"Domestic Care" refers to the health care services a hospital provides to its own employees.
Some hospitals charge their employees only what it actually costs the hospital to provide the service or supply.
Other hospitals charge their employees at full retail but give the employees a discount off of the charges that is comparable with the discount it gives to other insurance companies in its market.
Still others charge their employees full retail and give them little or no discount at all.
By paying itself at a higher rate the hospital is able to inflate its 'wage index' value and generate additional payments from Medicare.
My name is Joe Vincoli and I am a former Director of Managed Care at a hospital.
I have been working with John Schilling and Sal Barbera of Whistleblower Solutions since 2008 to address this scheme which is being used by many hospitals across the country.
John and Sal are both successful former Medicare whistleblowers (see here) who were rewarded by the US Government for stepping up and 'doing the right thing'.
If you are aware of a hospital(s), a provider owned PPO or TPA, or any claims payer that is engaged in such a scheme and you have factual knowledge concerning the rates that the hospital's employees are being charged as compared to other payers in the hospital's market, then you may be able to file a Medicare Whistleblower case.
These hospital plans usually have names like: "XYZ Healthnet", or "Anytown Hospital Direct".
However, some hospitals even use a health insurer's PPO network but have their employees' claims repriced at a smaller discount than the discount that applies to the insurer's other covered companies, so even a situation like that might qualify.
If you have such information and knowledge about a hospital engaging in this scheme you could help your co-workers, taxpayers, and yourself by contacting Whistleblower Solutions at 239-598-5043 .
The information contained in this web site was prepared by Joe Vincoli and is provided for informational purposes only and is not intended to constitute legal advice. Joe Vincoli is not a lawyer. EthicSolutions, LLC (dba, "Whistleblower Solutions") is not a law firm. Any communications with Joe Vincoli or EthicSolutions LLC by email, telephone, or through this site is not intended to create any relationship whatsoever with Joe Vincoli or EthicSolutions LLC, and any information sent to Joe Vincoli or EthicSolutions LLC through their respective web sites or via email is not secure. EthicSolutions LLC will use any provided information to investigate and determine whether they wish to engage in a partnership with you and execute a written agreement. Until a written agreement is reached and executed by both parties EthicSolutions has no relationship with you.
Joe Vincoli Website on Hospital "Domestic Care"/"Wage Index"
Medicare Fraud Scheme