Governor Scott Announces Dr. John Armstrong as State Surgeon General

 On April 27, 2012, Florida Governor Rick Scott appointed Dr. John H. Armstrong M.D. to serve as State Surgeon General and Secretary of the Florida Department of Health. He will assume this role on May 23, 2012.

“Dr. Armstrong is recognized as a national expert in medical team training and public health preparedness for disasters, and his leadership will be a great asset to the citizens of Florida,” said Governor Rick Scott. “As an outstanding trauma surgeon, public health professional, educator and military veteran, he will be a great addition to my executive leadership team.”

Since 2011, Dr. Armstrong has been the Chief Medical Officer of the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) and Associate Professor of Surgery with the Morsani College of Medicine at the University of South Florida. He was a member of the Council on Public Health with the Florida Medical Association from 2008 to 2011 and is a member of the national Residency Review Committee for Surgery since 2011 and of the Board of Governors for the American College of Surgeons since 2010.

Dr. Armstrong served in the U.S. Army Medical Corps for 17 years, concluding his service with the rank of Colonel. His final assignment was Director of the U.S. Army Trauma Training Center (ATTC) in Miami. He led the development and implementation of a two-week award-winning team training program in trauma care for military medical units deploying to Iraq and Afghanistan. His military service includes Director of the Surgical Intensive Care Unit at Brooke Army Medical Center from 2002 to 2003 and at Walter Reed Army Medical Center from 1999 to 2001.

Within the American Medical Association, he is a Delegate from the American College of Surgeons to the AMA House of Delegates and a member of the House of Delegates compensation committee. He has served as a member of the Executive Committee of the National Disaster Life Support Educational Consortium, founding chair of the AMA Disaster Medicine Caucus, AMA Young Physician Trustee, and AMA Secretary.

Dr. Armstrong received a bachelor’s degree in economics from Princeton University and a medical degree from the University of Virginia School of Medicine. He completed his surgical residency at Tripler Army Medical Center in Hawaii and his fellowship in trauma/surgical critical care at the University of Miami/Jackson Memorial Medical Center, as well as the Master Educators of Medical Education Program at the University of Florida. He is a graduate of the U.S. Army Command and General Staff College,

“I am honored by the opportunity to serve as Florida’s State Surgeon General and look forward to advancing the department’s mission to make Florida the place to live, work, and play by ensuring the health and well-being of Floridians,” said Dr. Armstrong.



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The U.S. Government Accountability Office ("GAO") has designated Medicare as a high-risk program, in part because its complexity makes it particularly vulnerable to fraud.  Fraud involves an intentional act or representation to deceive with the knowledge that the action or representation could result in gain.  The deceptive nature of fraud makes its extent in the Medicare program difficult to measure in a reliable way, but it is clear that fraud contributes to Medicare’s fiscal problems. Reducing fraud could help rein in the escalating costs of the program.

This statement focuses on the progress made and steps that remain to be taken by the Centers for Medicare & Medicaid Services ("CMS")—the agency that administers Medicare--to implement recent legislation and GAO’s past recommendations to prevent or reduce fraud in Medicare.  It is based on relevant GAO products issued from April 2004 through April 2012 using a variety of methodologies, such as analyses of Medicare claims, review of relevant policies and procedures, and interviews with officials.  In April 2012, GAO also received updated information from CMS on agency actions.

The CMS has made progress in implementing several key strategies that GAO identified in prior work as helpful in protecting Medicare from fraud; however, some actions that could help combat fraud remain incomplete.

Provider Enrollment: GAO’s previous work found persistent weaknesses in Medicare’s enrollment standards and procedures that increased the risk of enrolling entities intent on defrauding the program. CMS has strengthened provider enrollment—for example, in February 2011, CMS designated three levels of risk—high, moderate, and limited—with different screening procedures for categories of providers at each level. However, CMS has not completed other actions, including implementation of some relevant provisions of the Patient Protection and Affordable Care Act (PPACA). Specifically, CMS has not (1) determined which providers will be required to post surety bonds to help ensure that payments made for fraudulent billing can be recovered, (2) contracted for fingerprint-based criminal background checks, (3) issued a final regulation to require additional provider disclosures of information, and (4) established core elements for provider compliance programs.

Pre- and Post-payment Claims Review: GAO had previously found that increased efforts to review claims on a prepayment basis can prevent payments from being made for potentially fraudulent claims, while improving systems used to review claims on a post-payment basis could better identify patterns of potentially fraudulent billing for further investigation. CMS has controls in Medicare’s claims processing systems to determine if claims should be paid, denied, or reviewed further by comparing information on claims with information on providers and Medicare coverage and requirements. These controls require timely and accurate information about providers that GAO has previously recommended that CMS strengthen. GAO is currently examining CMS’s use of prepayment edits to implement coverage and payment policies and CMS’s new Fraud Prevention System, which uses analytic methods to examine claims before payment. CMS could better use post-payment claims review to identify patterns of fraud by incorporating prior GAO recommendations to develop plans and timelines for fully implementing and expanding two information technology systems it developed. These systems are a central storehouse of Medicare and other data and a Web portal to the storehouse with tools for analysis.

Robust Process to Address Identified Vulnerabilities:  Having mechanisms in place to resolve vulnerabilities that lead to erroneous payments is critical to effective program management and could help address fraud. Such vulnerabilities are service- or system-specific weaknesses that can lead to payment errors—for example, providers receiving multiple payments as a result of incorrect coding. GAO has previously identified weaknesses in this process, which resulted in vulnerabilities being left unaddressed. GAO is evaluating the current status of the process for assessing and developing corrective actions to address vulnerabilities.

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A FAMILY MEMBER HOMECARE — Approved by the Joint Commission on Accreditation of Healthcare Organizations. A Broward, Miami-Dade and Palm Beach County Home Health Care Agency Serving Coconut Creek, Cooper City, Coral Springs, Dania, Davie, Deerfield, Ft. Lauderdale, Hallandale, Hillsboro, Hollywood, Lauderdale Lakes, Lauderdale-by-the-Sea, Lauderhill, Lighthouse Point, Margate, Miramar, North Lauderdale, Oakland Park, Parkland, Pembroke Park, Pembroke Pines, Plantation, Pompano, Sea Ranch Lakes, Southwest Ranches, Sunrise, Tamarac, Weston, Wilton Manors, Aventura, Hialeah, North Miami, Miami Lakes, Sunny Isles, Bal Harbour, Surfside, Boynton, Boca Raton, Lake Worth & Delray Beach With Comprehensive Home Health Care Services, In-Home Caregivers, Nursing & Home Health Aides for Seniors, Elderly, Disabled, Dementia & Alzheimer’s Patients. Licensed, Bonded, Insured