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Hospital chain allegedly admitted patients fraudulently to make more $$$


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2012 Dec 2, 11:28am   41,855 views  43 comments

by curious2   ➕follow (2)   💰tip   ignore  

http://www.cbsnews.com/8301-18560_162-57556670/hospitals-the-cost-of-admission/

For more than a year, we have been looking into the admission and billing practices of Health Management Associates. It's the fourth largest for-profit hospital chain in the country with revenues of $5.8 billion last year, nearly half of that coming from Medicare and Medicaid programs. We talked to more than 100 current and former employees and we heard a similar story over and over: that HMA relentlessly pressured its doctors to admit more and more patients -- regardless of medical need -- in order to increase revenues.

Health Management Associates owns 70 hospitals in 15 states. It's thrived buying small, struggling hospitals in non-urban areas, turning them into profit centers by filling empty beds. Generally speaking, the more patients a hospital admits, the more money it can make, a business strategy that HMA has aggressively pursued.

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41   MMR   2015 Mar 15, 8:41pm  

MMR says

Prime Healthcare Associates

Looks like the DCHS Prime sale fell through....It's pretty much a done deal that those hospitals will have to declare bankruptcy.

http://www.healthcarefinancenews.com/news/report-prime-backing-out-daughters-charity-deal

While I don't like to call a billionaire a victim, especially one who has a spotty track record, Prime was the best candidate to keep the hospital open and honor the pension agreements of the SEIU workers. Instead of agreeing to 5-7 years running the hospital the way it was running (hemorrhaging money) she asked them to do that for 10 years. Prime Healthcare would be required to operate the hospitals as they are now, despite the fact that they are losing more than $10 million a month. "[The Daughters chain] would lose nearly $3 billion over the 10 years the conditions are in effect. Conditions dictate operations far beyond the scope of what is typical, including service offerings, financial reporting, governance, staffing levels, on-call coverage, seismic compliance and insurance contracts."

......One thing that isn't going to happen, Collis said, is Harris applying less stringent terms to any other buyer of the Daughters' chain. The best a buyer could hope for, he said, is that the attorney general might provide some relief down the road.

Translation: Prime was the best offer available, even if they would have cut some of the safety net operations of the hospital to stay afloat.....now the hospital will crash and burn and it will be interesting to see what effect that will have on the pensions of the SEIU rank-and-file.

http://www.latimes.com/opinion/opinion-la/la-ol-prime-daughters-of-charity-kamala-harris-20150310-story.html#page=1

This article represents essentially the first time Prem Reddy was ever spoken about in a positive light in the LA Times.

42   curious2   2015 May 18, 4:28pm  

Update: Even before they start in on fraudulent admissions, "Hospitals grab at least $1 billion in extra fees for emergency room visits"

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