Hospital CEO Blames Obamacare Contractor for Medicare Payment Delays

NE Houston hospital unable to pay employees, blames new Medicare payment facilitator 

 

HOUSTON (KTRK) -- Dozens of employees at a hospital in northeast Houston have had to make it through the holidays without getting paid for weeks. The CEO of Saint Anthony's Hospital on Little York is blaming a new Medicare payment contractor for his payroll problems

Nearly 150 employees, ranging from doctors to nurses and administrators, haven't been paid in nearly a month, and the CEO says it's not his fault. 

For the neighbors around St. Anthony'S Hospital, the care has been convenient. 

"Since it was close and I was bleeding, I had to come over here," former patient Delores Cano said. But that could soon change. According to the CEO Jason Leday, more than 150 employees haven't been paid in nearly a month. 

"I understand that they have children and a house payment, bills. Not getting paid is wow," nearby resident Theresa Gutierrez said. 

The hospital is strapped for cash not because its not making money, but because Leday says a new Medicare payment facilitator named Novitas Solutions is taking too way long to pay out Medicare claims to the hospital. 

Leday says he's owed nearly $3 million in payments from Medicare and can't make payroll.

Read More: ABC 13 Houston News

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Hospital CEO Blames Obamacare Contractor for Medicare Payment Delays

Employees at a Houston area hospital haven't been paid for nearly a month, and the facility's top official blames a contractor building the financial management system for the Obamacare insurance exchange website for delaying Medicare reimbursements.

Saint Anthony's Hospital CEO Jason Leday told ABC-KTRK in Houston that Medicare owes the facility nearly $3 million and he can't meet payroll for more than 150 employees until the reimbursement bill is paid.

Leday says Novitas Solutions, the federal government's new Medicare payment contractor for the south-central U.S. region is to blame. The company was hired by the Centers for Medicare and Medicaid Services (CMS), reports The Weekly Standard.

The Texas Medical Association reports it has been getting other complaints about Novitas, which also operates the south-central region's Medicare website, which was launched two days before the HealthCare.gov site launched on Oct. 1. The regional Medicare website site also has problems similar to the troubles that initially plagued the Healthcare.gov site, and officials say it will not be fully operational until well into 2014.

Novitas was awarded a contract on Aug. 9 to build the backend system of the Obamacare website that handles accounting and premium payments to insurers. The company got the contract without having to bid for it under an emergency designation by CMS because of the fast-approaching Jan.1, 2014 launch of Obamacare.

The contract, valued at nearly $12 million, is just one of many contracts the company has with CMS, including some that cover doctor and hospital claim administration under the Medicare program.

Leday told KTRK that he's "very remorseful and disappointed" that he can't pay his employees. He said his own salary hasn't been paid in a year and that he has provided gas and grocery money for some employees from his own personal bank account during the past month.

"Its been hard for everybody," he told the television station. "This is a national issue that affects us locally. We are adapting to the new ways of doing business that have been created. We think we can be successful in 2013 and can take care of all of our employees through the transition."

Read Latest Breaking News from Newsmax.com http://www.newsmax.com/Newsfront/novitas-medicare-payments/2014/01/02/id/544827#ixzz2pJ1gKjEL
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Who is Novitas Solutions?

Novitas Solutions, Inc., (Novitas) proudly serves as an administrative services processing company for government-sponsored health care programs on behalf of the federal government. We employ more than 1,000 staff in the Mechanicsburg and Harrisburg, Pa. areas. Nearly 1,000 other associates are located in field offices in Hunt Valley, Md.; Pittsburgh and Williamsport, Pa.; Dallas, Texas; Milwaukee, Wis.; and Jacksonville, Fla. Novitas currently administers:

• The Medicare Administrative Contract (MAC) Jurisdiction L (JL), which spans four states and Washington D.C.;

• The Medicare Administrative Contract (MAC) Jurisdiction H (JH), which spans seven states, Indian Health Service (IHS) and Veterans Affairs (VA); and

• The payment processing for the Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens contract, as authorized under Section 1011 of the 2003 Medicare Modernization Act.

