Sen. Rick Scott (R-FL): Led a Hospital Company That Paid $1.7 Billion in Medicare Fraud Settlements, Now Chairs the Senate Committee on Aging

Sen. Rick Scott has represented Florida in the U.S. Senate since January 2019. Before entering politics he co-founded Columbia Hospital Corporation in 1988, which merged with HCA in 1994 to form the single largest for-profit hospital company in the United States at the time. In 1997, federal agents raided company facilities. Scott resigned as CEO that same year. Over the following six years, HCA paid more than $1.7 billion in federal and state settlements to resolve what the U.S. Department of Justice described as “the largest healthcare fraud case in U.S. history.” Scott now chairs the Senate Special Committee on Aging, the body with direct oversight of Medicare and Medicaid policy.

Columbia/HCA and the Medicare Fraud Settlements

On March 19, 1997, agents from the FBI, the IRS, and the Department of Health and Human Services served search warrants at Columbia/HCA facilities across the country. Federal investigators alleged the company had billed Medicare for laboratory tests that were not medically necessary and not ordered by physicians. The company had also engaged in “upcoding,” falsely representing patients as sicker than they were to collect higher government reimbursements. It billed Medicaid for home health visits for patients who did not qualify and for visits that were never provided.

Scott resigned as chairman and CEO in July 1997. He was never personally charged with a crime. In a civil deposition in 2000, Scott invoked his Fifth Amendment right against self-incrimination 75 times. A former HCA accountant testified that Scott had led “a criminal enterprise.”

The company entered two major settlements with the federal government. In 2000, HCA paid $840 million in fines, penalties, and damages to the federal government, along with $13.6 million to state Medicaid agencies. In 2002, the company paid an additional $631 million plus interest to the federal government, along with $17.5 million to state Medicaid agencies. Wikipedia notes that total civil lawsuit costs for the company exceeded $2 billion.

Scott personally left HCA with $9.88 million in severance and stock worth more than $350 million, according to public reporting.

Scott’s Campaign Finance in the Senate

Healthcare is not among the top donor sectors to Scott’s Senate campaigns. OpenSecrets data for the 2024 election cycle lists his leading contributor industries as correctional facility construction and management, homebuilding, and defense electronics. Scott is one of the wealthiest members of Congress, with a reported net worth of over $500 million.

Key Votes on Medicare and Medicaid

In August 2022, Scott voted against the Inflation Reduction Act. Among its provisions, that law allows Medicare to negotiate lower drug prices directly with pharmaceutical companies, caps the monthly cost of insulin for Medicare patients at $35, and limits annual out-of-pocket prescription drug costs to $2,000 for Medicare Part D enrollees. Every Republican senator voted against the bill.

In June and July 2025, Scott pushed an amendment to H.R. 1, the One Big Beautiful Bill Act, that would have added $313 billion in Medicaid spending reductions on top of the bill’s existing cuts. The amendment would have reduced the federal government’s Medicaid cost-sharing rate from 90 percent to 50 percent for new enrollees in Medicaid expansion states after 2030. Nine states have statutes that would automatically end their Medicaid expansion programs if the federal matching rate fell below that threshold. The Senate declined to take up the amendment during its marathon vote-a-rama. Scott voted for the final bill anyway.

The One Big Beautiful Bill Act was signed into law on July 4, 2025, as Public Law 119-21. The Center for American Progress calculates the law cuts $1.02 trillion from Medicaid and the Children’s Health Insurance Program over ten years. The American Medical Association estimates the law’s health provisions will cause 11.8 million Americans to lose health coverage by 2034.

What This Means for Floridians

The One Big Beautiful Bill Act imposes new work requirements, mandates six-month eligibility redeterminations (rather than annual ones), and adds administrative hurdles that apply to Medicaid programs in every state, including Florida. The CBO’s coverage loss projections account for these provisions nationally.

The drug pricing provisions Scott voted against in 2022 applied directly to Medicare Part D enrollees, a program with significant enrollment across Florida’s population of retirees and older residents.

Scott chairs the Senate Special Committee on Aging, which holds hearings, conducts oversight, and issues reports on the federal programs that most directly affect seniors: Medicare, Medicaid for long-term care, and Social Security.

What You Can Do

Sen. Scott’s Senate office can be reached to ask how he weighs the CBO’s projection of 11.8 million Americans losing health coverage under Public Law 119-21 and whether he supports restoring Medicare’s authority to negotiate drug prices.