Prime Healthcare announced that it has resolved a civil qui tam (whistleblower) lawsuit by the U.S. Department of Justice (DOJ) concerning Medicare inpatient admissions from January 2006 through September 2013 involving 14 of Prime Healthcare's California hospitals.
The lawsuit also involved certain claims related to coding by a whistleblower. However, after extensive review, the government did not find merit in these claims and declined to intervene.
This settlement resolves all claims raised in the matter. There was no finding of improper conduct or wrongdoing of any kind by Prime Healthcare. Prime Healthcare's exemplary record of clinical quality care was never in question. This matter dealt with the technical classification of the category under which patients were admitted and billed.
Physicians, not hospitals, direct the level of care needed for their patients. Prime continues to support physicians in the care they determine is best. Prime Healthcare hospitals, employees and clinicians are nationally recognized for providing clinically excellent care.
Prime is committed to defending the rights of patients to receive high-quality care, and it has always supported the clinical decision making of physicians acting in the best interests of their patients. Prime Healthcare's Founder, Chairman, President, and CEO, Prem Reddy, M.D. stands with Prime Healthcare in support of this settlement and personally participated. Lawsuits related to inpatient admissions have become increasingly common among hospitals and health systems nationally.
In 2016, the American Hospital Association (AHA) and the California Hospital Association (CHA) filed briefs in support of Prime Healthcare, stating the government's regulation of hospital admissions inappropriately challenged the clinical decisions of physicians. These briefs by the two large hospital associations in the country called for reform of the government's standards related to inpatient admissions versus outpatient observation status.
Kanczel, who has a 3.68 grade point average, plans on attending medical school with aspirations of becoming a surgeon with the ultimate goal of becoming head of surgery.“We’re grateful for Dr. Reddy’s generosity in funding scholarships to these two deserving students as well as other High Desert students here on campus,” said CSUSB President Tomás D. Morales.
Reddy’s foresight is an investment in our future to help students interested in becoming doctors, nurses or other types of healthcare professionals at a time when our region faces shortages in medical care providers.”“These students are our future, and it is imperative that we help foster their interest in medicine,” said Dr. Reddy.
“I came from an impoverished background to become a cardiologist.
Nothing is impossible for these hard working students, and I hope that this scholarship helps them achieve their dreams.”Established in 2006, the Dr. Prem Reddy Academic Excellence Scholarship is awarded to a qualifying student or students in pre-med, nursing, and/or health education programs at Cal State San Bernardino.
During his 25 years of practice in the High Desert, he has committed himself to the service of his patients and performed more than 5,000 cardiac procedures, including coronary angiography and angioplasty, and permanent pacemaker implantations.Reddy also founded Prime Healthcare in 2001, starting with Desert Valley Hospital in Victorville.
Since then, Prime Healthcare has expanded to own and operate 23 hospitals across the nation.
Prem Reddy, MD, FACC, FCCP, Chairman, President and CEO of Prime Healthcare, has once again been named to Modern Healthcare's prestigious list of the "100 Most Influential People in Healthcare" for 2017.
This is the fourth time that Dr. Reddy has been recognized as among the most influential healthcare leaders in the nation.
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