Senate Holds Hearing on Prime Healthcare’s Billing, Medical Practices
At a Senate health committee hearing onÂ Friday, California senators scrutinized billing and medical practices by hospital chain Prime Healthcare Services, the Los Angeles Times reports.
The hearing came one day after Prime announced the resignation of CEO Lex Reddy.
Prime recentlyÂ has come under increased scrutiny for allegedly submitting fraudulent bills to Medicare and Medi-Cal, California's Medicaid program.
Last year, the California Department of Public Health looked into claims that Prime "upcoded" patient bills and referred the matter to CMS officials (Terhune, Los Angeles Times, 2/25).
In addition, the FBI has begun questioning former Prime staff members about the health system's billing practices.
Details of the Hearing
During the hearing, lawmakers questioned Prime's billing practices, including its unusually high rates for conditions such as heart failure and severe malnutrition (Jewett, California Watch, 2/24).
The hearing also focused on whether Prime has violated state mandates that require hospitals to transfer out-of-network patients to their preferred physician once their condition stabilizes (AP/North County Times, 2/25).
Prime officials said the company is confident it has followed all laws and regulations.After the hearing, Sen. Ed Hernandez (D-West Covina), chair of the committee, said that the proceedings "shed a lot of light" on Primes' practices but that he is not sure if more legislation is needed to regulate hospital billing practices (Los Angeles Times, 2/25). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.