Overview of Novitas Solutions, Inc. in Camp Hill, PA

Novitas Solutions, Inc. filed as a Foreign for Profit Corporation in the State of Florida on Monday, May 14, 2012 and is approximately two years old, as recorded in documents filed with Florida Department of State. The filing is currently active as of the last data refresh which occurred on Sunday, September 01, 2013. A corporate filing is called a foreign filing when an existing corporate entity files in a state other than the state they originally filed in. This does not necessarily mean that they are from outside the United States.

Key People

Stephen Booma serves as the Director and has interests in other corporate entities including Navigy, Inc., First Coast Service Options, Inc. and five more corporations.

Guy Marvin is the Director of Novitas Solutions, Inc.. Guy's additional corporate interests include First Coast Service Options, Inc., Pirates Bay Homeowners Association, Inc. and two more corporations. Guy's past corporate affiliations include Capital Insurance Facilities, Inc.
 
The President of Novitas Solutions, Inc. is Sandra Coston. . Sandra has other corporate interests including First Coast Service Options, Inc., Diversified Service Options, Inc. and two more corporations.

The registered agent for the company is Thomas C. Anderson. Also known as a statutory or resident agent, the registered agent is responsible for receiving legal notifications regarding court summons, lawsuits, and other legal actions involving the corporate entity.

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Overview of Novitas Solutions Inc in Jacksonville, FL

This profile for Novitas Solutions Inc is located in Jacksonville, FL. Novitas Solutions Inc industry is listed as Nonclassifiable Establishments.

Key People

Guy Marvin serves as the Principal

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PARENT COMPANY:  Diversified Service Options

Overview of Diversified Service Options, Inc. in Jacksonville, FL

Diversified Service Options, Inc. filed as a Domestic for Profit Corporation in the State of Florida on Tuesday, May 19, 1998 and is approximately sixteen years old, as recorded in documents filed with Florida Department of State. The filing is currently active as of the last data refresh which occured on Sunday, September 01, 2013.

Key People

Deanna McDonald serves as the Chairman and has interests in other corporate entities including Blue Cross and Blue Shield of Florida Foundation, Inc., H.H. Holdings, Inc. , and First Coast Service Options, Inc.
 
Sandra Coston is the CEO of Diversified Service Options, Inc.. Sandra's additional corporate interests include First Coast Service Options, Inc., C2C Solutions, Inc.
 
The Treasurer of Diversified Service Options, Inc. is Jonathan Hogan. . Jonathan has other corporate interests including C2C Solutions, Inc. located in Jacksonville, FL

The registered agent for the company is Thomas C. Anderson. Also known as a statutory or resident agent, the registered agent is responsible for receiving legal notifications regarding court summons, lawsuits, and other legal actions involving the corporate entity.

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 SISTER COMPANY: First Coast Service Options

Overview of First Coast Service Options, Inc. in Jacksonville, FL

First Coast Service Options, Inc. filed as a Domestic for Profit Corporation in the State of Florida on Friday, May 22, 1998 and is approximately sixteen years old, according to public records filed with Florida Department of State. The filing is currently active as of the last data refresh which occurred on Sunday, September 01, 2013.

Key People

Sandra Coston serves as the President and has interests in other corporate entities including Diversified Service Options, Inc., C2C Solutions, Inc.
 
Guy Marvin is the Chairman of First Coast Service Options, Inc.. Guy's additional corporate interests include Novitas Solutions, Inc., The Florida Sunnyland Chapter of The Antique and Classic Boat Society, Inc. and two more corporations. Guy's past corporate affiliations include Capital Insurance Facilities, Inc.
 
The Director of First Coast Service Options, Inc. is Kathy Ledvina.  Kathy has other corporate interests including Novitas Solutions, Inc. located in Camp Hill, PA

The registered agent for the company is Thomas C. Anderson. Also known as a statutory or resident agent, the registered agent is responsible for receiving legal notifications regarding court summons, lawsuits, and other legal actions involving the corporate entity.

