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Prime Healthcare Services is a United States privately held healthcare company. It was established in 2001, by chairman and CEO
Prem Reddy Prem N. Reddy (born 1948 in India) is a cardiologist and an owner of Prime Healthcare Services, Inc., which owns 45 hospitals. Life and career Reddy was born in a rural village called Niduguntapalem, Nellore district in southern India. He gra ...
, MD, and operates 45 hospitals in 14 states. It is affiliated with the nonprofit Prime Healthcare Foundation.


Charity

Reddy and his family have established the Prem Reddy Family Foundation, which has supported several efforts, including one of country's newest schools of medicine at the California University of Science and Medicine, the Dr. Prem Reddy Nursing Laboratory at CSUSB, and the Dr. Prem Reddy Lecture Hall at
Western University of Health Sciences Western University of Health Sciences (WesternU) is a private medical school and health sciences university with its main campus in Pomona, California, with an additional osteopathic medical school in Lebanon, Oregon. With an enrollment of 3,81 ...
. In response to the surge of COVID-19 in India in spring of 2021, Prime Healthcare supplied ventilators, bipap machines, oxygen concentrators and associated equipment.


Controversy

In 2007, the ''
Los Angeles Times The ''Los Angeles Times'' (abbreviated as ''LA Times'') is a daily newspaper that started publishing in Los Angeles in 1881. Based in the LA-adjacent suburb of El Segundo since 2018, it is the sixth-largest newspaper by circulation in the Un ...
'' ran a news story that alleged that the policies of Prime HealthCare Services, Inc., resulted in higher-than-average profits for the possible cost of patient care: "When Reddy's company, Prime Healthcare Services Inc., takes over a hospital, it typically cancels insurance contracts, allowing the hospital to collect steeply higher reimbursements. It has suspended services — such as chemotherapy treatments, mental health care and birthing centers — that patients need but aren't lucrative.... On four occasions since 2002, inspectors have found that Prime Healthcare facilities failed to meet minimum federal safety standards, placing their Medicare funding at risk." In 2008 the State of California and
Kaiser Permanente Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser P ...
each sued Prime Healthcare over its
balance billing Balance billing, sometimes called surprise billing, is a medical bill from a healthcare provider billing a patient for the difference between the total cost of services being charged and the amount the insurance pays. It is an especially common pr ...
practices and Kaiser obtained an injunction preventing Prime from continuing the practice; Prime had cancelled agreements with insurance companies when it acquired hospitals, leaving patients in an out-of-network situation resulting in higher costs, and has been aggressively pursuing patients including sending unpaid costs to collection agencies. This was the first of several suits between Prime and Kaiser. In June 2010 Kaiser sued Prime Healthcare for "trapping patients" and contended that Prime Healthcare needlessly admitted emergency department patients, rather than transfer them to Kaiser facilities and then sending their insurance companies highly inflated bills. Prime counter-sued Kaiser and the Service Employees International Union, claiming that Kaiser owed it $100 million in unpaid medical claims and that Kaiser and the union conspired to keep Prime out of the market; that suit was dismissed in 2012, and Prime appealed all the way to the US Supreme Court, which declined to hear the case in 2016. In 2015 both sides agreed on dropping their respective lawsuits and resolve them through confidential and binding arbitration. In 2010 Prime Healthcare came under investigation by the
US Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
and the
California Department of Justice The California Department of Justice is a statewide investigative law enforcement agency and legal department of the California executive branch under the elected leadership of the California Attorney General (AG) which carries out complex cri ...
about concerns over a reported spike in
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
. The investigation centers around whether the spike in sepsis represents a large public health issue or multimillion-dollar Medicare fraud. Six Prime hospitals ranked in the 99th percentile of U.S. hospitals for sepsis and five were in the 95th percentile. In 2011 Prime Healthcare Service had high rates of
kwashiorkor Kwashiorkor ( , ) is a form of severe protein malnutrition characterized by edema and an enlarged liver with fatty infiltrates. It is thought to be caused by sufficient calorie intake, but with insufficient protein consumption (or lack of goo ...
among its elderly patients. At
