from FCPA violations to healthcare fraud to accounting problems. What little law there is in the area has developed haphazardly, and there has not been much attention paid to these agreements in academia. Stetson law professors Candace Zierdt and Ellen Podgor, co-editor of this blog, have contributed to the discussion with their new article, Corporate Deferred Prosecutions Through the Looking Glass of Contract Policing. From the abstract:
This article examines deferred and non-prosecution agreements entered into between corporations and the Department of Justice (DOJ) through the lens of contract policing theory. It adds a new dimension to the contractual law now applicable to plea bargains and proffer agreements by suggesting key provisions that should be prohibited in deferred prosecution agreements. Three provisions common to many deferred prosecution agreements, or used by the government as leverage to secure a deferred prosecution agreement, are of particular interest here. These are: (1) the requirement of a corporation to waive its attorney-client privilege; (2) the determination of a breach of the agreement being within the sole province of the government; and (3) the provision that corporations not abide by previously negotiated contract terms that allow the corporation to pay the attorney fees of corporate employees. Specifically, this article examines the viability of specific provisions within these agreements when matched up against contract policing principles such as duress and unconscionability. This article concludes that corporations are deprived of basic contract rights as a result of the over-powering prosecutorial power used in reaching these agreements.
The article is available to download on SSRN (here). (ph)
Tuesday, November 20, 2007
Former Florida Health Care Company Owner Sentenced for Medicare FraudPosted on Sunday, November 18, 2007
LAWFUEL - The Legal Newswire - The owner and operator of a Florida health care company has been sentenced to 66 months incarceration for Medicare fraud, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today. Marianela Smith was sentenced on Friday, Nov. 9, 2007, by U.S. District Court Judge Joan A. Lenard at the federal court in Miami. Judge Lenard also ordered Smith to pay approximately $363,000 in restitution for submitting approximately $800,000 worth of fraudulent claims to the Medicare program. Smith owned and operated Smith Medical Equipment, a Miami medical equipment company, from approximately 2000-2003. She was convicted on five charges following a seven-day trial in August 2007. At trial, the government established that Smith had been paying kickbacks to Medicare beneficiaries throughout Miami-Dade County to gain access to their Medicare information. After gaining access to their Medicare cards, Smith billed Medicare for unnecessary services on behalf of these patients, including oxygen concentrators and nebulizers. One of these patients testified that Smith paid him in cash and that he did not need the treatments or medication that Smith was billing to Medicare. Further, he testified that he threw away the medication that was paid for by Medicare. According to trial testimony, Smith paid $150 per month if the patients agreed to accept unneeded aerosol medications, such as Albuterol, and related respiratory equipment such as oxygen concentrators.Smith obtained the compounded aerosol medications from previously convicted pharmacy owners in Miami. From 2000 to 2003, these pharmacies billed the Medicare program for over $17 million.The case was prosecuted by Assistant Chief John Kelly and Trial Attorney Hank Bond Walther from the Fraud Section of the U.S. Department of Justice in Washington, D.C., with the investigative assistance of the U.S. Department of Health and Human Services, Office of the Inspector General; the FBI; and the Medicaid Fraud Control Unit from the State of Florida. This case was brought as part of the Medicare Fraud Strike Force initiative created in March 2007, led by the Fraud Section in Washington, D.C., and the U.S. Attorney’s Office in the Southern District of Florida. The Strike Force operates out of the federal Health Care Fraud Facility in Miramar, Florida, and has brought over 74 cases involving 120 defendants since March 1, 2007.A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at www.usdoj.gov/usao/fls . Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on .
LAWFUEL - The Legal Newswire - The owner and operator of a Florida health care company has been sentenced to 66 months incarceration for Medicare fraud, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today. Marianela Smith was sentenced on Friday, Nov. 9, 2007, by U.S. District Court Judge Joan A. Lenard at the federal court in Miami. Judge Lenard also ordered Smith to pay approximately $363,000 in restitution for submitting approximately $800,000 worth of fraudulent claims to the Medicare program. Smith owned and operated Smith Medical Equipment, a Miami medical equipment company, from approximately 2000-2003. She was convicted on five charges following a seven-day trial in August 2007. At trial, the government established that Smith had been paying kickbacks to Medicare beneficiaries throughout Miami-Dade County to gain access to their Medicare information. After gaining access to their Medicare cards, Smith billed Medicare for unnecessary services on behalf of these patients, including oxygen concentrators and nebulizers. One of these patients testified that Smith paid him in cash and that he did not need the treatments or medication that Smith was billing to Medicare. Further, he testified that he threw away the medication that was paid for by Medicare. According to trial testimony, Smith paid $150 per month if the patients agreed to accept unneeded aerosol medications, such as Albuterol, and related respiratory equipment such as oxygen concentrators.Smith obtained the compounded aerosol medications from previously convicted pharmacy owners in Miami. From 2000 to 2003, these pharmacies billed the Medicare program for over $17 million.The case was prosecuted by Assistant Chief John Kelly and Trial Attorney Hank Bond Walther from the Fraud Section of the U.S. Department of Justice in Washington, D.C., with the investigative assistance of the U.S. Department of Health and Human Services, Office of the Inspector General; the FBI; and the Medicaid Fraud Control Unit from the State of Florida. This case was brought as part of the Medicare Fraud Strike Force initiative created in March 2007, led by the Fraud Section in Washington, D.C., and the U.S. Attorney’s Office in the Southern District of Florida. The Strike Force operates out of the federal Health Care Fraud Facility in Miramar, Florida, and has brought over 74 cases involving 120 defendants since March 1, 2007.A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at www.usdoj.gov/usao/fls . Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on .
Friday, November 16, 2007
Found guilty by a jury of 40 counts of health care fraud.
Doctor’s Ambulance Service was placed on probation for 5 years
PROBATION ?
Found guilty by a jury of 40 counts of health care fraud.
East Texan Going to Prison for Health Care Fraud
Posted: Friday, 16th November 2007 3:01AM
TYLER -- An East Texas man has been sentenced in Tyler Federal Court to just over eight years in prison for health care fraud. Anura Andradi, 47, of Forney, and his ambulance company, Doctor’s Ambulance Service, were sentenced by United States District Judge Michael Schneider after previously being found guilty by a jury of 40 counts of health care fraud.
According to federal prosecutors, from March 2004 to December 2005, Andradi and Doctor's Ambulance Service defrauded Medicare and the Texas Medicaid program by certifying that dialysis patients met the Medicare and Medicaid guidelines for ambulance transports, when in fact, they did not. The jury also found that Andradi and Doctor's Ambulance Service obtained $750,000 from the fraudulent scheme and that five ambulances and over $220,000 seized from various bank accounts were derived from the proceeds fraudulently obtained by the defendants. Andradi was sentenced to 97 months in federal prison and ordered to pay restitution in the amount of $2,710,015. Doctor’s Ambulance Service was placed on probation for 5 years and ordered to pay restitution of $2,710,015.
Two other defendants, Maulie Happawana, 46, of Plano, and Ron Paytt, 39, of Grand Prairie, were also sentenced for their roles in the health care fraud scheme. Happawana and Pyatt previously pleaded guilty in federal court to conspiracy to commit health care fraud. From March 2004 to December 2005, Happawana and Pyatt defrauded Medicare and the Texas Medicaid program by certifying that dialysis patients met the Medicare and Medicaid guidelines for ambulance transports, and, in fact, they did not. Happawana was placed on probation for 5 years and ordered to pay restitution of $54,808.57. Pyatt was placed on probation for 3 years, with 180 days of home confinement, and ordered to pay restitution of $12,553.74.
PROBATION ?
Found guilty by a jury of 40 counts of health care fraud.
East Texan Going to Prison for Health Care Fraud
Posted: Friday, 16th November 2007 3:01AM
TYLER -- An East Texas man has been sentenced in Tyler Federal Court to just over eight years in prison for health care fraud. Anura Andradi, 47, of Forney, and his ambulance company, Doctor’s Ambulance Service, were sentenced by United States District Judge Michael Schneider after previously being found guilty by a jury of 40 counts of health care fraud.
According to federal prosecutors, from March 2004 to December 2005, Andradi and Doctor's Ambulance Service defrauded Medicare and the Texas Medicaid program by certifying that dialysis patients met the Medicare and Medicaid guidelines for ambulance transports, when in fact, they did not. The jury also found that Andradi and Doctor's Ambulance Service obtained $750,000 from the fraudulent scheme and that five ambulances and over $220,000 seized from various bank accounts were derived from the proceeds fraudulently obtained by the defendants. Andradi was sentenced to 97 months in federal prison and ordered to pay restitution in the amount of $2,710,015. Doctor’s Ambulance Service was placed on probation for 5 years and ordered to pay restitution of $2,710,015.
Two other defendants, Maulie Happawana, 46, of Plano, and Ron Paytt, 39, of Grand Prairie, were also sentenced for their roles in the health care fraud scheme. Happawana and Pyatt previously pleaded guilty in federal court to conspiracy to commit health care fraud. From March 2004 to December 2005, Happawana and Pyatt defrauded Medicare and the Texas Medicaid program by certifying that dialysis patients met the Medicare and Medicaid guidelines for ambulance transports, and, in fact, they did not. Happawana was placed on probation for 5 years and ordered to pay restitution of $54,808.57. Pyatt was placed on probation for 3 years, with 180 days of home confinement, and ordered to pay restitution of $12,553.74.
Thursday, November 15, 2007
Richard Rainwater..ENSCO INTERNATIONAL INC ....NAIC: 213110 Drilling Oil and Gas Wells ...
Item 12. Security Ownership of Certain Beneficial Owners and Management
Form:10-K/A Filing Date:6/29/1999
ENSCO INTERNATIONAL INC
The following table sets forth certain information concerning the number of
shares of Common Stock owned beneficially as of February 28, 1999, by (i) each
person known to the Company to own more than 5 percent of the Common Stock (the
only class of voting securities outstanding); (ii) each director of the Company
including employee directors; (iii) the three other most highly compensated
executive officers of the Company who are not also directors and (iv) all
directors and executive officers of the Company as a group.
