HCA faces scrutiny about medical necessity of some cardiac procedures done at some hospitals

HCA Holdings Inc., the biggest for-profit U.S. hospital operator, told investors that federal prosecutors in Miami are probing the "medical necessity" of cardiology procedures performed at several of its hospitals in Florida. The company made an unusual statement defending its operations in anticipation of a New York Times article that appeared online late Monday.

The New York Times: Hospital Chain Inquiry Cited Unnecessary Cardiac Work
HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports (Abelson and Creswell, 8/6).

The Wall Street Journal: HCA Discloses Federal Probe
HCA Holdings Inc. said federal prosecutors in Miami are probing the "medical necessity" of cardiology procedures performed at several of its hospitals ... The company, which is the biggest for-profit U.S. hospital operator with 163 facilities, also made an unusual statement defending its operations in anticipation of a New York Times article that appeared online late Monday. The statement addressed potential questions on its cardiac care, emergency-room billing practices and treatment of uninsured patients. In the wake of the disclosures, HCA shares fell 4% to $25.55 in 4 p.m. composite trading on the New York Stock Exchange, despite second-quarter earnings that were up from last year, largely based on improved patient volumes (Mathews and Weaver, 8/6).

The Associated Press/Los Angeles Times: HCA Holdings Questioned About Need For Some Cardiology Services
Hospital chain HCA Holdings said the Justice Department wants information about heart procedures performed at some of its locations. HCA said it has been asked about reviews that assessed the medical necessity of some cardiology services. The questions came from the U.S. Attorney's office in Miami, the company said. The New York Times published a report late Monday citing evidence that some HCA hospitals in Florida were performing unnecessary, and sometimes dangerous, heart procedures with the aim of driving up profit for the hospital chain (8/7).

Reuters: U.S. Probes HCA Heart Procedures, Hospital Billing
U.S. authorities are probing whether heart procedures performed at HCA Holdings Inc hospitals were medically necessary and are investigating the company's billing practices, the company said on Monday. Shares of HCA, the largest U.S. for-profit hospital chain, fell as much as 10 percent after the news. HCA, in an unusual move, issued a detailed rebuttal defending itself ahead of the publication of a New York Times article that said a complaint by a nurse at an HCA hospital in Florida led to an internal investigation that uncovered evidence of unnecessary heart procedures being performed at some of the company's hospitals (Berkrot and Kelly, 8/7).

Bloomberg: HCA Says Heart Procedures In Florida Scrutinized by U.S.
A U.S. attorney in Miami has asked HCA Holdings Inc. (HCA), the nation's biggest hospital operator, for information on the "medical necessity" of the cardiac procedures done in its Florida hospitals, according to a regulatory filing. The disclosure came as the New York Times reported that Nashville, Tennessee-based HCA had investigated numerous cases in which doctors conducted unnecessary surgeries in its facilities, and didn't contact patients, medical authorities or insurers about the results of those probes ..."I think we have to look at it seriously" in weighing the potential risk for the company, said Sheryl Skolnick, a CRT Capital Group LLC analyst in Stamford, Connecticut, in a telephone interview (Nussbaum, 8/7).