Whole Foods CEO Standing Up For Capitalism And Against Obama's Facist Policies

This is a rush transcript from "On the Record," January 17, 2013. This copy may not be in its final form and may be updated.

GRETA VAN SUSTEREN, FOX NEWS HOST: Whole Foods CEO John Mackey sparking controversy, comparing ObamaCare to fascism. But does he stand by that statement? He's going to tell you in just a minute. But first, 347 Whole Foods stores worldwide, 73,000 employees -- what is Whole Foods CEO John Mackey's secret to his enormous success? He not only heads a company that has changed the way people eat and shop, but now he's the author of a new book, "Conscious Capitalism." Now, we spoke with Mackey at one of the busiest Whole Foods in New York City.

(BEGIN VIDEOTAPE)  
VAN SUSTEREN: Now, what people may not know, but they will when they read your book, that this started in a very sort of -- almost in a garage, this business, right?

JOHN MACKEY, WHOLE FOODS CEO: Not quite like Apple computer, not that kind of garage. But we did start in an old house that was only a few thousand square feet back in 1978.

VAN SUSTEREN: Except that in one part of the book, it caught my attention that in the beginning, you were actually having to take your showers in the dishwasher?

MACKEY: That was the house. It was called SaferWay. And my girlfriend, who co-founded the company with me, we lived on the third floor. And there was no baths or showers in the store. So we -- when we had to bathe, we'd get into the -- climb into the Hobart dishwasher because it had the thing that would hang down, and we'd shower there.

VAN SUSTEREN: And the business (INAUDIBLE) interesting it -- it had sort of a rocky start. You got a flood.

MACKEY: Yes. When we relocated, Austin had a 100 year flood in 1981. We had eight feet of water in our store and we were completely wiped out, bankrupt.

VAN SUSTEREN: Why do you think the people, you talk about all the people who came in and helped once you had that flood, that it was almost sort of a breaking point the way I read it in your book, that the business could have gone belly up at that point.

MACKEY: It could have. We were bankrupt. No one was more surprised than me when we came up and there were dozens of customers helping us clean up the store. Why did they do it? Because they loved us. Whole Foods was important to them. They didn't want us to die. And if they hadn't helped us there may not be a Whole Foods and we may not be talking right now.

VAN SUSTEREN: Is that part of conscious capitalism? In the 1970's, sort of the left people thought that capitalism was the greedy people, the cheats, the people trying to squeeze every dime out of somebody else. But your book talks about conscious capitalism, which is something different.

MACKEY: Yes. Well, I think the critics of capitalism have hijacked the narrative. They judge business by the worst practitioners, by the Bernie Madoffs and the Enrons, and treat business as basically selfish, greedy, and exploitive. And it doesn't have to be that way. Business is greatest creator of value in the world. It's helped lift humanity out of poverty into prosperity. And we're making tremendous progress due to business and capitalism.

VAN SUSTEREN: Have you always felt that way about capitalism, embraced it and thought it was something inspiring and lifted people up?

MACKEY: No.

VAN SUSTEREN: What happened?

MACKEY: When I was young, I believed in the myth that business was selfish and greedy, and I certainly didn't want to be a business person. It was never my ambition. But once I did -- once we did start whole foods and I did have a meet a payroll, I was having trouble. I mean, we had our team members wanted higher pay and our customers saw our prices were too high and suppliers, we were small and they didn't want to give them discounts. So we lost half of the capital. We had $45,000 to start with and we lost $23,000 of it the first year. Renee and I only got paid $200 a month and people were saying I was, you know, kind of a bad guy now because I was a business person. So, I threw out that philosophy, didn't work, and I began to read widely and I read a number of free market economists like Frederick Hayek and Ludwig Von Mises and I discovered these explanations of the world worked a lot better than the philosophy I had previously. I learned the business is the greatest value creator in the world. We create value for customers, for employees, for suppliers, for investors, the communities we're part of. Business people are heroic. We're not the bad guys. We're the good guys. 

VAN SUSTEREN: Has capitalism specifically been demonized over the years?

