Remembering everything we learned in kindergarten and still need to know is not easy in these trying times. Sandwiched somewhere on the list between "Play fair" and "Warm cookies and cold milk are good for you" is "Don't take things that aren't yours."
Avoiding the temptation to take advantage of a situation requires willpower, fortitude and a sense of fairness. But all's fair in love, war and hospital accounting, if you can believe a recent whistleblower suit joined by the U.S. Justice Department. The suit suggests that a core group of investor-owned hospitals may have gone too far in trying to maximize Medicare reimbursement.
Specifically, the Justice Department says more than 200 hospitals in at least 37 states bilked the government for "many millions of dollars" over 14 years by inflating reimbursable claims and including unallowable claims on their annual Medicare cost reports.
The alleged fraud was carried out by hospitals preparing two sets of cost reports. The government contends padded books, including expenses for such items as advertising, room amenities and physician recruiting, were submitted to Medicare, while a second, more conservative set of records was kept by hospital chief financial officers in case of an audit.
The government still must prove this is outright fraud instead of simply gaming a complicated reimbursement system. Regardless of the suit's merit, the companies involved should act promptly to defend their policies and settle the differences. Dodging questions, running for cover or denying the truth can only create more confusion and ill will.
Columbia/HCA Healthcare Corp., Quorum Health Group and others (no matter what their tax status) that create reserve cost reports probably have good reasons that are grounded in generally accepted accounting principles. If so, now is not the time to back away.