NC Attorney General's office: HCA's annual report conflicts with court statements

ASHEVILLE - HCA Healthcare, the owner of Mission Health, made statements in its annual report that contradict what it has told a court about its trouble with federal regulators, the North Carolina Attorney General's Office has said.

Assistant Attorney General Llogan R. Walters said in an Aug. 28 letter that HCA either failed to explain in its annual report how it violated Medicare and Medicaid rules − or it "misstated its position" to N.C. Business Court.

In a statement Aug. 29, HCA did not deny that it should have reported its non-compliance with federal regulators.

Dogwood Health Trust, formed to handle the $1.5 billion in proceeds of the for-profit HCA's 2019 purchase of the nonprofit Mission, is also responsible for ensuring the company follows the purchase agreement.

In July, an independent monitor hired by Dogwood reported that HCA was potentially out of compliance with the agreement regarding issues of emergency and oncology services, Medicare and Medicaid compliance and charity care. Dogwood passed on the findings to the office of AG Josh Stein for review. Stein is suing HCA over the purchase agreement, particularly allegations that it failed to maintain promised levels of emergency and cancer care. Stein is also the Democratic candidate for governor, running against Republican Lt. Gov. Mark Robinson.

It was during that review that Walters, the assistant AG, said the office found another potential problem. In his Aug. 28 letter written to Dogwood Board Chair John F.A.V. Cecil, Walters noted that HCA said in its annual report that it had followed Section 7.13(h) of the purchase agreement. That section requires all facilities to “remain enrolled and in good standing in the Medicare and Medicaid programs," the state prosecutor said.

"But HCA told the Business Court that Section 7.13(h) requires Mission Hospital to 'comply with the (Centers for Medicare and Medicaid Services’) Conditions of Participation," he said.

The Centers for Medicaid and Medicare Services determined in 2023 that Mission Hospital had not complied with the conditions and, in fact, assigned an "immediate jeopardy" status, saying some failures had resulted in patient deaths. The hospital has since come back into compliance.

"HCA did not dispute that conclusion," Walters said, adding that unless HCA "misstated its position" to the court, it should have self-reported the noncompliance with Section 7.13(h) of the purchase agreement.

HCA spokesperson Nancy Lindell in a statement issued to the Citizen Times did not address whether the company should have said in its annual report that it was out of compliance with Medicare and Medicaid rules. Or if that was different that what it told the court. Instead, Lindell noted HCA was currently performing at level expected by the federal regulators.

"Mission Hospital is in compliance with governing regulations and at no time was the hospital suspended from treating Medicare or Medicaid patients," she said.

The Citizen Times reached out Aug. 29 to Dogwood.

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Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: NC Attorney General's office: HCA's annual report conflicts with court statements