9
Name and Address Beneficial Ownership(1)
of Beneficial Owner(2) Amount Percentage
---------------------- ------------- ----------
FMR Corp. 17,888,910(3) 13.1%
82 Devonshire
Boston, MA 02109
Richard E. Rainwater 7,374,160(4) 5.4%
777 Main Street, Suite 2100
Fort Worth, TX 76102
Carl F. Thorne 1,881,877(5) 1.4%
Chairman, President and
Chief Executive Officer
Morton H. Meyerson 433,163(6) --(7)
Director
Richard A. Wilson 197,384(8) --(7)
Director, Senior Vice President
and Chief Operating Officer
C. Christopher Gaut 238,830(9) --(7)
Vice President - Finance and
Chief Financial Officer
William S. Chadwick, Jr. 198,587(10) --(7)
Vice President - Administration
and Secretary
Dillard S. Hammett 106,101(11) --(7)
Director
Marshall Ballard 147,451(12) --(7)
Vice President - Business
Development
Orville D. Gaither, Sr. 79,259(13) --(7)
Director
Thomas L. Kelly II 68,437(14) --(7)
Director
Craig I. Fields 42,259(15) --(7)
Director
Gerald W. Haddock 19,553(16) --(7)
Director
All Directors and Executive Officers 3,660,734(17) 2.7%
as a Group (14 persons, including
those named above)
-------------------------
(1) At February 28, 1999, there were 137,047,152 shares of Common
Stock outstanding. Unless otherwise indicated, each person or
group has sole voting and dispositive power with respect to
all shares.
(2) Princeton Services, Inc., Merrill Lynch Asset Management,
L.P., Merrill Lynch & Co., Inc. and Merrill Lynch Growth Fund
advised the Company that they divested their holdings of the
shares of Common Stock reported on Amendment No. 7 to Schedule
13G dated January 8, 1999.
(3) Based upon information obtained from FMR Corp. as of February
28, 1999, FMR Corp. may be deemed to be the beneficial owner
of 17,888,910 shares of Common Stock.
(4) Based upon information supplied by Richard E. Rainwater's
attorney, Mr. Rainwater may be deemed to be the beneficial
owner of 7,374,160 shares of Common Stock. Includes 893,600
shares held by the Richard E. Rainwater Charitable Remainder
Unitrust No. 1, of which Mr. Rainwater is sole trustee, and
also includes 16,200 shares held by Mr. Rainwater's spouse, as
to all of which Mr. Rainwater disclaims beneficial ownership.
Does not include 783,054 shares held by Mr. Rainwater's adult
children, as to all of which Mr. Rainwater disclaims
beneficial ownership.
10
Form:10-K/A Filing Date:6/29/1999
ENSCO INTERNATIONAL INC
The following table sets forth certain information concerning the number of
shares of Common Stock owned beneficially as of February 28, 1999, by (i) each
person known to the Company to own more than 5 percent of the Common Stock (the
only class of voting securities outstanding); (ii) each director of the Company
including employee directors; (iii) the three other most highly compensated
executive officers of the Company who are not also directors and (iv) all
directors and executive officers of the Company as a group.
9
Name and Address Beneficial Ownership(1)
of Beneficial Owner(2) Amount Percentage
---------------------- ------------- ----------
FMR Corp. 17,888,910(3) 13.1%
82 Devonshire
Boston, MA 02109
Richard E. Rainwater 7,374,160(4) 5.4%
777 Main Street, Suite 2100
Fort Worth, TX 76102
Carl F. Thorne 1,881,877(5) 1.4%
Chairman, President and
Chief Executive Officer
Morton H. Meyerson 433,163(6) --(7)
Director
Richard A. Wilson 197,384(8) --(7)
Director, Senior Vice President
and Chief Operating Officer
C. Christopher Gaut 238,830(9) --(7)
Vice President - Finance and
Chief Financial Officer
William S. Chadwick, Jr. 198,587(10) --(7)
Vice President - Administration
and Secretary
Dillard S. Hammett 106,101(11) --(7)
Director
Marshall Ballard 147,451(12) --(7)
Vice President - Business
Development
Orville D. Gaither, Sr. 79,259(13) --(7)
Director
Thomas L. Kelly II 68,437(14) --(7)
Director
Craig I. Fields 42,259(15) --(7)
Director
Gerald W. Haddock 19,553(16) --(7)
Director
All Directors and Executive Officers 3,660,734(17) 2.7%
as a Group (14 persons, including
those named above)
-------------------------
(1) At February 28, 1999, there were 137,047,152 shares of Common
Stock outstanding. Unless otherwise indicated, each person or
group has sole voting and dispositive power with respect to
all shares.
(2) Princeton Services, Inc., Merrill Lynch Asset Management,
L.P., Merrill Lynch & Co., Inc. and Merrill Lynch Growth Fund
advised the Company that they divested their holdings of the
shares of Common Stock reported on Amendment No. 7 to Schedule
13G dated January 8, 1999.
(3) Based upon information obtained from FMR Corp. as of February
28, 1999, FMR Corp. may be deemed to be the beneficial owner
of 17,888,910 shares of Common Stock.
(4) Based upon information supplied by Richard E. Rainwater's
attorney, Mr. Rainwater may be deemed to be the beneficial
owner of 7,374,160 shares of Common Stock. Includes 893,600
shares held by the Richard E. Rainwater Charitable Remainder
Unitrust No. 1, of which Mr. Rainwater is sole trustee, and
also includes 16,200 shares held by Mr. Rainwater's spouse, as
to all of which Mr. Rainwater disclaims beneficial ownership.
Does not include 783,054 shares held by Mr. Rainwater's adult
children, as to all of which Mr. Rainwater disclaims
beneficial ownership.
10
How To Use The False Claims Act General Accounting Office (GAO) that as much as 10 percent of the federal budget is lost to fraud and abuse
How To Use The False Claims Act To Prevent Nursing Home Fraud And Patient Abuse
As the baby boom generation moves from middle age to retirement, tens of millions of Americans will be entitled to Medicare benefits. Nursing home care and home health care are two of the fastest rising areas of Medicare spending.
It has been estimated by the General Accounting Office (GAO) that as much as 10 percent of the federal budget is lost to fraud and abuse. The Federal False Claims Act, with its "qui tam" provision, has become one of the primary means the government has for fighting fraud in the Medicare, and Medicaid programs.
The False Claims Act, sometimes referred to as "Lincoln's Law," was passed at the urging of President Abraham Lincoln in 1863 to combat the fraud being perpetrated on the Union by profiteers selling shoddy, defective, or nonexistent goods. The act provided that the individuals who provided information were compensated by receiving bounties of up to 50 percent of the money the lawsuit recovered for the Treasury. This bounty or "qui tam" was the reward given whistle blowers for information.
The Congress amended the Act in 1986 to provide successful qui tam plaintiffs at least 15 percent and up to 30 percent of the funds they help recover from the defendant.
The latest figures show in 1998, that 60 percent of the cases involved health care. In 1998, the government filed 472 cases and recovered 394 Million dollars for false claims. On average, the amount paid by the government to individuals who provided information as their share has been 17 percent.
A small but growing number of cases have been b brought under the False Claims Act alleging fraud in the context of nursing home care, either by improper billing for supplies, unnecessary care, and more recently, substandard care.
We can all help our government by coming forward with information we have concerning Medicaid or Medicare fraud. A personal injury attorney can help review the case and direct the "whistle blower" in the proper channels.
As the baby boom generation moves from middle age to retirement, tens of millions of Americans will be entitled to Medicare benefits. Nursing home care and home health care are two of the fastest rising areas of Medicare spending.
It has been estimated by the General Accounting Office (GAO) that as much as 10 percent of the federal budget is lost to fraud and abuse. The Federal False Claims Act, with its "qui tam" provision, has become one of the primary means the government has for fighting fraud in the Medicare, and Medicaid programs.
The False Claims Act, sometimes referred to as "Lincoln's Law," was passed at the urging of President Abraham Lincoln in 1863 to combat the fraud being perpetrated on the Union by profiteers selling shoddy, defective, or nonexistent goods. The act provided that the individuals who provided information were compensated by receiving bounties of up to 50 percent of the money the lawsuit recovered for the Treasury. This bounty or "qui tam" was the reward given whistle blowers for information.
The Congress amended the Act in 1986 to provide successful qui tam plaintiffs at least 15 percent and up to 30 percent of the funds they help recover from the defendant.
The latest figures show in 1998, that 60 percent of the cases involved health care. In 1998, the government filed 472 cases and recovered 394 Million dollars for false claims. On average, the amount paid by the government to individuals who provided information as their share has been 17 percent.
A small but growing number of cases have been b brought under the False Claims Act alleging fraud in the context of nursing home care, either by improper billing for supplies, unnecessary care, and more recently, substandard care.
We can all help our government by coming forward with information we have concerning Medicaid or Medicare fraud. A personal injury attorney can help review the case and direct the "whistle blower" in the proper channels.
False Claims Act "Qui Tam" Whistleblower Cases Recover More Than $1 Billion In Latest Year, Justice Department Announces
Once again displaying the effectiveness of the False Claims Act in combating government fraud, the Justice Department has announced that it recovered $2 billion in fraud cases in the latest fiscal year that ended September 30, 2007. Qui tam whistleblower cases under the False Claims Act accounted for at least $1.45 billion of those recoveries, with the whistleblowers (or "relators') sharing in those recoveries.
In all but one year since 2000, False Claims Act cases have generated at least $1 billion in recoveries, with whistleblowers responsible for cases that produced most of those judgments and settlements.
