HCA disputes investment group's claims, defends ER admission rates

Nashville, Tenn.-based HCA Healthcare released a letter April 6 that contradicts statements made by an investment group that is accusing the company of excessive emergency department admissions and calling for the ouster of its director and audit committee chair. 

CtW Investment Group sent a letter to HCA shareholders April 1 urging them to oppose the reelection of director and audit and compliance committee chair Charles Holliday Jr. The letter comes after the investment group accused HCA of improper ED admissions practices and demanded the company's board address the issue. 

The investment group claims HCA has "exhibited patterns of Medicare emergency admissions" that are similar to those of companies that have been the subject of investigations by the U.S. Justice Department and resulted in settlements. 

CtW Investment Group said HCA's audit and compliance committee failed to respond to a letter it sent in October raising concerns about the company's practices. 

On April 6, HCA released a letter it sent in March to CtW Investment Group's executive director. The company claims it tried to contact the investment group's executive director and its research director in November and December but didn't receive a return call. 

"We have taken your allegations seriously and thoroughly reviewed them," Phillip Billington, senior vice president of internal audit services, wrote in the March 8 letter. "We found nothing to suggest that ER or medical-staff physicians admit patients to our hospitals based upon anything other than their independent medical judgment. None of our contractual arrangements with physicians incentivize them to admit patients to our hospitals." 

Quality improvement organizations retained by CMS reviewed thousands of admissions at HCA's hospitals and most were found to be appropriate, according to Mr. Billington. 

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