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).

This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from major news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.