Health care fraud cases involving Medicare, Medicaid, and other government programs once again generated the most dollars--$1.54 billion, more than 75% of the total recoveries.
Pharmaceutical companies paid the lion's share of the health care fraud recoveries. The government's settlements with Bristol-Myers Squibb Co., Aventis Pharmaceuticals, Inc., Medco Health Solutions, Inc., Purdue Pharma L.P., Purdue Frederick Co., and InterMune, Inc. totalled over $800 million.
The Justice Department has focused on cases of Pharma's “off-label” marketing; kickbacks to physicians, wholesalers, and pharmacies to induce sales of drugs or medical devices; inflating the drug "prices" that federal programs use to reimburse providers, then "marketing the spread” between the federal reimbursement and the provider’s lower cost; and failing to report the drug company’s actual “best price” so as to reduce rebates required to be paid.
In addition to the federal dollars recovered, states recovered an additional $264 million in pharmaceutical fraud cases--demonstrating why state versions of the False Claims Act such as those enacted in 2007 by New York, Georgia, and Oklahoma are such a good idea.
The defense industry once again holds the number two position in government fraud, accounting for more than $48 million.
For an understanding of the False Claims Act, please see our in-depth article explaining the False Claims Act and its increasing importance in combating fraud by rewarding whistleblowers for stepping forward.
http://www.whistleblowerlawyerblog.com/2007/11/false_claims_act_qui_tam_whist.html?
In all but one year since 2000, False Claims Act cases have generated at least $1 billion in recoveries, with whistleblowers responsible for cases that produced most of those judgments and settlements.
Health care fraud cases involving Medicare, Medicaid, and other government programs once again generated the most dollars--$1.54 billion, more than 75% of the total recoveries.
Pharmaceutical companies paid the lion's share of the health care fraud recoveries. The government's settlements with Bristol-Myers Squibb Co., Aventis Pharmaceuticals, Inc., Medco Health Solutions, Inc., Purdue Pharma L.P., Purdue Frederick Co., and InterMune, Inc. totalled over $800 million.
The Justice Department has focused on cases of Pharma's “off-label” marketing; kickbacks to physicians, wholesalers, and pharmacies to induce sales of drugs or medical devices; inflating the drug "prices" that federal programs use to reimburse providers, then "marketing the spread” between the federal reimbursement and the provider’s lower cost; and failing to report the drug company’s actual “best price” so as to reduce rebates required to be paid.
In addition to the federal dollars recovered, states recovered an additional $264 million in pharmaceutical fraud cases--demonstrating why state versions of the False Claims Act such as those enacted in 2007 by New York, Georgia, and Oklahoma are such a good idea.
The defense industry once again holds the number two position in government fraud, accounting for more than $48 million.
For an understanding of the False Claims Act, please see our in-depth article explaining the False Claims Act and its increasing importance in combating fraud by rewarding whistleblowers for stepping forward.
http://www.whistleblowerlawyerblog.com/2007/11/false_claims_act_qui_tam_whist.html?
Warren Buffett called on Congress to maintain the estate tax
Nov. 14 (Bloomberg) -- Warren Buffett called on Congress to maintain the estate tax, saying that plans to repeal the levy would benefit a handful of the richest American families and widen U.S. income disparity.
Buffett, the billionaire chairman of Omaha, Nebraska-based Berkshire Hathaway Inc., told the Senate Finance Committee that advocates of repeal were ``dead wrong'' to call the levy a ``death tax.''
It would be more appropriate to call it a ``death present,'' said Buffett, 77, who is the third-richest person in the world, according to Forbes Magazine. ``A meaningful estate tax is needed to prevent our democracy from becoming a dynastic plutocracy.'' Heirs to vast fortunes, he said, have already won the ``ovarian lottery'' and shouldn't be further rewarded by the tax system.
Congressional Democrats are likely to seize on Buffett's comments to bolster their argument that repeal of the estate tax amounts to a windfall for a few wealthy families. Republicans have pushed to permanently eliminate the tax or reduce the rate and increase the value of exempt estates.
Buffett said that in the last 20 years, tax laws have allowed the ``super-rich'' to get richer.
``Tax-law changes have benefited this group, including me, in a huge way,'' he said. ``During that time the average American went exactly nowhere on the economic scale: He's been on a treadmill while the super rich have been on a spaceship.''
Dormant Issue
The estate tax has been a dormant issue for the last year after Republicans failed to lure enough Democrats to agree to a repeal or permanent reduction of the levy. In August 2006, former Senate Majority Leader Bill Frist, a Tennessee Republican, tried to win Democratic votes by tying repeal to an increase in the minimum wage.
Lawmakers are under pressure to reach some agreement on the future of the tax because a law enacted by Congress in 2001 gradually phases it out through 2010, when it will be fully repealed for one year. The tax is scheduled to return in 2011 with a top rate of 55 percent on estates worth more than $1 million. For this year, individual estates valued at more than $2 million are taxed at a top rate of 45 percent. By 2009, estates valued at less than $3.5 million will be exempt.
Senate Finance Committee Chairman Max Baucus, a Montana Democrat, said today that less than 1 percent of U.S. households currently pay the tax. He said repeal lacked support in the Senate and the purpose of the hearing today was to solicit ideas for replacing the shifting rules and uncertainty of the current system.
`Taxable Event'
Senator Charles Grassley of Iowa, the ranking Republican on the panel, said the estate tax should be repealed because ``death should not be a taxable event.''
``As long as a person has accumulated an estate in accordance with the law, the government should not be able to profit from that person's death,'' he said. He said, however, that he may be willing to accept a compromise short of repeal, as long as lawmakers ``are looking out for small business owners and family farmers.''
Buffett urged the committee to keep the estate tax in some form and to use the $24 billion it raises to give a $1,000 tax rebate to low-income households.
`Shifting' Tax Burden
``We need to raise about 20 percent of GDP to fund the programs the American people want from the federal government,'' he said. ``Further shifting this burden away from the super-rich is not the way to go.''
He said that if he had his ``druthers,'' the tax code would be restructured to remove some of the burden from households earning less than $20,000 a year. Those households pay a 15.3 percent Social Security and Medicare tax, he said, while top money managers at hedge funds and private-equity firms pay a 15 percent rate on most capital gains, dividends, and profits they earn.
``I can't imagine a tougher problem than living in the United States and having a $20,000 income and having $3,000 taken out of that,'' Buffett said.
Weighing in on another tax issue being debated in Congress, he said he favored increasing the tax rate on so-called carried interest, the compensation that executives at buyout and venture- capital firms, as well as real estate partnerships, receive for investment services. Carried interest is currently taxed at the 15 percent capital-gains rate. The House passed a measure last week that would require it to be taxed as income, at rates as high as 37.9 percent.
Bill Gates
Other billionaires have joined Buffett in urging Congress to keep the estate tax, including Bill Gates, the world's richest man and founder of Microsoft Corp. Gates told a Senate panel in March that he agrees with his father, William H. Gates Jr., who wrote a book in support of the estate tax.
George Soros, a billionaire investor, has joined Buffett in signing a petition sponsored by an activist group called Responsible Wealth that calls on lawmakers to preserve the tax. More than 2,000 people whose estates would be subject to the tax have signed the petition, according to the group's Web site.
Republicans say the estate tax threatens small family businesses and farms because heirs are often forced to sell the business to be able to pay the levy.
Eugene Sukup, founder and chairman of Sukup Manufacturing Co. told the committee today that the tax is ``one of the greatest threats to our family-owned business.'' He told the panel that if he and his wife die, his sons would have to sell the Sheffield, Iowa-based company, which makes grain-handling equipment, to pay as much as $20 million in taxes.
Tax Planning
Sukup said tax-planning strategies that minimize that liability cost his company money that otherwise would be reinvested.
Dean Rhoads, a rancher and state senator from Nevada, testified that his family had to sell a ranch in the 1970s when his parents died and they owed $300,000 in estate tax. The family owed an additional $340,000 in 1995 when his father-in-law died.
``Because of this, I can say without a doubt that we have not made very many capital improvements to our ranch,'' he said.
Mark Bloomfield, president of the American Council for Capital Formation, a Washington group that has lobbied for repeal of the levy, said the Senate hearing today is a prelude to a congressional compromise on the issue next year.
Missing Votes
``I don't think complete repeal has the votes, has not had the votes for a few years, and won't have the votes in the future,'' Bloomfield said.
A compromise that exempts estates worth several million dollars and sets a rate on those valued at more than that at between 15 percent and 35 percent may be achievable, he said.
Committee members appeared to be leaning to an overhaul that would raise the exemption to between $4 million and $6 million and lowering the rate.
``The parameters for a deal are there. They've been there for the last couple of years. The politics have gotten in the way,'' he said. The thorniest disagreement, Bloomfield said, has been over setting the rate. Republicans such as Senator Jon Kyl of Arizona, want it to be 15 percent, while Democrats have rejected a 30 percent rate as too low.
Buffett said lawmakers should find a compromise that creates certainty for taxpayers and businesses.
Senator Maria Cantwell, a Washington Democrat, pointed out that Buffett has pledged to donate the bulk of his fortune to the Bill & Melinda Gates Foundation and will largely avoid paying estate tax on that amount.
In an interview after the hearing, Buffett said that after his wife's death in 2004, her estate paid $82 million in federal taxes and $32 million in state estate tax. He said he would give the Gates Foundation his Berkshire Hathaway stock, valued at more than $40 billion, and estate taxes would be paid on the assets he leaves his children.
To contact the reporter on this story: Ryan J. Donmoyer in Washington at rdonmoyer@bloomberg.net Alison Fitzgerald in Washington at Afitzgerald2@bloomberg.net
Last Updated: November 14, 2007 14:38 EST
Buffett, the billionaire chairman of Omaha, Nebraska-based Berkshire Hathaway Inc., told the Senate Finance Committee that advocates of repeal were ``dead wrong'' to call the levy a ``death tax.''
