Well-deserved award for uncovering Prime abuses..

The Center for Investigative Reporting’s California Watch has won a well-deserved Polk Award for their investigation in to Prime, a controversial Southern California hospital chain.

Congrats to reporters Lance Williams, Christina Jewett and Stephen K. Doig for uncovering a Prime’s questionable pattern of billing Medicare for rare and unlikely ailments. Either there is some strange outbreaks in California communities, or this is a troubling, fradulent practice of “upcoding” to bring in more Medicare dollars.

The prestigious Polk award said California Watch “offered a glimpse into the broader problem of waste, fraud and abuse within the nation’s $2.5 trillion health-care system.”

According to California Watch, their reporters “analyzed data containing more than 51 million patient records from 2005 through 2010 and reviewed thousands of pages of documents to uncover billing patterns at Prime that stand apart from other acute care general hospitals in the state.”

Prime is the subject of several state and federal investigations. The FBI has been questioning former Prime billing administrators and patients. Earlier this month, Prime abandoned its efforts to acquire a Christ Hospital in Jersey City, NJ–after getting significant requests for more information by their attorney general. The chain also lost its bid last fall to acquire another hospital in California when the state attorney general ruled it wouldn’t be in the public’s interest. And California’s public health officials have started to ask questions about the chain’s billing methods.

This Friday, the CA Assembly and Senate Health Committees will hold a joint hearing in Los Angeles (at USC) on hospital reimbursement mechanism, like Prime’s patient-admission practices. Our own Beth Capell will provide testimony, among others.

Prime’s practices deserve the scrutiny that they are getting–and hopefully it will lead to appropriate rules and reforms to prevent abuses in the future.

Health Access California promotes quality, affordable health care for all Californians.
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