Morning Briefing
Summaries of health policy coverage from major news organizations
One Of Nation's Largest Hospital Systems Agrees To $65M Settlement Over Medicare Overbilling Allegations
Prime Healthcare Services, one of the nation鈥檚 largest hospital systems, agreed Friday to pay $65 million to settle allegations of Medicare overbilling in California. The company and CEO Prem Reddy agreed to settle a whistleblower lawsuit alleging that 14 of its hospitals unnecessarily admitted patients and also 鈥渦pcoded鈥� patient diagnoses, exaggerating their illnesses in order to receive more Medicare money. (8/3)
Prime Healthcare Services Inc. will pay the bulk of the settlement, while Chief Executive Prem Reddy will pay $3.25 million and the system鈥檚 nonprofit affiliate will pay an undisclosed small amount, according to the Justice Department and a Prime spokeswoman. Ontario, Calif.-based Prime also agreed to a five-year corporate integrity agreement with the U.S. Health and Human Service Department鈥檚 inspector general. The agreement requires Prime to have an 鈥渋ndependent review organization鈥� scrutinize its Medicare bills. Under the terms, the settlement resolves allegations against Prime and its nonprofit affiliate Prime Healthcare Foundation without a determination of liability. (Evans, 8/3)