Shasta Regional Medical Center Shasta Regional Medical Center, formerly known as Redding Medical Center and Memorial Hospital, is a general acute care hospital that is located in Redding, California. It opened in 1945 and currently has 226 beds with a basic emergency departme ...
, Prime reported 16.1% of its Medicare patients suffered from kwashiorkor, but California's average for Medicare patients is 0.2%. In 2011 ''California Watch'' reported that Prime Healthcare had a practice of transferring high numbers of patients from its emergency department to its hospital beds, specifically with patients on Medicare. Some families describe being trapped by doctors at Prime facilities and were unable to see their own doctor at another facility. Former Prime employees have described an orchestrated campaign of admitting Medicare and Kaiser patients, moving them from the emergency department to a hospital bed, in the interest of changing the fortune of a money-losing hospital. In September 2011,
California Attorney General The attorney general of California is the state attorney general of the Government of California. The officer's duty is to ensure that "the laws of the state are uniformly and adequately enforced" (Constitution of California, Article V, Section ...
Kamala Harris Kamala Devi Harris ( ; born October 20, 1964) is an American politician and attorney who is the 49th vice president of the United States. She is the first female vice president and the highest-ranking female official in U.S. history, as well ...
rejected the approval for the sale of the Victor Valley Global Medical Center in
Victorville Victorville is a city in Victor Valley in San Bernardino County, California. Its population as of the 2020 census was 134,810. History In 1858, Aaron G. Lane came to what is now known as Victorville and founded a waystation called "Lane's Cro ...
, California, and stated that the sale would not be in the public interest. In 2012, two executives at Prime Healthcare Services disclosed a patient's chart to multiple media outlets without the patient's express written consent. The release was in response to a California Watch article on Prime Healthcare Services billing practices at Shasta Regional Medical Center, which included claims by a Darlene Courtois about her treatment by Shasta. In this incident, Randall Hempling, the hospital CEO, and Dr. Marcia McCampbell, its chief medical officer, showed up at the offices of the ''
Redding Record Searchlight The ''Redding Record Searchlight'' is a newspaper serving Redding, California. It has a daily circulation of about 30,000 and hosts a Redding news Web site, Redding.com. History On October 17, 1938, the John P. Scripps Newspaper Group publ ...
'' and successfully convinced the paper's editor not to publish an article, echoing the California Watch claims by reference to Courtois' actual medical records. In May 2016
US Department of Justice The United States Department of Justice (DOJ), also known as the Justice Department, is a federal executive department of the United States government tasked with the enforcement of federal law and administration of justice in the United State ...
joined a
qui tam In common law, a writ of ''qui tam'' is a writ through which private individuals who assist a prosecution can receive for themselves all or part of the damages or financial penalties recovered by the government as a result of the prosecution. Its ...
case against Prime Health Care and its chief executive concerning
Medicare fraud In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare ...
. The case was settled in August 2018 for $65 million, resolving the "allegations that 14 Prime hospitals in California knowingly submitted false claims to Medicare by admitting patients who required only less costly, outpatient care and by billing for more expensive patient diagnoses than the patients had (a practice known as "up-coding")." An additional case was settled in February 2019 for $1.25 million for similar allegations regarding two Prime hospitals in Pennsylvania. In July 2021 US Department of Justice announce another settlement with Prime Health Care and its CEO Prem Reddy concerning kickbacks, overcharging for medical implants, and billing for a non-eligible provider by using another provider's billing identity. Dr. Reddy paid $1,775,000; and Prime paid $33,725,000.


Operations

Prime operates 45 acute care hospitals in 14 states. The hospital network has over 50,000 employees and physicians and more than 8,700 patient beds.


Prime Healthcare Foundation

The Prime Healthcare Foundation is an affiliated 501(c)(3).


References


External links

* {{authority control 2001 establishments in California American companies established in 2001 Hospitals established in 2001 Companies based in San Bernardino County, California Hospital networks in the United States Privately held companies based in California