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CAUGHT AGAIN: Rick Scotts Tricky Health Care Math Exposed

Last night, Florida Governor Rick Scott wasforced to backtrackon his laughable

estimate that Medicaid expansion would cost his state $26 billion after he was

repeatedlycalled outby independent news organizations and fact-checkers. But its

not the first time Scott has been caught red-handed fudging health care numbers -both as Governor and CEO of Columbia/HCA, hes had a problem with being honest

about math. The problem for Scott? He keeps getting caught.

Tuesday provided the most recent example:

January 2013: Rick Scott Cited Flawed Cost Estimates In Opposing Medicaid Expansion, Even After Legislative Analysts

Warned Him They Were Wrong.

Health News Florida Investigation Showed Gov. Rick Scott Continued Citing Debunked Medicaid Cost Estimates.

[Floridas] chief economist has warned the staff of Gov. Rick Scott that his Medicaid cost estimates are wrong, but

Scott keeps using them anyway, according to e-mails obtained by Health News Florida. Scott says he opposes

expanding Florida Medicaid because it would cost too much: $63 billion over 10 years, he says, with the state paying

$26 billion of that. But those numbers are based on a flawed report, according to a legislative budget analyst and

State Economist Amy Baker. A series of e-mails obtained by Health News Florida shows the analysts warned Scotts

office the numbers were wrong weeks ago, but he is still using them. He cited them in a Tampa Bay Times op-ed on

Sunday and at a Washington press conference on Monday. [Health News Florida, WUSF Public Media,1/8/13]

Floridas Chief Economist, House Budget Analyst Warned Cost Estimate Was Flawed.In several publicstatements, Scott has cited $26 billion as the 10-year cost of Medicaid expansion, saying he got it from the

Agency for Health Care Administration. AHCA estimated the total state and federal 10-year cost at $63

billion. AHCA is part of the executive branch and its chief, Liz Dudek, reports to Scott. The states chief

economist Amy Baker and Eric Pridgeon, a House budget analyst, sent e-mails to AHCA and Scotts staff Dec.20 advising that the estimates could not be used because theyre based on a flawed assumption. AHCA

assumed that the federal government would not come through with the money promised under the

Affordable Care Act to states that expand Medicaid. [Health News Florida, WUSF Public Media,1/9/13]

In E-mail, Scott Staffer Mike Anway Said He Would Continue Presenting Flawed Estimates As AnAlternate.Baker and Pridgeon asked AHCA to correct the assumptions and re -do the estimates Last

Friday, Scotts health policy and budget staffer Mike Anway sent an e-mail to Baker saying he wants to

present the AHCA numbers as an alternative estimate to whatever AHCA comes up with. Anway said he

believes the AHCA estimates because he doesnt trust the federal government to come through with the

money. [Health News Florida, WUSF Public Media,1/9/13]

After Outcry, Scott Administration Backtracked, Claimed They Would Review Different Cost Estimates.Tuesday

evening, after a day of criticism provoked by the article, Scott spokeswoman Sellers released this statement: []

AHCAs report concluded that adding people to Medicaid under the new law would cost Florida $26 billion over 10

years. Others have asked AHCA to use different assumptions to calculate different cost estimates. We look forward

to reviewing those cost estimates as well. [Health News Florida, WUSF Public Media, 1/9/13]

PolitiFact Florida: Scott Medicaid Cost Claims False, Based On Questionable Analysis Directed By His Own

Office. According to a review by PolitiFact Florida, [R]ather than have a fact -based discussion about the states

responsibilities when it comes to health care, it appears that Scott and his staff are making strange assumptions to

make the estimates higher than they actually will be. This is also a case where Scott cannot simply hide behind the