It would be more appropriate to call it a ``death present,'' said Buffett, 77, who is the third-richest person in the world, according to Forbes Magazine. ``A meaningful estate tax is needed to prevent our democracy from becoming a dynastic plutocracy.'' Heirs to vast fortunes, he said, have already won the ``ovarian lottery'' and shouldn't be further rewarded by the tax system.
Congressional Democrats are likely to seize on Buffett's comments to bolster their argument that repeal of the estate tax amounts to a windfall for a few wealthy families. Republicans have pushed to permanently eliminate the tax or reduce the rate and increase the value of exempt estates.
Buffett said that in the last 20 years, tax laws have allowed the ``super-rich'' to get richer.
``Tax-law changes have benefited this group, including me, in a huge way,'' he said. ``During that time the average American went exactly nowhere on the economic scale: He's been on a treadmill while the super rich have been on a spaceship.''
Dormant Issue
The estate tax has been a dormant issue for the last year after Republicans failed to lure enough Democrats to agree to a repeal or permanent reduction of the levy. In August 2006, former Senate Majority Leader Bill Frist, a Tennessee Republican, tried to win Democratic votes by tying repeal to an increase in the minimum wage.
Lawmakers are under pressure to reach some agreement on the future of the tax because a law enacted by Congress in 2001 gradually phases it out through 2010, when it will be fully repealed for one year. The tax is scheduled to return in 2011 with a top rate of 55 percent on estates worth more than $1 million. For this year, individual estates valued at more than $2 million are taxed at a top rate of 45 percent. By 2009, estates valued at less than $3.5 million will be exempt.
Senate Finance Committee Chairman Max Baucus, a Montana Democrat, said today that less than 1 percent of U.S. households currently pay the tax. He said repeal lacked support in the Senate and the purpose of the hearing today was to solicit ideas for replacing the shifting rules and uncertainty of the current system.
`Taxable Event'
Senator Charles Grassley of Iowa, the ranking Republican on the panel, said the estate tax should be repealed because ``death should not be a taxable event.''
``As long as a person has accumulated an estate in accordance with the law, the government should not be able to profit from that person's death,'' he said. He said, however, that he may be willing to accept a compromise short of repeal, as long as lawmakers ``are looking out for small business owners and family farmers.''
Buffett urged the committee to keep the estate tax in some form and to use the $24 billion it raises to give a $1,000 tax rebate to low-income households.
`Shifting' Tax Burden
``We need to raise about 20 percent of GDP to fund the programs the American people want from the federal government,'' he said. ``Further shifting this burden away from the super-rich is not the way to go.''
He said that if he had his ``druthers,'' the tax code would be restructured to remove some of the burden from households earning less than $20,000 a year. Those households pay a 15.3 percent Social Security and Medicare tax, he said, while top money managers at hedge funds and private-equity firms pay a 15 percent rate on most capital gains, dividends, and profits they earn.
``I can't imagine a tougher problem than living in the United States and having a $20,000 income and having $3,000 taken out of that,'' Buffett said.
Weighing in on another tax issue being debated in Congress, he said he favored increasing the tax rate on so-called carried interest, the compensation that executives at buyout and venture- capital firms, as well as real estate partnerships, receive for investment services. Carried interest is currently taxed at the 15 percent capital-gains rate. The House passed a measure last week that would require it to be taxed as income, at rates as high as 37.9 percent.
Bill Gates
Other billionaires have joined Buffett in urging Congress to keep the estate tax, including Bill Gates, the world's richest man and founder of Microsoft Corp. Gates told a Senate panel in March that he agrees with his father, William H. Gates Jr., who wrote a book in support of the estate tax.
George Soros, a billionaire investor, has joined Buffett in signing a petition sponsored by an activist group called Responsible Wealth that calls on lawmakers to preserve the tax. More than 2,000 people whose estates would be subject to the tax have signed the petition, according to the group's Web site.
Republicans say the estate tax threatens small family businesses and farms because heirs are often forced to sell the business to be able to pay the levy.
Eugene Sukup, founder and chairman of Sukup Manufacturing Co. told the committee today that the tax is ``one of the greatest threats to our family-owned business.'' He told the panel that if he and his wife die, his sons would have to sell the Sheffield, Iowa-based company, which makes grain-handling equipment, to pay as much as $20 million in taxes.
Tax Planning
Sukup said tax-planning strategies that minimize that liability cost his company money that otherwise would be reinvested.
Dean Rhoads, a rancher and state senator from Nevada, testified that his family had to sell a ranch in the 1970s when his parents died and they owed $300,000 in estate tax. The family owed an additional $340,000 in 1995 when his father-in-law died.
``Because of this, I can say without a doubt that we have not made very many capital improvements to our ranch,'' he said.
Mark Bloomfield, president of the American Council for Capital Formation, a Washington group that has lobbied for repeal of the levy, said the Senate hearing today is a prelude to a congressional compromise on the issue next year.
Missing Votes
``I don't think complete repeal has the votes, has not had the votes for a few years, and won't have the votes in the future,'' Bloomfield said.
A compromise that exempts estates worth several million dollars and sets a rate on those valued at more than that at between 15 percent and 35 percent may be achievable, he said.
Committee members appeared to be leaning to an overhaul that would raise the exemption to between $4 million and $6 million and lowering the rate.
``The parameters for a deal are there. They've been there for the last couple of years. The politics have gotten in the way,'' he said. The thorniest disagreement, Bloomfield said, has been over setting the rate. Republicans such as Senator Jon Kyl of Arizona, want it to be 15 percent, while Democrats have rejected a 30 percent rate as too low.
Buffett said lawmakers should find a compromise that creates certainty for taxpayers and businesses.
Senator Maria Cantwell, a Washington Democrat, pointed out that Buffett has pledged to donate the bulk of his fortune to the Bill & Melinda Gates Foundation and will largely avoid paying estate tax on that amount.
In an interview after the hearing, Buffett said that after his wife's death in 2004, her estate paid $82 million in federal taxes and $32 million in state estate tax. He said he would give the Gates Foundation his Berkshire Hathaway stock, valued at more than $40 billion, and estate taxes would be paid on the assets he leaves his children.
To contact the reporter on this story: Ryan J. Donmoyer in Washington at rdonmoyer@bloomberg.net Alison Fitzgerald in Washington at Afitzgerald2@bloomberg.net
Last Updated: November 14, 2007 14:38 EST
Tuesday, November 13, 2007
NCFE president loses law team
The former president of the defunct National Century Financial Enterprises Inc. is for the time being facing criminal charges without legal representation.
Lawyers for Lance K. Poulsen, a founder of Dublin-based NCFE, were allowed by U.S. District Court Judge Algenon L. Marbley Nov. 2 to end their representation of the indicted executive. Thomas M. Tyack and James P. Tyack from Tyack Blackmore & Liston Co. LPA requested the discharge.
"Certain events relating to allegations of activities of Mr. Poulsen, including his arrest for a charge of obstruction of justice, have occurred since Oct. 17, 2007," the attorneys wrote to the court. "It has become apparent that in fact, as a result of the allegations raised and the circumstances surrounding thereto, counsel are in a position of being in a conflict of interest with Mr. Poulsen."
Neither lawyer was available for comment.
Lawyers for Lance K. Poulsen, a founder of Dublin-based NCFE, were allowed by U.S. District Court Judge Algenon L. Marbley Nov. 2 to end their representation of the indicted executive. Thomas M. Tyack and James P. Tyack from Tyack Blackmore & Liston Co. LPA requested the discharge.
"Certain events relating to allegations of activities of Mr. Poulsen, including his arrest for a charge of obstruction of justice, have occurred since Oct. 17, 2007," the attorneys wrote to the court. "It has become apparent that in fact, as a result of the allegations raised and the circumstances surrounding thereto, counsel are in a position of being in a conflict of interest with Mr. Poulsen."
Neither lawyer was available for comment.
Monday, November 12, 2007
Moore said she and her husband, Richard Rainwater....
How Darla Moore’s gift to USC of $25 million ballooned to $37 million
Submitted by: John Warner on Aug 28, 2005 at 10:41 am
Tagged with: Academia
Source:
How gift to USC of $25 million ballooned
Darla Moore’s endowment to business school in 1999 has grown to $37 million
By JAMES T. HAMMOND
Staff writer
Lake City native Darla Moore’s 1999 gift of $25 million to the University of South Carolina business school has grown to more than $37 million.
It also spins off more than $1.25 million in income each year for the school that now bears her name.
How did the money grow so fast?
“We put it in such good investments, it was a home run for the school,” Moore said, adding the money is being managed by a Texas hedge fund. “It’s in a hedge fund that we started 10 or 12 years ago. We just left it in that fund.”
Moore said she and her husband, Richard Rainwater, invest money in the fund, too.
The hedge fund, she said, is made up of stocks commonly traded in the market, but the stocks are traded actively by skilled traders.
Submitted by: John Warner on Aug 28, 2005 at 10:41 am
Tagged with: Academia
Source:
How gift to USC of $25 million ballooned
Darla Moore’s endowment to business school in 1999 has grown to $37 million
By JAMES T. HAMMOND
Staff writer
Lake City native Darla Moore’s 1999 gift of $25 million to the University of South Carolina business school has grown to more than $37 million.
It also spins off more than $1.25 million in income each year for the school that now bears her name.
How did the money grow so fast?
“We put it in such good investments, it was a home run for the school,” Moore said, adding the money is being managed by a Texas hedge fund. “It’s in a hedge fund that we started 10 or 12 years ago. We just left it in that fund.”
Moore said she and her husband, Richard Rainwater, invest money in the fund, too.
The hedge fund, she said, is made up of stocks commonly traded in the market, but the stocks are traded actively by skilled traders.
