KHN Morning Briefing

Summaries of health policy coverage from major news organizations

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).

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