Intersection of Tax-Exemption and Fraud and Abuse Issues

Thomas Boyle


Mr. Boyle: Thank you, Alan. First, I want to thank Jan Wenzel from our firm who is a 1999 Health Law Certificate graduate for pulling together some research material.

With regard to Tom Hyatt’s comments, let me raise a couple of questions or comments to respond to those comments before I move into some of the other areas. First off, when you look at the test that was designed by the IRS in 1969 we really did not have many hospitals in large parts of the country that were participating in Medicare and Medicaid. In other words, you had a lot of hospitals that were not Medicare/Medicaid providers. You also at that time did not have a very high population that was covered by Medicare and Medicaid. UPMC today, my guess is, 50 to 60 percent of their revenue or patient flow is from Medicare or Medicaid. So of course you have today very few hospitals that do not participate in Medicare or Medicaid because the percentage of the population that has gone into those programs has grown far beyond what was projected in the mid-60s and certainly by 1969.



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