PREPARING FOR THE INCREASING RISK OF RECESSION IN 2008
November 10, 2007
PREPARING FOR THE INCREASING RISK OF RECESSION IN 2008, WHILE TRYING TO TRANSFORM OUR OWN MINDS, IN ORDER TO ACHIEVE A GLOBAL RENAISSANCE!
SANTA BARBARA, CA/11.10.07--Dear Sisters and Brothers: In my Sept. 13th letter to you all, entitled "UCLA Study Predicts a 'Near Recession' For The U.S.," I suggested all should consider becoming more frugal, as America's--and our world's--belt is about to be tightened, and the wise will have set aside something to tide them over during the rainy days ahead.
This looming recession is now nearer, as those even cursorily monitoring Wall Street have noticed, since that barometer is looking six-to-twelve months into America's corporate and economic future. My own global business--which is entirely in the discretionary income field--began to reflect this in October. After almost perfectly tracking 2006 revenue through September, October's income fell by 66%, and this substantial drop-off is continuing here in November.
Discretionary income, as all know, is that extra bit in everyone's budget which can be spent on non-essentials. Thus, during recessions, when discretionary income gets seriously squeezed, people become worried about the future and cut back on discretionary spending. This means, of course, that they don't have to fast, or eat out in restaurants as often, just as many decide to skip seeing their doctor or dentist for things they normally might have.
Like a growing swell in the mighty ocean that is our world's most powerful economy, marry this growing lack of consumer confidence about our economy to individual fears about one's job or the ability to pay off one's credit cards, car payments or mortgage, and you can literally feel the increased suffering which attends all contracting economies.
THE PARENTS of many of us endured America's Great Depression, when an enormous percentage of the population lost their jobs and wound up in soup lines, still holding onto their pride by wearing their Sunday dresses, suits and hats--almost comical in its tragedy. Our global economy, which is presently stronger than America's, will eventually be affected, as well, since we're the importing market keeping the Chinese and Indian growth miracles booming, just as our buying helps the economies of Europe, Latin and South America. In other words, when America gets the flu, the rest of the world will eventually suffer, as well.
Again, please be wise and take this opportunity to save for the rainy days ahead. No one has to tell those just entering America's job market during this growing slowdown, that firms everywhere are not only cutting back on their hiring, but beginning to lay off employees in increasing numbers. This, in turn, puts more in the unemployment lines, while frightening those still working into spending less, as the snowball picks up speed rolling downhill.
America's retailers just reported their worst October sales in 14 years. General Motors just posted its largest loss in history--$39 billion. Wall Street brokerages, banks and mortgage lenders are in the process of writing off what may turn out to be a quarter-trillion dollars in bad loans, as a result of the current sub-prime mortgage implosion and resultant credit crunch.
Democrats in the U.S. House and Senate are crafting legislation to try to shift some of the tax burden off the backs of the working poor and middle class, and onto the wealthy whom Bush's tax cuts have favored during his two terms, at all others expense, just as corporate welfare ensured by armies of K Street lobbyists in Washington have enabled more than 60% of U.S. corporations to pay no taxes at all (and that doesn't include the growing number setting up offshore operations to avoid U.S. taxes altogether, or those shifting plants to China, India, Mexico, Ireland and elsewhere around the world where they can pay workers significantly less, resulting in millions upon millions of lost jobs which are not coming back.
THOSE OF US a bit longer in the teeth have suffered through recessions before, and know to start saving and preparing for harder times. Those of you who've not yet experienced such prolonged, economic downdrafts will want to follow our lead, as the fear of recession in 2008 continues to mount. Homelessness is already growing, just as the number of Americans unable to pay their mortgages has skyrocketed during the past year, throwing millions more into the rental market in every city, driving rents even higher with their competition for living space.
Meanwhile, the price of a barrel of oil is climbing inexorably toward $100 (hit $98 this week), and exogenous events from chaos in once-democratic Pakistan (now under martial law in a virtual military dictatorship in that dicey nuclearized nation housing bin Laden and more radical Islamic jihadists than perhaps any Muslim nation on Earth) to more than 100,000 heavily-armed Turkish troops massed on their border with Iraq, threaten to drive prices of a gallon of the gas most of us need to get to work, etc., before we know it to $4.00, causing our economy to further contract as consumers spend more on gas and heating oil, leaving them less for even basic needs, let alone 'discretionary' ones such as rewarding themselves with FAR greater health, happiness and healing power through prolonged scientific fasting.
The Federal Reserve, unfortunately, is caught between a rock and a hard place. If it lowers interest rates further to help stimulate the economy, it drives the value of the dollar down even further, increasing the prices of imports (including all that Made-In-China stuff filling the shelves of FAR more U.S. chains than just Wal-Mart), which fuels inflation just as surely as does the increasing prices of oil and commodities. We're already seeing the results in higher prices every time we go shopping for food.
Only the wealthiest among us will not feel pain. Ask any homeowner who's watched the value of her/his home depreciate over the past year, knowing things are not going to get better in the housing market anytime soon, just as these huge, gas-guzzling trucks and SUVs which Detroit's shortsighted automakers have flooded our nation with, are driving them to record losses which also will not stop anytime soon, forcing them to continue cutting prices and offering 0-interest loans just to move their bloated inventory, not unlike U.S. retailers already announcing price-cutting not normally seen until the day AFTER Christmas. . .a Christmas when we might all be giving each other oranges, if the lowered expectations of America's retailers are indicative of what's shaping up to be a disastrous holiday season--normally, their busiest period of each year.
THE BUDDHA, in his wisdom, mentioned that we should all learn to live with both poverty and plenty. As our severely-threatened home called Earth moves more rapidly toward resource wars--particularly over oil (the TRUE reason for the Bush/Cheney invasion of Iraq, sitting astride the world's second-largest known reserves, just as Iran sits atop the third, unless you're factoring in Canadian oil sands)--and devastating climate change resulting from over-population and over-pollution, the suffering will increase exponentially, with my own generation bequeathing our children and theirs a world so fraught with wall-to-wall problems they'll all have to be geniuses to even attempt to solve them. . .while trying to pay off America's staggering $9.1 TRILLION national debt, which presently works out to $30,030 for every one of our 303,496,748 citizens, and thanks to the present Administration's perpetual wars in Afghanistan and Iraq (not to mention the one they're itching to start in Iran before they're forced from office in January of 2009), has been increasing at an average of $1.49 BILLION per day since Sept. 29, 2006.
Are such wars inevitable? Will there be any Social Security, MediCare or corporate retirement plans left for our children and theirs? Will the debt-ridden American empire go the way of the British, Ottoman, Romansand Mongolian before us? Will we continue reproducing our over-polluting selves into climate-changing disaster? Is there anything else we can do beyond fiddling, while Russia's oil-rich President Putin embraces Iran's oil-rich President Ahmadinejad--the former systematically taking out his challengers just as ruthlessly as President Musharraf is right now in a devolving, nuclearized Pakistan, while Ahmadinejad insanely denies the Holocaust ever happened and pledges to erase Israel from the face of our Earth.
Meanwhile, the no-longer-sleeping dragon known as China, having developed an insatiably increasing appetite for commodities and oil to continue stacking skyscraper-level billions in national SURPLUSES as our world's largest sweatshop, supplies arms to both Iran--threatening America's geopolitical designs there--and Sudan, enabling a genocide long in uninterrupted progress there. . . .and not just small arms.
China is now promoting its FBC2 and J10A fighters to Iran. The J10A was officially offered on the overseas market this year, but under the name FC20. The new generation YJ6-2 and C802A anti-ship missiles are also being promoted to Middle East countries including Iran. Sudan is reportedly seeking to acquire FC1 fighters from China.
As China faces an ever-greater demand for energy, it is challenging America's hegemony by importing more crude oil from Middle Eastern countries. It is also exerting greater political and military influence upon this region, through expanded sales of military weapons. The long shadow of Chinese weapons has fallen over all six Gulf countries, and continues to do so. Iran has already become an important source of oil for China, as well as a key target-market for China's arms exports.
And the U.S., bogged down in unwinnable wars in opium-rich Afghanistan and oil-rich Iraq, burning our nation's national treasure as rapidly as California wildfires, has its foreign and military policy in the hands of a small, radical, extreme, right-wing cabal of neoconservative Masters of War who've never served our nation in war one day, themselves, yet thump their collective chest while shipping others' precious sons and daughters into their perpetual meatgrinders, forcing those naive young men and women into second, third and fourth tours which increase their chances of being blown apart, maimed for life, or becoming victims of stress-related suicide and broken marriages, already showing up back on America's streets joining that one-fourth of our nation's homeless population who are Viet Nam vets and will similarly never be 'right' again.
Who are these Masters of War controlling our nation's foreign policy, supported by precisely the Military-Industrial Complex our Five-Star Army Gen. and President Dwight Eisenhower warned us against in his "Farewell Address To America" upon leaving office. . Masters of War INCREASING by tens of thousands the number of U.S. troops in Iraq despite the MAJORITY of the U.S. electorate rejecting their Iraq War last November--finally understanding it was based in its entirety on lies, fabrications and deceits. . .a war about to enter it's fifth year, engineered by these Masters of War who chose NOT to serve our country (as I did as a paratrooper for three years--two in Asia--in America's famed 82nd Airborne Division, whose members derisively referred to all on the following list as "chickenhawks") when their own generation was called during the Vietnam Era, such as Bush (who hid out in the Alabama National Guard after allowing taxpayers to spend over a million dollars training him as a pilot), Cheney (similarly gamed the system for five deferments, none for physical reasons), Paul Wolfowitz, Karl Rove, Richard Perle, Scooter Libby, Douglas Feith, Eliot Abrams, John Bolton and William Kristol, holding others' coats right along with their armchair comrades such as Dennis Hastert, Tom Delay, Roy Blunt, Bill Frist, Mitch McConnell, Rick Santorum, Trent Lott, John Ashcrof, Jeb Bush, Saxby Chambliss, Vin Weber, Richard Shelby, Jon Kyl, Tim Hutchison, Christopher Cox and Newt Gingrich.
