HCA Healthcare Pays $1.7 Billion in Largest Medicare Fraud Settlement in U.S. History

The Department of Justice announced that HCA Inc. (formerly Columbia/HCA), once led by Rick Scott, agreed to pay the United States $631 million in civil penalties and damages, bringing the total recovery to $1.7 billion when combined with earlier settlements—the largest healthcare fraud case in U.S. history. The fraud schemes, which occurred while Scott served as CEO, included billing Medicare for tests that were not medically necessary or ordered by physicians, attaching false diagnosis codes to inflate reimbursements, illegally claiming non-reimbursable marketing costs as community education expenses, and billing for home health visits for patients who didn’t qualify. Columbia/HCA pleaded guilty to at least 14 corporate felonies as part of a 2000 settlement. Federal investigators served search warrants on March 19, 1997, and four months later the board pressured Scott to resign. Scott received a $9.88 million severance and retained 10 million shares worth over $350 million, despite invoking the Fifth Amendment 75 times in a 2000 deposition. He was never personally charged with wrongdoing. Scott later became Florida Governor (2011-2019) and U.S. Senator (2019-present), making him the only person to oversee the largest hospital fraud in history and ascend to major political office. The case remains the largest fraud settlement for a hospital corporation in U.S. history, establishing that systematic Medicare fraud by for-profit hospital chains could result in massive settlements but no executive accountability.

2026-09-16 update — the “$1.7 billion” figure decomposed. This total is not one settlement; it is the sum of the December 14, 2000 action ($840M: $95,336,432 criminal fines + $745M civil, see 2000-12-14–columbia-hca-guilty-plea-840-million-largest-healthcare-fraud-to-date for the criminal-plea detail), this June 26, 2003 civil settlement ($631M, broken out by DOJ as $356M cost-report fraud + $225.5M kickback allegations + $17M wound-care billing + smaller named-facility matters), and a separate $250M CMS administrative settlement. Citing “$1.7 billion” as a single figure without this breakdown collapses three distinct, separately dated legal actions into one number — exactly the failure mode this corpus has been burned by before (feedback_real_statistic_mutated_by_paraphrase). Whistleblowers received a combined $151,591,500 in qui tam shares (James Alderson and John Schilling, $100M combined; Dr. James Thompson, $41.5M; smaller shares to Gary King, Ann Mroz, Joseph Parslow, Francesco Lanni, Michael Marine, and relator Pogue).