MACKEY: Absolutely. It's blamed for all the problems in the world when he in fact capitalism is mostly the solution to most of the problems in the world. What's wrong in the world is not that there's too much capitalism. The problem in the world is there's not enough of it.

VAN SUSTEREN: Where does -- where is the problem then? How come so many people can't seem to make it in business? A lot of people do make it, but a lot of people don't. What's in the way?

MACKEY: Well, we live in a competitive marketplace where customers get to vote. If you don't create value for them, they're going to your competitors. So that's a great thing about business. Competition forces business to improve and get better, and if it doesn't, if you can't, if your competitors do a better job than you, you basically get voted out of existence, voted out of business. That's how we make progress in our society, though.

VAN SUSTEREN: I take it government can be in the way or helpful depending on your viewpoint. Compare for instance, the current decade of business with the prior decades? Have regulations increased and they've made it easier or harder for you to work?

MACKEY: Well, regulations have increased every year since I got in the business. Regulations are something that they don't get rid of them, they just add new ones on. That's one of the things we need to reform. We need to get rid of bad regulation. Instead they just layer on. It's harder to start up a business today than when I started 30, 40 years ago.

VAN SUSTEREN: Do you consider yourself a libertarian? Is that politically fair where you are?

MACKEY: There's so much baggage with that term. I think of myself as conscious capitalist.

VAN SUSTEREN: I know that's the name of the book, but define it for me.

MACKEY: Conscious capitalism recognizes that business has the potential for a higher purpose besides just maximizing profits and making money. It creates value for all of shareholders and not just the investors. It's a different philosophy of leadership where the leader serves the enterprise and is not just trying to line their own pockets. You have to create a culture that empowers people and allows human beings to flourish.

VAN SUSTEREN: In a publicly owned business under conscious capitalism, explain to me if a board or the executives of a company can make a decision to maximize profits or make one that maybe something that they think is something more in tune politically whether it's for the environment or for good health, whatever. Is that part of conscious capitalism you make a decision not to just go for the absolute dollar?

MACKEY: Actually, conscious capitalism rejects the premise behind that question.

VAN SUSTEREN: OK.

MACKEY: The premise is there's trade-offs and you have to negotiate between the trade-offs. If you're doing something for the environment it must come at the expense of the investors. The secret is good conscious leadership is to define win, win, win strategies so that all of these stakeholders simultaneously winning. That's sometimes not easy. It requires imagination and creativity, but that's the secret.

VAN SUSTEREN: Corporate taxes, have you thought about our corporate tax rate?

MACKEY: Of course. We have the highest corporate tax rate in the entire world now. Japan used to be number one and U.S. number two. They cut their rates. And now when you combine state and federal taxes, the highest corporate tax rates in the world.

VAN SUSTEREN: How does that affect your business? You're very successful, you're a rich man and how does it affect you and your employees?

 MACKEY: Every dollar we pay in taxes is a dollar that we can't give back to the customers in lower prices. It's a dollar we can't pay to our team members and higher wages and benefits. It's a dollar that we can't give back to the suppliers with lower prices. It's a dollar that we can't donate philanthropically to other organizations. All the stakeholders lose with higher taxes.

(END VIDEOTAPE)

VAN SUSTEREN: Up next, more with Whole Foods CEO John Mackey. This could spell trouble for many Americans. Mackey says ObamaCare will lead to less full time jobs. You need to hear this. That's next.

(COMMERCIAL BREAK)

VAN SUSTEREN: Yesterday, Whole Foods CEO John Mackey compared ObamaCare to fascism. Now his word choice set some on fire, so today, John Mackey explained.

(BEGIN VIDEO CLIP)

VAN SUSTEREN: This is a controversy, and I take it you dialed it back. I think you called the ObamaCare, I think the term you used was "fascist." You've now dialed that one back a bit?

MACKEY: That was a very poor choice of words on my part. I asked about the question, the differences do I think it's socialistic, and I gave a definition of socialism and a definition of fascism, and I think it's closer to that.