http://www.forbes.com/sites/brucejapsen/2013/01/08/rick-scott-outed-in-florida-for-inaccurate-medicaid-numbers/http://www.forbes.com/sites/brucejapsen/2013/01/08/rick-scott-outed-in-florida-for-inaccurate-medicaid-numbers/http://www.orlandosentinel.com/news/politics/os-scott-fudged-medicaid-math-20130110,0,7504543.storyhttp://www.orlandosentinel.com/news/politics/os-scott-fudged-medicaid-math-20130110,0,7504543.storyhttp://www.orlandosentinel.com/news/politics/os-scott-fudged-medicaid-math-20130110,0,7504543.storyhttp://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://health.wusf.usf.edu/post/legislative-analysts-told-scott-his-medicaid-estimates-are-wrong-hes-using-them-anywayhttp://health.wusf.usf.edu/post/legislative-analysts-told-scott-his-medicaid-estimates-are-wrong-hes-using-them-anywayhttp://health.wusf.usf.edu/post/legislative-analysts-told-scott-his-medicaid-estimates-are-wrong-hes-using-them-anywayhttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/scott-look-other-medicaid-cost-estimateshttp://health.wusf.usf.edu/post/legislative-analysts-told-scott-his-medicaid-estimates-are-wrong-hes-using-them-anywayhttp://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.orlandosentinel.com/news/politics/os-scott-fudged-medicaid-math-20130110,0,7504543.storyhttp://www.forbes.com/sites/brucejapsen/2013/01/08/rick-scott-outed-in-florida-for-inaccurate-medicaid-numbers/

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fact that he is accurately citing a study. His office directed the analysis, and it was notified that the assumptions

were questionable. Scott gets a pass on one thing: The cost to expand Medicaid is largely unknown. But using a

study to say that the expansion of Medicaid would cost Florida taxpayers over $26 billion is False. [PolitiFact

Florida,1/8/13]

Scott Hasnt Learned His Lesson He Tried The Same Act Last Year And Got Caught:

July 2012: Scott Falsely Claimed Medicaid Expansion Would Cost Florida $1.2 Billion Per Year.

PolitiFact Florida: Scott Repeatedly Made False Claim That Medicaid Expansion Would Cost Florida $1.9 Billion

Per YearDont Believe It.Gov. Rick Scott announced June 29, 2012, that Florida will not expand its Medicaid

program, saying that provision of the federal health care law would cost the state an additional $1.9 billion a year.

Its going to cost Florida $1.9 billion a year, Scott said July 2, 2012, while co-hosting CNBCs Squawk Box. Scott

repeated the $1.9 billion claim on Fox News June 29 and July 2, on CNN July 1 and in a July 1 official statement.

Dont believe it. [PolitiFact Florida,7/2/12]

PolitiFact: Scotts $1.9 Billion Claim Wildly High, Included Provisions Beyond Medicaid Expansion. Themost recent estimate from the state health care agency says a series of changes to Medicaid could wind up

costing about $1.4 billion a year, but that number includes things beyond the expansion to Medicaid that

Scott was talking about. For instance, about $400 million is tied to increased reimbursement payments to

Medicaid providers. But the state isn't required to pay that out. And another estimated $516 million will pay

for people who are eligible for Medicaid under its current provisions but have not enrolled. They would

remain eligible whether or not the program is expanded in Florida yes, the Medicaid expansion will cost

the state. But Scotts $1.9 billion claim appears to be wildly high. We rate this claim False. [PolitiFact

Florida,7/2/12]

Orlando Sentinel: Scott Greatly Exaggerated Medicaid Expansion Costs, Federal Government Would Bear Most

Expansion Costs Through 2016.Whilerefusing to implement Obamacare, Gov. Rick Scott has greatly exaggerated

the state's projected cost for expanding Medicaid to explain why Florida cannot afford to cover nearly two million

more low-income residents by the end of the decade. Scott said the state refuses to sacrifice its job creation,economic growth, quality education and low cost of living by spending $1.9 billion to expand Medicaid under the

new health-care law citing a price that is nearly double state and federal projections... Uncle Sam would bear

most of the expansion cost through 2016, and Florida's share would not reach $1 billion until 2016, according to the

Florida Agency for Health Care Administration. [Orlando Sentinel,7/2/12]

Weve Seen This Movie Before: When Scott Was CEO Of Columbia/HCA, The Company Was Defrauding Medicare,

Medicaid And Other Federal Programs:

Justice Department Charged Scotts Company With Defrauding Medicare, Medicaid, And Other Government