With Bush/Cheney having presently moved four U.S. Navy carrier groups into that Middle East caldron for their next war in Iran, they've similarly no exit plan, let alone care much in their game of global hegemony, about what will happen if Iranian missiles--purchased from Russia and China--plug the Strait of Hormuz with sufficient tankers to drive the price of oil well over $200, sending global markets and ALL our retirement investments into a bloody tailspin that will increase the present, unnecessary suffering of our looming recession by several orders of magnitude.
WHAT TO DO? Well, besides immediately paying off credit-card debt and saving for the coming rainy days of recession, you might go see a film just released nationwide as an urgent, impassioned wake-up call for our nation. Entitled "Lions For Lambs," starring Academy Award winners Meryl Streep and Robert Redford, along with 3-time Academy Award nominee Tom Cruise, the lions are the soldiers who do the fighting; the lambs are the unworthy politicians who send them into battle, and "Lions for Lambs" is a feature-film response to the war in Iraq, and to currents in post-9/11 American life.
Some say our society's values are reflected in the politicians we elect to represent us in Washington. As a lifelong political Independent, I've never believed all the best ideas or politicians were in any particular party. However, it's clear to all but those with their heads in the sand that our nation's democracy was hijacked during the final decade of the last century when few were paying attention, and that we're presently a Corporate Oligarchy led by Big Oil, which pulled George Bush and Dick Cheney right out of their Oil Patch and twice bought their way into our White House.
Perhaps it's time we changed ourselves, so that we can then begin to change those we elect to guide our nation, in our name? How to do this? Well, my friend and teacher since 1982, His Holiness the Dalai Lama, invited 40 of the world's most innovative thinkers to his Dharamsala, India, home-in-exile (where I was blessed to meet one-on-one with Him three times in late 1987, after returning from Tibet with my son Atisha, then 12, and daughter Malika, then 10, and asking Him how I could help; He asked me to write a book on the "Tibetan Crisis," which I did--"Tibet: The Final Solution"--for which he wrote the Foreword), to discuss precisely how we CAN begin to solve our world's problems.
That film, about another type of mind transformation, has been making the rounds of the world's best film festivals, today premiering in both New York and Los Angeles at one-day screenings. Thus, it's not out yet, but will be soon enough. Entitled "Dalai Lama Renaissance," it's narrated by Harrison Ford, and you can check out its video trailer at (http://www.youtube.com/watch?v=qBbuyZIRXjA). As Harrison notes in introducing one of the most thought-provoking films of our time: "Everybody thinks of changing humanity, and nobody thinks of changing her- or himself."
After watching the trailer, you might wish to click just to the right of it for "Related Videos." There, you'll discover a treasure trove of others, from Barbara Walters' interview with His Holiness, to a three-part "Dalai Lama--Exclusive Interview 1 (ONE)," in which H.H. responds to a devil's-advocate interviewer giving China's view of Tibet's current appeal for autonomy. Know that a couple of the videos there are unworthy, including some satirical garbage entitled "Steven Seagal--Dalai Lama," and another showing President Bush's meeting in the White House with His Holiness, into which the filmmaker unfortunately introduced out-takes from previous Dalai Lama teachings to make his points.
Several among those reading this know the Columbia University Chair of the Religious Studies Department, Bob Thurman, Ph.D. (father of Uma and four others), who's one of the half-dozen most dynamic speakers I've heard in my life. Bob gives a superb introduction to a priceless, four-part video you can view there entitled "Dalai Lama: The Four Noble Truths." Other excellent ones include: "10 Questions For the Dalai Lama," "Dalai Lama In Chicago," "Dalai Lama Visits UB 2006" (Univ. of Buffalo in upstate New York), "The Dalai Lama At Woodstock," "Dalai Lama In Harvard University," "Compassion--Dalai Lama, Muhammad Ali, Thomas Merton," "Dalai Lama Speaking In Long Beach," et. al. Kick back and relax with some good organic juice, and just surf there to your heart's content.
TWICE IN THE PAST YEAR, I've taken three-day, mind-transformation teachings with thousands of other fortunate beings in New York and San Francisco, given by the Dalai Lama. I've been blessed to take Atisha, Malika, her husband Rob, and other friends on this Esoteric List with me. Those teachings were among the most precious and meaningful I've received from any human being during my 66 years on this Earth. My longtime friend and teacher who gave them will be 73 next July, and will not be here forever, just as you and I will not. Thus, if you ever have the chance, do yourself an enormous favor.
As a lifelong social activist, I've provided the above overview in hopes it inspires you to prepare intelligently for the more difficult days ahead. . .for all of us, both in America and around our globe. My hope and prayer is for each of you to enjoy a stable, meritorious life. Alone, we're helpless to solve our world's growing problems, but collectively--once we've learned to open our hearts to ALL living beings, with equanimity--we CAN perhaps achieve the quantum leap in human consciousness I believe is now required to save humanity from itself. . .and leave our children and theirs a world worth inheriting.
Beyond that, my Sisters and Brothers, may you each be happy; may you be healthy; may you be peaceful and at ease, and may you be filled with loving kindness. May goodness and virtue flourish. Practice, as much as possible, loving kindness, compassion, empathic joy and equanimity, remembering these words from His Holiness: "The key to a happier and more successful world is the growth of compassion." Big Love; your friend, Dennis
Posted by dpaulson at November 10, 2007 11:10 AM
PREPARING FOR THE INCREASING RISK OF RECESSION IN 2008, WHILE TRYING TO TRANSFORM OUR OWN MINDS, IN ORDER TO ACHIEVE A GLOBAL RENAISSANCE!
SANTA BARBARA, CA/11.10.07--Dear Sisters and Brothers: In my Sept. 13th letter to you all, entitled "UCLA Study Predicts a 'Near Recession' For The U.S.," I suggested all should consider becoming more frugal, as America's--and our world's--belt is about to be tightened, and the wise will have set aside something to tide them over during the rainy days ahead.
This looming recession is now nearer, as those even cursorily monitoring Wall Street have noticed, since that barometer is looking six-to-twelve months into America's corporate and economic future. My own global business--which is entirely in the discretionary income field--began to reflect this in October. After almost perfectly tracking 2006 revenue through September, October's income fell by 66%, and this substantial drop-off is continuing here in November.
Discretionary income, as all know, is that extra bit in everyone's budget which can be spent on non-essentials. Thus, during recessions, when discretionary income gets seriously squeezed, people become worried about the future and cut back on discretionary spending. This means, of course, that they don't have to fast, or eat out in restaurants as often, just as many decide to skip seeing their doctor or dentist for things they normally might have.
Like a growing swell in the mighty ocean that is our world's most powerful economy, marry this growing lack of consumer confidence about our economy to individual fears about one's job or the ability to pay off one's credit cards, car payments or mortgage, and you can literally feel the increased suffering which attends all contracting economies.
THE PARENTS of many of us endured America's Great Depression, when an enormous percentage of the population lost their jobs and wound up in soup lines, still holding onto their pride by wearing their Sunday dresses, suits and hats--almost comical in its tragedy. Our global economy, which is presently stronger than America's, will eventually be affected, as well, since we're the importing market keeping the Chinese and Indian growth miracles booming, just as our buying helps the economies of Europe, Latin and South America. In other words, when America gets the flu, the rest of the world will eventually suffer, as well.
Again, please be wise and take this opportunity to save for the rainy days ahead. No one has to tell those just entering America's job market during this growing slowdown, that firms everywhere are not only cutting back on their hiring, but beginning to lay off employees in increasing numbers. This, in turn, puts more in the unemployment lines, while frightening those still working into spending less, as the snowball picks up speed rolling downhill.
America's retailers just reported their worst October sales in 14 years. General Motors just posted its largest loss in history--$39 billion. Wall Street brokerages, banks and mortgage lenders are in the process of writing off what may turn out to be a quarter-trillion dollars in bad loans, as a result of the current sub-prime mortgage implosion and resultant credit crunch.
Democrats in the U.S. House and Senate are crafting legislation to try to shift some of the tax burden off the backs of the working poor and middle class, and onto the wealthy whom Bush's tax cuts have favored during his two terms, at all others expense, just as corporate welfare ensured by armies of K Street lobbyists in Washington have enabled more than 60% of U.S. corporations to pay no taxes at all (and that doesn't include the growing number setting up offshore operations to avoid U.S. taxes altogether, or those shifting plants to China, India, Mexico, Ireland and elsewhere around the world where they can pay workers significantly less, resulting in millions upon millions of lost jobs which are not coming back.
THOSE OF US a bit longer in the teeth have suffered through recessions before, and know to start saving and preparing for harder times. Those of you who've not yet experienced such prolonged, economic downdrafts will want to follow our lead, as the fear of recession in 2008 continues to mount. Homelessness is already growing, just as the number of Americans unable to pay their mortgages has skyrocketed during the past year, throwing millions more into the rental market in every city, driving rents even higher with their competition for living space.
Meanwhile, the price of a barrel of oil is climbing inexorably toward $100 (hit $98 this week), and exogenous events from chaos in once-democratic Pakistan (now under martial law in a virtual military dictatorship in that dicey nuclearized nation housing bin Laden and more radical Islamic jihadists than perhaps any Muslim nation on Earth) to more than 100,000 heavily-armed Turkish troops massed on their border with Iraq, threaten to drive prices of a gallon of the gas most of us need to get to work, etc., before we know it to $4.00, causing our economy to further contract as consumers spend more on gas and heating oil, leaving them less for even basic needs, let alone 'discretionary' ones such as rewarding themselves with FAR greater health, happiness and healing power through prolonged scientific fasting.
