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House Oversight Official Calls For Probe of HCA Over Fraud, Staffing Allegations

The chairman of the U.S. House Ways and Means Committee’s oversight subcommittee is calling for an investigation into Nashville, Tenn.-based HCA Healthcare over reports of alleged fraud and staffing issues at its facilities.

“Recent reports of systematic, unnecessary inpatient admissions intended to raise more-profitable reimbursement rates, in addition to severe understaffing issues, raise disturbing questions about HCA’s corporate policies and practices,” Rep. Bill Pascrell, Democrat of New Jersey, wrote in a letter Sept. 13 to Health and Human Services HHS Secretary Xavier Becerra.

Pascrell asked Becerra to investigate whether HCA, a 182-hospital system that owns and operates Asheville’s Mission Hospital, five other hospitals in western North Carolina, and many other healthcare facilities in the area, is improperly admitting patients to hospitals when patients do not require inpatient care. 

Pascrell cited a report by the Service Employees International Union that HCA may have billed Medicare as much as $1.8 billion in unnecessary admissions from 2008 to 2019. 

“I am especially alarmed by these findings given HCA’s history of health care fraud settlements with both federal and state authorities,” Pascrell wrote. “This includes a settlement for $1.7 billion in the early 2000s that resolved multiple criminal counts and civil fraud allegations — at the time the largest health care fraud in U.S. history — as well as other health fraud settlements involving HCA in subsequent years.”

Pascrell asked HHS to investigate HCA’s joint venture with EmCare, which provides emergency physician staffing in many of HCA’s hospitals. 

“There have also been allegations that HCA sets corporate admission targets and routinely threatens retaliation against staff if those targets are not met,” Pascrell wrote. “HCA’s long-standing joint venture with EmCare, a subsidiary of private-equity-owned Envision Healthcare, may play an essential role in the setting and/or implementation of these admission targets.” 

Pascrell also wrote to HCA Healthcare CEO Sam Hazen, requesting details about incentives for physicians related to patient admissions, a description of data collected related to physician performance, and a description of the company’s internal review processes. 

“We are reviewing Congressman Pascrell’s letter and will respond to his requests for information,” HCA said in a statement to Becker’s Hospital Review. “The issues raised in the letter appear to be similar to ones we addressed previously and publicly. HCA Healthcare operates more than 180 hospitals in a variety of communities throughout the country. Our hospitals are staffed by physicians, clinicians and nurses who work tirelessly to ensure our patients receive medically necessary care in the appropriate clinical setting.” — Peter H. Lewis

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