Overbilling at women's health care group padded private equity profits while costing patients, insider says

The Florida attorney general’s office said it is investigating Florida Woman Care, one of the largest female health care operations in the state.

When seven expectant mothers in Palm Beach County had their babies delivered by midwives at Florida Woman Care, one of the largest female health care operations in the state, the cost should have been at least 20% less than what physicians charge.

Instead, Florida Woman Care documents show, the women were all billed at the higher doctor’s rate, unknowingly becoming part of an alleged billing tactic that Dr. Kenneth Konsker, a founder of the company-turned-whistleblower, says generated millions in higher — and improper — revenues.

Those seven deliveries in 2023 and 2024 represent a small portion of the billing improprieties Konsker said he has identified at Florida Woman Care in which patients were charged for seeing a doctor — care that carries a higher cost — when they actually saw a midwife or other lower-level provider.

“There’s no gray here,” Konsker told NBC News. “This is money that’s owed back to patients.”

Billing more than is appropriate for deliveries, office visits and other patient care is an example of a practice called "upcoding" — a major problem in American health care, experts say, and one reason the costs of care spiral higher every year. According to a recent report from the Government Accountability Office, improper billing practices cost taxpayers $100 billion in Medicare and Medicaid overpayments in 2023.