California Investigation Finds Prime Healthcare Misdiagnosed 22 Patients With Septicemia
Septicemia is a serious and often fatal condition that nets hospitals a high level of reimbursement when treated. According to the report, Prem Reddy, MD, chairman of Prime Healthcare, testified in 2005 that Prime hospitals were reimbursed approximately $9,000 per septicemia case.
The investigation by the California Department of Public Health looked at records from four Prime Healthcare hospitals and found that 22 of 120 patients diagnosed with septicemia showed few to no signs of infection. Inspectors said that seven patients diagnosed with septicemia at a Los Angeles County hospital showed symptoms of urinary tract infections, which are less serious and reimbursed at a much lower rate.
According to the report, HHS is investigating the healthcare system to determine whether it overbilled Medicare for treating septicemia in elderly patients. The probe began in Feb. 2011 after a study of medical records by Service Employees International Union showed that Prime hospitals reported septicemia rates among Medicare beneficiaries at more than three times the national average.
Read the San Francisco Chronicle report on Prime Healthcare and septicemia.
Related Articles on Fraud:
Understanding and Avoiding Retaliation Lawsuits for Healthcare Leaders
Gynecologist Dr. Latika Patel to Pay $750K to Settle False Claims Allegations
Trial Rescheduled for Former Mississippi Hospital CEO Accused of Kickback Scheme
© Copyright ASC COMMUNICATIONS 2015. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
To receive the latest hospital and health system business and legal news and analysis from Becker's Hospital Review, sign-up for the free Becker's Hospital Review E-weekly by clicking here.