A whistleblower allegedly exposed the up -coding in Florida Women’s Care, which indicated the investigation.
Dr. Kenneth Consker, once a co -founder of Florida Women’s Care, claims that the health care organization raised patients more than years, producing millions of additional taxes for private equity firms that now own the company. Consor, who became a whistleblower, says that the doctor’s rate was received more and more on the patients, even when they were treated by the midwife or other lower -level suppliers. Their charges cover office visits, pre -birth care, supply and other services, suggesting a widespread misuse of billing methods on women’s care, called “up coding”.
Up to coding occurs when the bill to care for the providers is far more expensive than the fact that was reached. In the United States, this exercise pursues health care costs and puts pressure on public programs. The Government Accountability Office reported in 2023 that unknown billing costs about $ 100 billion in payments to taxpayers than medical and medicated. Experts say such procedures are often hidden until the internal documents come forward, which makes it a whistleblower, such as a whistleblower, in exposing potential fraud.
Consker began sending evidence to Florida’s Attorney General and several insurance companies last year, highlighting examples that affect them more than 150 patients and could contain more than 100 million inappropriate billing. He shared the spreadsheet by comparing the patients’ records with the benefits of insurance companies, noting the contradictions where the caregivers listed in the records reflect the insurance documents. In some cases, the midwife was supplied, but the bills instead filed the doctors, promoting charges without medical justification.
Florida’s Attorney General confirmed an active investigation into Florida Women’s Care through its Medicated Fraud Control Unit. Meanwhile, Florida Women Care has denied wrongdoing, saying that it has not found any evidence to support the claims of which. The company emphasized that it maintains compliance with the programs, audits and staff to ensure proper billing. Private equity firms, who own the company, IRS management and Ultas Capital, have refused to comment.
Consker was eliminated by Florida Women’s Care in May 2024, after raising concerns about billing, payroll, and administrative methods. His firing gave rise to legal disputes. It filed a defamation case against the company, and claimed that executives spread false information for patients and colleagues, while the company had sued him for allegedly interfering with employees’ contracts.
After his departure, consumers practically returned to work briefly without paying for the patients, many of whom were expecting children. A former colleague, Dr. Emily Woodbury, described a chaos atmosphere in which staff suffered a heavy workload and patients were at risk of unsafe care. “Private equity comes and benefits – they carry you, a doctor, a burden,” said Woodbury. He said that doctors, who usually managed ten delivery in a month, were suddenly responsible for fifty, which raises concerns about stress and safety.
Sudden changes left patients anxious. The late patient, Misty Pes, said that when she found out that Consker was no longer part of the exercise, she was afraid of her health. Now she follows her care at her new Boka Ratan clinic, where she relieves her to preserve her children’s ability in the future.
Consumer warns that private equity ownership pressure can push medical methods into unsafe financial and medical conditions. He believes that patients ‘charges are essential to controlling the cost of billing and transparency and protecting patients’ care. Their allegations highlight the ongoing tension between corporate property, health care costs, and the safety of patients, which reflect the challenges in ensuring moral methods in major health care organizations. This issue draws attention to the importance of monitoring billing methods and exposing whistleblowers, as unlicensed financial concessions can compromise on both the safety and confidence of patients in the health care system.
Sources:
Internal individuals say the increase in women’s health care group pads private equity profits while the price of patients
Women’s Healthcare Group organized over-billing and up-to-coding-self-financing projects.