However, what I didn't realize, there's so much emotional baggage with that term dating back to Germany and Spain and Italy in World War II, that's just a loaded word, very politically incorrect, can't use it.

So, now I just want to say I believe in free enterprise capitalism or conscious capitalism the way we've articulated in the book. My problem with where health care is it's very government controlled and it's becoming more government controlled. So it's the opposite of free enterprise capitalism.

VAN SUSTEREN: What's the problem with that? I take it you're not a fan of ObamaCare and I read your op-ed in the "Wall Street Journal." Why don't you like ObamaCare?

MACKEY: Well, I think it's raising the costs for business. We have a great health care plan that our team members vote on every three years.

VAN SUSTEREN: Meaning your employees at Whole Foods.

MACKEY: Yes.

VAN SUSTEREN: OK.

MACKEY: They like it. It's been a good -- we've been able to customize it, keep it very affordable and we can include everybody in it, so it's a really good plan.

And now, with the health care reforms, they're adding additional costs onto it, like we have to cover free checkups, checkups have to be free for physical, things like that, and cover people that are up to age 26, even though they're just dependents that have grown up. Those aren't free. Those cost things.
And now there's going to be with lobbying and crony capitalism with the health care act you're going to see lots of new mandates on and determine what we can do. So our freedom to customize our health care plan to the best for our team members has been compromised.

VAN SUSTEREN: And this health care is a growing nightmare for a lot of businesses because of the costs.

MACKEY: Yes.

VAN SUSTEREN: And people really are unsure of what it's going to do to business. Do you have a sense how it's going to affect your business in two years, three years, or four years?

MACKEY: Yes, I can tell you generally what will happen. As the costs go up, you're not required to provide health care for part-time workers, under 30 hours. So there will be a strong temptation for businesses to keep people under 30 hours, so they don't have to provide health care. And you will have a lot of part-time workers and fewer full-time workers, a lot of people underemployed.
Whole Foods prided itself, we've always had a higher mix of full-time to part-time workers like 80 percent full-time and 20 percent part-time, which is very rare in retail. But as I suspect as our health care costs are driven up by health care reforms then we'll end up gradually lower our full-time ratio to a much lower number.

VAN SUSTEREN: In your book, do you think that your ideas are easily converted to other types of industries?

MACKEY: Absolutely.

VAN SUSTEREN: So your book is not just limited to your business?

MACKEY: Absolutely not. We wrote this book primarily to help businesses become more conscious. I think that capitalism is the greatest thing in the world, but we can make it better. If businesses can become more conscious on their higher purposes and begin to create value for all of their shareholders and stakeholders, the world is going to be transformed.

VAN SUSTEREN: If you could have five minutes with President Obama to talk about what would make it easier to get more jobs in this country, any hints for him?

MACKEY: Cut corporate income tax and dial back on regulations. Let entrepreneurs do their thing. They're creative individuals. We can solve all the problems that are in the world through our own creative entrepreneurship and through nonprofit social entrepreneurship. And we need to liberate the entrepreneurial spirit and the heroic spirit of business.

VAN SUSTEREN: Nice to see you, and good luck with the book.
MACKEY: Thanks, Greta. Good to see you, too.

Source: On The Record With Greta VanSusteren

CEO Blasts Obama Over 'Class Warfare'

By now, nearly everyone has seen the scathing letter investor Leon Cooperman sent to President Barack Obama earlier this week.

Cooperman, who's the founder of Omega Advisors, is well-known for his rags-to-riches, "American dream"-esque life story. His dad was a plumber in South Bronx, and he was educated in New York City's public school system. He went on to attend Columbia Business School, and worked for over 20 years at Goldman Sachs before leaving to start Omega. Currently, Forbes estimates his net worth at around $1.8 billion.

Yesterday, on CNBC, he jokingly admitted another step he was thinking about taking towards the American dream: running for president. Cooperman had tossed the idea around as a joke in an investor conference call three months ago.

He then shared his 9-point plan that would make up his presidential platform. (Looks like he's thought it through a lot!) And we actually found it a bit more erudite than other political platforms with the number 9 out there.

Read more: Business Insider