Excessive billing at a women's healthcare organization inflated profits for private equity, resulting in increased costs for patients, as claimed by an insider.
In a shocking revelation, Dr. Kenneth Konsker, a founder of Florida Woman Care and a whistleblower, has accused the healthcare provider of engaging in widespread and improper billing practices. The allegations, which span over five years, allege that Florida Woman Care billed Medicare for services that were inflated or not provided at all. Konsker, an insider, has identified instances where patients were charged for seeing a doctor, when they actually saw a midwife or other lower-level provider. This practice, known as 'upcoding,' is a major problem in American healthcare and is one reason costs of care spiral higher every year. Florida Woman Care, one of the largest female health care operations in the state, allegedly billed seven expectant mothers for deliveries at the higher doctor's rate, despite the care being provided by midwives. The seven deliveries in 2023 and 2024 represent a small portion of the billing improprieties identified by Konsker at Florida Woman Care. The Florida attorney general's office is currently investigating Florida Woman Care, according to a spokeswoman. Last year, Konsker began providing documentation of Florida Woman Care's billing practices to state authorities and insurance companies. Unified Women's Healthcare, the company that owns Florida Woman Care, is owned by two private equity firms: Ares Management and Altas Capital. Neither responded to requests for comment regarding Konsker's allegations of widespread and improper billing at Florida Woman Care. Florida Woman Care agreed to pay $1.7 million to resolve the allegations, but the settlement made no determination of liability. The settlement came after Konsker was fired without cause in May 2024, as shown in legal documents. Konsker claims his termination came after he began complaining about management practices at the company, including payroll problems and other administrative issues. His warnings were reportedly unheeded. It's important to note that Florida Woman Care is part of Unified Women's Healthcare, a large OB-GYN practice management company operating in 21 states and responsible for 'nearly 1 in 21 births' in the U.S. A recent report from the Government Accountability Office states that improper billing practices cost taxpayers $100 billion in Medicare and Medicaid overpayments in 2023. This underscores the importance of addressing such issues in the healthcare industry. Dr. Konsker, in light of the settlement, suggested that Florida Woman Care should improve its compliance by auditing all care centers as the company grows. Only time will tell if these measures will be implemented to ensure transparency and accountability in Florida Woman Care's billing practices.
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