Investigators wondering: Fraud, bad medicine or Union manuevering at Calif. hospital chain?

The Los Angeles Times reports that  state and federal investigators are trying to determine whether "a serious health problem or multimillion-dollar Medicare fraud" is behind a reported spike in blood poisoning cases at hospitals operated by Prime Healthcare Services, "a Southern California hospital chain known for aggressive billing practices and cost-cutting."

Prime Healthcare officials said allegations of $18 million in fraudulent septicemia bills to Medicare are part of an effort by the Service Employees International Union, whose analysis spurred lawmakers to launch the investigation, "'to extort concessions from Prime Healthcare in contract negotiations.'" Prime's reimbursement management director said the high rates of septicemia instead "reflect the company's emphasis on 'early detection and treatment' of the illness" (Williams and Jewett, 10/12).

Kaiser Health NewsThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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