Rick Scott

During Rick Scott's decade as founder and CEO of Columbia/HCA, the corporation systematically defrauded Medicare and Medicaid across hundreds of hospitals nationwide. The specific documented practices: cost report fraud (claiming marketing costs as reimbursable); illegal physician kickbacks (paying doctors for referrals, including hospital ownership stakes); pneumonia "upcoding" (billing Medicare for more serious diagnoses than warranted); false facility utilization claims; and fraudulent home health agency billing. In December 2000, HCA subsidiaries pled guilty to multiple federal felony counts. In 2002–2003, the company paid an additional $631 million in civil penalties. Total government recovery: $1.7+ billion — the largest Medicare fraud settlement in American history at the time. The company's guilty pleas covered conduct that occurred throughout Scott's tenure. Scott resigned in July 1997, nine days after FBI agents raided 18 Columbia hospitals and 15 other locations across six states. He was never charged. He has maintained he was unaware of the fraud.

• —December 14, 2000: Columbia Management Companies Inc. and Columbia Homecare Group Inc. (HCA subsidiaries) entered guilty pleas to multiple federal felony counts.
• —Criminal fine breakdown: $27.5 million for the pneumonia upcoding conspiracy; $30 million for the physician kickback conspiracy (paid 2001); total criminal fines $840 million including civil damages.
• —Civil settlement: $631 million additional payment, finalized December 2002 / June 2003.
• —Total government recovery: $1.7+ billion — the largest Medicare and Medicaid fraud settlement ever recorded at that time.
• —Fraud categories documented by DOJ: cost report fraud, physician kickbacks (hospital ownership stakes as quid pro quo), pneumonia diagnosis upcoding, home health agency kickback schemes, false facility-use data, fraudulent management fee billing.
• —The FBI executed search warrants on 18 Columbia hospitals and 15 other locations across six states on July 16, 1997. Nine days later, the Columbia/HCA board forced Scott to resign.
• —Rick Scott was never indicted, never questioned by federal prosecutors in the criminal case, and was never personally charged with a crime.
• —Scott's stated position: he was unaware that fraud was occurring at the company he founded and ran.

When Rick Scott resigned as Columbia/HCA CEO in July 1997, he held approximately 10 million shares of HCA stock — worth an estimated $300 to $350 million at the time of his departure. He also received a cash severance of approximately $5 million and a five-year consulting contract valued at $4.75 million ($950,000 per year). The total package: over $300 million. The company Scott was leaving had, over the preceding decade, systematically overcharged Medicare and Medicaid by more than a billion dollars. The value of Scott's stock position was built during the period of systemic fraud that inflated the company's revenues. No clawback mechanism existed. No legal instrument required Scott to return proceeds tied to fraudulent conduct. He was legally entitled to every dollar. The patients and programs defrauded had no equivalent protection.

• —Scott's stock position at resignation: approximately 10 million HCA shares, valued at $300–350 million.
• —Cash severance: approximately $5–9.88 million (most sources cite ~$5.13 million).
• —Consulting contract: $950,000 per year for five years = $4.75 million.
• —Total estimated personal gain at departure: $300M+ (primarily stock).
• —The stock value was accumulated during the period of systematic Medicare fraud — from HCA's founding in 1987 through Scott's 1997 departure.
• —No fraud-related clawback. No civil forfeiture action against Scott personally. No court order required return of proceeds.
• —By contrast, the hospitals Scott left behind paid $1.7 billion to the government — costs borne by the corporate entity, not by the CEO who built it.
• —Scott subsequently used his personal wealth to fund his 2010 Florida gubernatorial campaign ($70M+ of his own money), winning the race.

On July 27, 2000 — after HCA subsidiaries had already pled guilty to multiple felony counts but before the final civil settlement — Rick Scott was deposed in a civil lawsuit: Nevada Communications Corp. v. Columbia/HCA. Under oath, Scott invoked his Fifth Amendment right against self-incrimination 75 times. His attorney cited the pending HCA fraud proceedings as justification for the refusals. Scott was not, at this point, a criminal defendant. He was being asked questions in a civil proceeding. The invocations are a matter of public record. When Scott ran for Governor of Florida in 2010, this fact became campaign fodder. PolitiFact investigated and rated the claim TRUE. Scott's explanation: he was advised by counsel not to answer.

• —Date: July 27, 2000.
• —Proceeding: Nevada Communications Corp. v. Columbia/HCA — a civil lawsuit, not a criminal case.
• —Fifth Amendment invocations: 75 confirmed.
• —Context: the HCA criminal guilty pleas had already been entered; the civil settlement was still pending.
• —Scott was not under criminal indictment at the time of the deposition.
• —Attorney's stated justification: the pending HCA fraud cases created exposure for Scott if he testified under oath.
• —PolitiFact (June 2014) investigated the "75 times" claim and rated it TRUE.
• —Scott's explanation when asked during his gubernatorial campaign: "On advice of counsel, I pled the Fifth."

Rick Scott was elected Governor of Florida in 2010, using over $70 million of personal wealth — built on HCA stock — to self-fund his campaign. He served two terms as Governor (2011–2019), during which he fought Medicaid expansion under the Affordable Care Act, made Florida a lead plaintiff in ACA repeal litigation, and ran ads claiming the ACA would "kill jobs." In 2018 he was elected to the US Senate. In 2022, Scott published his "Plan to Rescue America," which proposed sunsetting all federal legislation every five years — including Medicare, Medicaid, and Social Security — requiring Congress to re-authorize them or watch them lapse. Senate Republican leadership, including Mitch McConnell, publicly disavowed the plan. Also in 2022, Scott voted against the Inflation Reduction Act, which granted Medicare the authority to negotiate lower prescription drug prices for the first time. In 2024–2025, Scott proposed an additional $313 billion in Medicaid cuts. The man who presided over $1.7 billion in Medicare fraud, walked away with $300 million, and invoked the Fifth Amendment 75 times when asked about it is now in the United States Senate shaping Medicare policy.

• —2010 Florida gubernatorial campaign: Scott self-funded $70M+ using personal wealth built on HCA stock proceeds.
• —As Governor: made Florida lead plaintiff in ACA repeal lawsuit; initially refused ACA Medicaid expansion; signed legislation restricting abortion, which reduced Medicaid-covered services.
• —2022 "Plan to Rescue America": proposed 5-year sunset on all federal legislation including Medicare, Medicaid, Social Security. Senate Minority Leader McConnell: "Not a single Senate Republican voted for that plan."
• —2022: Voted against the Inflation Reduction Act — which included provisions allowing Medicare to negotiate drug prices for the first time.
• —2024–2025: Proposed $313 billion in Medicaid cuts as part of budget reconciliation negotiations.
• —2025: Introduced "Protect Our Seniors Act" requiring a supermajority vote to reduce Medicare benefits — framed as protection, but structurally limits the program's ability to adapt.
• —As of May 2026: Scott's voting record consistently opposes Medicare/Medicaid expansion, cost-containment through price negotiation, and ACA-related coverage extensions.
• —No statement from Scott acknowledging any connection between his HCA tenure and his Senate healthcare voting record.