Health Programs. For those of us who've covered health care for a while, the rebirth of Rick Scott as politician

and soon-to-be governor of Florida is really quite breathtaking. It wasn't so long ago that Scott built the biggest

and brashest chain of hospitals in the land. Back in the '90s, Columbia/HCA, as the company was then called, had

hospitals from coast to coast and a reputation as one shrewdly run operation. But there was trouble under the

surface, as whistle-blowers and government investigations ultimately revealed. Columbia/HCA's profits were

fueled in part by kickbacks paid to doctors and inflated bills sent to Medicare and Medicaid, the Justice

Department alleged. [NPR,11/3/10]

Columbia/HCA Paid $1.7 Billion In Settlement Fines, Scott Left Company Shortly After FBI Raid.In the early

part of the last decade Columbia/ HCA paid a total of $1.7 billion in fines to settle charges the chain defrauded

Medicare and other government health programs. Scott, who wasn't charged with any crimes, left the company

http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://articles.sun-sentinel.com/2012-07-02/news/fl-scott-inflates-obamacare-cost-20120702_1_medicaid-expansion-medicaid-program-rick-scotthttp://articles.sun-sentinel.com/2012-07-02/news/fl-scott-inflates-obamacare-cost-20120702_1_medicaid-expansion-medicaid-program-rick-scotthttp://articles.sun-sentinel.com/2012-07-02/news/fl-scott-inflates-obamacare-cost-20120702_1_medicaid-expansion-medicaid-program-rick-scotthttp://www.npr.org/blogs/health/2010/11/03/131044677/florida-governor-rick-scott-columbia-hca-fraud-justice-departmenthttp://www.npr.org/blogs/health/2010/11/03/131044677/florida-governor-rick-scott-columbia-hca-fraud-justice-departmenthttp://www.npr.org/blogs/health/2010/11/03/131044677/florida-governor-rick-scott-columbia-hca-fraud-justice-departmenthttp://www.npr.org/blogs/health/2010/11/03/131044677/florida-governor-rick-scott-columbia-hca-fraud-justice-departmenthttp://articles.sun-sentinel.com/2012-07-02/news/fl-scott-inflates-obamacare-cost-20120702_1_medicaid-expansion-medicaid-program-rick-scotthttp://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2012/jul/02/rick-scott/rick-scott-says-medicaid-expansion-will-cost-state/http://www.politifact.com/florida/statements/2013/jan/08/rick-scott/rick-scott-ignores-flaws-state-study-says-medicaid/

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in 1997 only days after the FBI raided its headquarters in Nashville and more than 30 of its hospitals. [NPR,

11/3/10]

PolitiFact Florida: Claim That Scotts Company Committed Fraud True.Was Scott running Columbia/HCA

when it found itself at the center of a massive federal investigation? Yes. Did the company pay a record $1.7

billion in government penalties and fines? Yes, Columbia/HCA paid. And as we checked in this item, did his

former company commit fraud? Yes, it pleaded guilty to fraud charges as part of a settlement. [PolitiFact

Florida,1/10/10]

PolitiFact: Settlement Revealed That Columbia Fraudulently Billed Government Programs While ScottWas CEO. In December 2000, the U.S. Justice Department announced what it called the largest

government fraud settlement in U.S. history when Columbia/HCA agreed to pay $840 million in criminal

fines and civil damages and penalties. Among the revelations from the 2000 settlement, which all apply

to when Scott was CEO: Columbia billed Medicare, Medicaid, and other federal programs for tests that

were not necessary or ordered by physicians Columbia billed the government for home health care

visits for patients who did not qualify to receive them. [PolitiFact Florida,1/10/10]

Hiaasen: Scotts Company Perpetrated The Largest Medicare Fraud In The History Of Medicare. Miami

Herald columnist Carl Hiaasen wrote, Even by Florida's shaky standards, Rick Scott stands out as one of the

most outlandish characters ever to pop out of the woodwork Scott has spent long hours among attorneys

because the health care firm that he headed, Columbia/HCA Healthcare Corp., falsified patients' bills and gavekickbacks to doctors, among other scams. While the FBI was hauling away company records, Scott got the boot.

Columbia/HCA later paid a $1.7 billion fine for perpetrating the largest Medicare fraud in the history of

Medicare, no small feat. [Carl Hiaasen, Miami Herald,10/27/10]

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