The Federal Reserve, unfortunately, is caught between a rock and a hard place. If it lowers interest rates further to help stimulate the economy, it drives the value of the dollar down even further, increasing the prices of imports (including all that Made-In-China stuff filling the shelves of FAR more U.S. chains than just Wal-Mart), which fuels inflation just as surely as does the increasing prices of oil and commodities. We're already seeing the results in higher prices every time we go shopping for food.
Only the wealthiest among us will not feel pain. Ask any homeowner who's watched the value of her/his home depreciate over the past year, knowing things are not going to get better in the housing market anytime soon, just as these huge, gas-guzzling trucks and SUVs which Detroit's shortsighted automakers have flooded our nation with, are driving them to record losses which also will not stop anytime soon, forcing them to continue cutting prices and offering 0-interest loans just to move their bloated inventory, not unlike U.S. retailers already announcing price-cutting not normally seen until the day AFTER Christmas. . .a Christmas when we might all be giving each other oranges, if the lowered expectations of America's retailers are indicative of what's shaping up to be a disastrous holiday season--normally, their busiest period of each year.
THE BUDDHA, in his wisdom, mentioned that we should all learn to live with both poverty and plenty. As our severely-threatened home called Earth moves more rapidly toward resource wars--particularly over oil (the TRUE reason for the Bush/Cheney invasion of Iraq, sitting astride the world's second-largest known reserves, just as Iran sits atop the third, unless you're factoring in Canadian oil sands)--and devastating climate change resulting from over-population and over-pollution, the suffering will increase exponentially, with my own generation bequeathing our children and theirs a world so fraught with wall-to-wall problems they'll all have to be geniuses to even attempt to solve them. . .while trying to pay off America's staggering $9.1 TRILLION national debt, which presently works out to $30,030 for every one of our 303,496,748 citizens, and thanks to the present Administration's perpetual wars in Afghanistan and Iraq (not to mention the one they're itching to start in Iran before they're forced from office in January of 2009), has been increasing at an average of $1.49 BILLION per day since Sept. 29, 2006.
Are such wars inevitable? Will there be any Social Security, MediCare or corporate retirement plans left for our children and theirs? Will the debt-ridden American empire go the way of the British, Ottoman, Romansand Mongolian before us? Will we continue reproducing our over-polluting selves into climate-changing disaster? Is there anything else we can do beyond fiddling, while Russia's oil-rich President Putin embraces Iran's oil-rich President Ahmadinejad--the former systematically taking out his challengers just as ruthlessly as President Musharraf is right now in a devolving, nuclearized Pakistan, while Ahmadinejad insanely denies the Holocaust ever happened and pledges to erase Israel from the face of our Earth.
Meanwhile, the no-longer-sleeping dragon known as China, having developed an insatiably increasing appetite for commodities and oil to continue stacking skyscraper-level billions in national SURPLUSES as our world's largest sweatshop, supplies arms to both Iran--threatening America's geopolitical designs there--and Sudan, enabling a genocide long in uninterrupted progress there. . . .and not just small arms.
China is now promoting its FBC2 and J10A fighters to Iran. The J10A was officially offered on the overseas market this year, but under the name FC20. The new generation YJ6-2 and C802A anti-ship missiles are also being promoted to Middle East countries including Iran. Sudan is reportedly seeking to acquire FC1 fighters from China.
As China faces an ever-greater demand for energy, it is challenging America's hegemony by importing more crude oil from Middle Eastern countries. It is also exerting greater political and military influence upon this region, through expanded sales of military weapons. The long shadow of Chinese weapons has fallen over all six Gulf countries, and continues to do so. Iran has already become an important source of oil for China, as well as a key target-market for China's arms exports.
And the U.S., bogged down in unwinnable wars in opium-rich Afghanistan and oil-rich Iraq, burning our nation's national treasure as rapidly as California wildfires, has its foreign and military policy in the hands of a small, radical, extreme, right-wing cabal of neoconservative Masters of War who've never served our nation in war one day, themselves, yet thump their collective chest while shipping others' precious sons and daughters into their perpetual meatgrinders, forcing those naive young men and women into second, third and fourth tours which increase their chances of being blown apart, maimed for life, or becoming victims of stress-related suicide and broken marriages, already showing up back on America's streets joining that one-fourth of our nation's homeless population who are Viet Nam vets and will similarly never be 'right' again.
Who are these Masters of War controlling our nation's foreign policy, supported by precisely the Military-Industrial Complex our Five-Star Army Gen. and President Dwight Eisenhower warned us against in his "Farewell Address To America" upon leaving office. . Masters of War INCREASING by tens of thousands the number of U.S. troops in Iraq despite the MAJORITY of the U.S. electorate rejecting their Iraq War last November--finally understanding it was based in its entirety on lies, fabrications and deceits. . .a war about to enter it's fifth year, engineered by these Masters of War who chose NOT to serve our country (as I did as a paratrooper for three years--two in Asia--in America's famed 82nd Airborne Division, whose members derisively referred to all on the following list as "chickenhawks") when their own generation was called during the Vietnam Era, such as Bush (who hid out in the Alabama National Guard after allowing taxpayers to spend over a million dollars training him as a pilot), Cheney (similarly gamed the system for five deferments, none for physical reasons), Paul Wolfowitz, Karl Rove, Richard Perle, Scooter Libby, Douglas Feith, Eliot Abrams, John Bolton and William Kristol, holding others' coats right along with their armchair comrades such as Dennis Hastert, Tom Delay, Roy Blunt, Bill Frist, Mitch McConnell, Rick Santorum, Trent Lott, John Ashcrof, Jeb Bush, Saxby Chambliss, Vin Weber, Richard Shelby, Jon Kyl, Tim Hutchison, Christopher Cox and Newt Gingrich.
With Bush/Cheney having presently moved four U.S. Navy carrier groups into that Middle East caldron for their next war in Iran, they've similarly no exit plan, let alone care much in their game of global hegemony, about what will happen if Iranian missiles--purchased from Russia and China--plug the Strait of Hormuz with sufficient tankers to drive the price of oil well over $200, sending global markets and ALL our retirement investments into a bloody tailspin that will increase the present, unnecessary suffering of our looming recession by several orders of magnitude.
WHAT TO DO? Well, besides immediately paying off credit-card debt and saving for the coming rainy days of recession, you might go see a film just released nationwide as an urgent, impassioned wake-up call for our nation. Entitled "Lions For Lambs," starring Academy Award winners Meryl Streep and Robert Redford, along with 3-time Academy Award nominee Tom Cruise, the lions are the soldiers who do the fighting; the lambs are the unworthy politicians who send them into battle, and "Lions for Lambs" is a feature-film response to the war in Iraq, and to currents in post-9/11 American life.
Some say our society's values are reflected in the politicians we elect to represent us in Washington. As a lifelong political Independent, I've never believed all the best ideas or politicians were in any particular party. However, it's clear to all but those with their heads in the sand that our nation's democracy was hijacked during the final decade of the last century when few were paying attention, and that we're presently a Corporate Oligarchy led by Big Oil, which pulled George Bush and Dick Cheney right out of their Oil Patch and twice bought their way into our White House.
Perhaps it's time we changed ourselves, so that we can then begin to change those we elect to guide our nation, in our name? How to do this? Well, my friend and teacher since 1982, His Holiness the Dalai Lama, invited 40 of the world's most innovative thinkers to his Dharamsala, India, home-in-exile (where I was blessed to meet one-on-one with Him three times in late 1987, after returning from Tibet with my son Atisha, then 12, and daughter Malika, then 10, and asking Him how I could help; He asked me to write a book on the "Tibetan Crisis," which I did--"Tibet: The Final Solution"--for which he wrote the Foreword), to discuss precisely how we CAN begin to solve our world's problems.
That film, about another type of mind transformation, has been making the rounds of the world's best film festivals, today premiering in both New York and Los Angeles at one-day screenings. Thus, it's not out yet, but will be soon enough. Entitled "Dalai Lama Renaissance," it's narrated by Harrison Ford, and you can check out its video trailer at (http://www.youtube.com/watch?v=qBbuyZIRXjA). As Harrison notes in introducing one of the most thought-provoking films of our time: "Everybody thinks of changing humanity, and nobody thinks of changing her- or himself."
After watching the trailer, you might wish to click just to the right of it for "Related Videos." There, you'll discover a treasure trove of others, from Barbara Walters' interview with His Holiness, to a three-part "Dalai Lama--Exclusive Interview 1 (ONE)," in which H.H. responds to a devil's-advocate interviewer giving China's view of Tibet's current appeal for autonomy. Know that a couple of the videos there are unworthy, including some satirical garbage entitled "Steven Seagal--Dalai Lama," and another showing President Bush's meeting in the White House with His Holiness, into which the filmmaker unfortunately introduced out-takes from previous Dalai Lama teachings to make his points.
Several among those reading this know the Columbia University Chair of the Religious Studies Department, Bob Thurman, Ph.D. (father of Uma and four others), who's one of the half-dozen most dynamic speakers I've heard in my life. Bob gives a superb introduction to a priceless, four-part video you can view there entitled "Dalai Lama: The Four Noble Truths." Other excellent ones include: "10 Questions For the Dalai Lama," "Dalai Lama In Chicago," "Dalai Lama Visits UB 2006" (Univ. of Buffalo in upstate New York), "The Dalai Lama At Woodstock," "Dalai Lama In Harvard University," "Compassion--Dalai Lama, Muhammad Ali, Thomas Merton," "Dalai Lama Speaking In Long Beach," et. al. Kick back and relax with some good organic juice, and just surf there to your heart's content.
