The FBI is interviewing former medical coders from Ontario, Calif.-based Prime Healthcare about the hospital company’s billing practices, according to a report from investigative news outlet California Watch.
While the FBI would not confirm nor deny a probe, two former Prime coders told the news outlet they have been contacted by special agents to provide information on billing practices at Alvarado Hospital Medical Center in San Diego, which Prime acquired in Nov. 2010.
The former employees have said in the past that Prime’s owner, Prem Reddy, MD, urged physicians to upcode by billing for rare medical conditions that bring in higher reimbursements compared to routine conditions, according to the report.
A Prime spokesperson said the chain is unaware of an FBI investigation. The chain has said it never engaged in upcoding and says former employees who bring forward such allegations are “disgruntled,” according to the report.
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