A premier Las Vegas hospital co-founded by a mobster who helped run the infamous casino skim to avoid federal taxes has essentially lost its initial appeal of audit findings it overbilled Medicare by nearly $20 million in just a two-year period.
“The appeal decision is unfavorable,” an independent review contractor for the U.S. Centers for Medicare and Medicaid Services wrote bluntly on the first page of the 83-page decision on the plea by Sunrise Hospital and Medical Center. Plus this stinger near the end: Sunrise “either knew or could reasonably be expected to know that the item or service would not be covered.” The decision lowered the total overpayment that Sunrise is on the hook for from $23.6 million in the original audit to $19.7 million. But it further said Sunrise couldn’t hit up the patients for any of the disallowed overbilled amount.
Even at $19.7 million, the overbilling amounted to 8% of the $245 million amount Sunrise billed the feds for Medicare in the audit period, 2017 to 2018. This is serious coin.
But it’s a fraction of the estimated 75% rake-off at the height of the casino skim starting in the 1940s, by which organized crime with hidden interests grabbed casino house winnings before counting profits, committing massive tax evasion. One of the leading figures in that endeavor was Morris Barney “Moe” Dalitz (1899-1989), an organized crime character who moved from the Midwest to Las Vegas in the 1940s. He eventually got control of several long-gone hotbeds of the skim, including Wilbur Clarke’s Desert Inn and the Stardust Resort and Casino. (The Stardust became a model for the mob-skimming casino in the 1998 movie Casino, starring Robert De Niro and Sharon Stone.) Dalitz’s life is the subject of a 2009 biography by Michael Newton whose title says it all: Mr. Mob: The Life and Crimes of Moe Dalitz.
In 1958, Dalitz was one of three co-founders of Sunrise Hospital, just a mile east of the Las Vegas Strip on East Desert Inn Rd. Neither his name nor his key role in starting the hospital comes up in a search of the facility’s extensive website. Originally a nonprofit, Sunrise is now owned by HCA Healthcare, the giant for-profit national health care provider with a long history of overbilling problems. Continue readingShare on Facebook