TWICE IN THE PAST YEAR, I've taken three-day, mind-transformation teachings with thousands of other fortunate beings in New York and San Francisco, given by the Dalai Lama. I've been blessed to take Atisha, Malika, her husband Rob, and other friends on this Esoteric List with me. Those teachings were among the most precious and meaningful I've received from any human being during my 66 years on this Earth. My longtime friend and teacher who gave them will be 73 next July, and will not be here forever, just as you and I will not. Thus, if you ever have the chance, do yourself an enormous favor.
As a lifelong social activist, I've provided the above overview in hopes it inspires you to prepare intelligently for the more difficult days ahead. . .for all of us, both in America and around our globe. My hope and prayer is for each of you to enjoy a stable, meritorious life. Alone, we're helpless to solve our world's growing problems, but collectively--once we've learned to open our hearts to ALL living beings, with equanimity--we CAN perhaps achieve the quantum leap in human consciousness I believe is now required to save humanity from itself. . .and leave our children and theirs a world worth inheriting.
Beyond that, my Sisters and Brothers, may you each be happy; may you be healthy; may you be peaceful and at ease, and may you be filled with loving kindness. May goodness and virtue flourish. Practice, as much as possible, loving kindness, compassion, empathic joy and equanimity, remembering these words from His Holiness: "The key to a happier and more successful world is the growth of compassion." Big Love; your friend, Dennis
Posted by dpaulson at November 10, 2007 11:10 AM
Medicare whistleblowers under attack
Monday, November 12, 2007
Medicare whistleblowers under attack
A day after legislation was introduced in the House calling for a moratorium on a controversial Medicare auditing program, the Atlanta-based company at the center of the California fight came out swinging. PRG-Schultz International officials, breaking their silence Friday for the first time since the controversy erupted this summer, disputed charges that it is mishandling the audits. They said that millions of dollars in overcharges they have identified at rehabilitation hospitals are returning money to the Medicare program just as Congress intended – and that only a fraction of its determinations are being overturned on appeal. Even so, they said the company has voluntarily agreed to forgo commissions that it is entitled to under its contract on decisions that are later overturned on appeal.
"They believe we are bounty hunters," N. Lee White, who heads U.S operations for PRG-Shultz International, said of California lawmakers and the California Hospital Association. "I don't appreciate the characterization."
California House members, prodded on the hospital association, have complained about the targeting of rehabilitation hospitals treating elderly patients recovering from knee and hip replacement surgery. More than 90 percent of those claims have been rejected by the auditors on grounds that they are not medically necessary. Auditor decisions have led to millions of dollars being withdrawn from the hospitals, putting some of them in financial jeopardy and altering treatment decisions for future patients.
On Thursday, Reps. Lois Capps, D-Santa Barbara, and Devin Nunes, R-Visalia, introduced a bill that would halt the program for a year while it is studied more deeply by CMS – the Centers for Medicare and Medicaid Services – which oversees it, and by the Government Accountability Office, the auditing arm of Congress. The two lawmakers charged that CMS has failed to answer questions about the program. The agency ordered a "pause" in PRG-Schultz's review of rehabilitation hospitals because of the concerns, but the lawmakers were unable this week to find out if the auditing has resumed.
White said the pause is still in effect, meaning that it has been extended longer than the month that was initially envisioned. The fact that the rejection rate has been so high, he said, is a reflection of how patients are being unnecessarily directed into the high-cost rehabilitation hospitals, taking money out of the Medicare program that otherwise would be going to serve other patients. But White noted that many of the 85 or so rehabilitation hospitals whose claims have been reviewed have had no rejections. "This implies that there are others who are doing it disproportionately wrong," he said. "Our charge is to find the people who have overcharged for whatever reason and recoup the money."
White also disputed critics' charges that it is the only for-profit company doing the audits. PRG-Schultz advertises itself as the largest recovery auditing company in the world, and White said it has many other government agencies and large companies among its client list. "We are a serious company, and we take this seriously," he said. The auditing program is part of a pilot project authorized by Congress that began in 2005 in California, Florida and New York. PRG-Schultz is the contractor selected for California, and it hopes to expand its work to other states when the program begins to expand nationally next year. The program was intended to help control skyrocketing Medicare costs by adding another tool to check for claims errors.
"To date, more than $230 million in overpayments to health care providers have been found in California alone," according to a recent handout the company said was distributed to California lawmakers. One criticism of the program is that it uses "recovery auditors" who are paid commissions. The hospital association said PRG-Schultz receives 25 to 30 cents on every dollar it recoups. In a two-hour meeting with McClatchy Newspapers on Friday, White declined to confirm that rate but didn't dispute it, either.
White acknowledged that auditors have focused heavily on rehabilitation hospitals' work with knee and hip replacement patients. He said that it is examining these claims because the GAO had identified the area as one likely to involve overcharges. "Although some joint replacement patients may need admissions to an inpatient rehabilitation facility, our analysis showed that few of these patients had comorbidities that suggested a possible need for the intensity of services offered by an IRF," the GAO said in an April 2005 report. Comorbidities are medical conditions in addition to the surgery that could complicate a patient's recovery. Because rehabilitation hospitals are prepared to handle the most needy of patients, their rates are much higher than alternative facilities such as nursing homes.
"The issue is not whether a joint replacement patient needs rehabilitation," White said. "It's the level of care needed. The issue is what is medically necessary for that patient."
Capps said in a statement Friday that she and Nunes introduced their bill because the auditing program was hurting health care for the elderly and the Centers for Medicare and Medicaid Services was refusing to answer questions about it. "I'm as concerned about ending Medicare fraud as anyone, but I'm also concerned when a poorly managed government program is running quality providers like the Santa Barbara Rehabilitation Institute out of business for no good reason," she said. Jan Emerson, spokeswoman for the hospital association, said, "We stand by our previously expressed concerns."
Medicare whistleblowers under attack
A day after legislation was introduced in the House calling for a moratorium on a controversial Medicare auditing program, the Atlanta-based company at the center of the California fight came out swinging. PRG-Schultz International officials, breaking their silence Friday for the first time since the controversy erupted this summer, disputed charges that it is mishandling the audits. They said that millions of dollars in overcharges they have identified at rehabilitation hospitals are returning money to the Medicare program just as Congress intended – and that only a fraction of its determinations are being overturned on appeal. Even so, they said the company has voluntarily agreed to forgo commissions that it is entitled to under its contract on decisions that are later overturned on appeal.
"They believe we are bounty hunters," N. Lee White, who heads U.S operations for PRG-Shultz International, said of California lawmakers and the California Hospital Association. "I don't appreciate the characterization."
California House members, prodded on the hospital association, have complained about the targeting of rehabilitation hospitals treating elderly patients recovering from knee and hip replacement surgery. More than 90 percent of those claims have been rejected by the auditors on grounds that they are not medically necessary. Auditor decisions have led to millions of dollars being withdrawn from the hospitals, putting some of them in financial jeopardy and altering treatment decisions for future patients.
On Thursday, Reps. Lois Capps, D-Santa Barbara, and Devin Nunes, R-Visalia, introduced a bill that would halt the program for a year while it is studied more deeply by CMS – the Centers for Medicare and Medicaid Services – which oversees it, and by the Government Accountability Office, the auditing arm of Congress. The two lawmakers charged that CMS has failed to answer questions about the program. The agency ordered a "pause" in PRG-Schultz's review of rehabilitation hospitals because of the concerns, but the lawmakers were unable this week to find out if the auditing has resumed.
White said the pause is still in effect, meaning that it has been extended longer than the month that was initially envisioned. The fact that the rejection rate has been so high, he said, is a reflection of how patients are being unnecessarily directed into the high-cost rehabilitation hospitals, taking money out of the Medicare program that otherwise would be going to serve other patients. But White noted that many of the 85 or so rehabilitation hospitals whose claims have been reviewed have had no rejections. "This implies that there are others who are doing it disproportionately wrong," he said. "Our charge is to find the people who have overcharged for whatever reason and recoup the money."
White also disputed critics' charges that it is the only for-profit company doing the audits. PRG-Schultz advertises itself as the largest recovery auditing company in the world, and White said it has many other government agencies and large companies among its client list. "We are a serious company, and we take this seriously," he said. The auditing program is part of a pilot project authorized by Congress that began in 2005 in California, Florida and New York. PRG-Schultz is the contractor selected for California, and it hopes to expand its work to other states when the program begins to expand nationally next year. The program was intended to help control skyrocketing Medicare costs by adding another tool to check for claims errors.
"To date, more than $230 million in overpayments to health care providers have been found in California alone," according to a recent handout the company said was distributed to California lawmakers. One criticism of the program is that it uses "recovery auditors" who are paid commissions. The hospital association said PRG-Schultz receives 25 to 30 cents on every dollar it recoups. In a two-hour meeting with McClatchy Newspapers on Friday, White declined to confirm that rate but didn't dispute it, either.
White acknowledged that auditors have focused heavily on rehabilitation hospitals' work with knee and hip replacement patients. He said that it is examining these claims because the GAO had identified the area as one likely to involve overcharges. "Although some joint replacement patients may need admissions to an inpatient rehabilitation facility, our analysis showed that few of these patients had comorbidities that suggested a possible need for the intensity of services offered by an IRF," the GAO said in an April 2005 report. Comorbidities are medical conditions in addition to the surgery that could complicate a patient's recovery. Because rehabilitation hospitals are prepared to handle the most needy of patients, their rates are much higher than alternative facilities such as nursing homes.
"The issue is not whether a joint replacement patient needs rehabilitation," White said. "It's the level of care needed. The issue is what is medically necessary for that patient."
Capps said in a statement Friday that she and Nunes introduced their bill because the auditing program was hurting health care for the elderly and the Centers for Medicare and Medicaid Services was refusing to answer questions about it. "I'm as concerned about ending Medicare fraud as anyone, but I'm also concerned when a poorly managed government program is running quality providers like the Santa Barbara Rehabilitation Institute out of business for no good reason," she said. Jan Emerson, spokeswoman for the hospital association, said, "We stand by our previously expressed concerns."
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