Federal lawmaker calls for investigation into HCA

A House lawmaker with oversight authority is requesting an investigation into Nashville, Tenn.-based HCA Healthcare regarding alleged fraud and staffing issues at its facilities. 

Rep. Bill Pascrell, D-N.J., the chair of the House Ways and Means Committee's subcommittee on oversight, has asked HHS Secretary Xavier Becerra to investigate whether HCA, a 182-hospital system, is improperly admitting patients to hospitals when patients do not require inpatient care. 

In a Sept. 13 letter to Mr. Becerra, Mr. Pascrell highlighted a union report that estimates unnecessary admissions by HCA may have resulted in $1.8 billion in excess charges to Medicare from 2008 to 2019. 

"I am especially alarmed by these findings given HCA's history of health care fraud settlements with both federal and state authorities," Mr. Pascrell wrote. 

Mr. Pascrell is requesting that HHS also investigate HCA's joint venture with EmCare, which provides emergency physician staffing in many of HCA's hospitals. 

"There have also been allegations that HCA sets corporate admission targets and routinely threatens retaliation against staff if those targets are not met," Mr. Pascrell wrote. "HCA's long-standing joint venture with EmCare, a subsidiary of private-equity-owned Envision Healthcare, may play an essential role in the setting and/or implementation of these admission targets." 

In a separate letter sent to HCA Healthcare CEO Sam Hazen, the lawmaker requests certain information from the company, including incentives for physicians related to patient admissions, a description of all data collected related to physician performance and a description of the company's internal review processes. 

"We are reviewing Congressman Pascrell's letter and will respond to his requests for information," HCA said in a statement to Becker's Hospital Review. "The issues raised in the letter appear to be similar to ones we addressed previously and publicly. HCA Healthcare operates more than 180 hospitals in a variety of communities throughout the country. Our hospitals are staffed by physicians, clinicians and nurses who work tirelessly to ensure our patients receive medically necessary care in the appropriate clinical setting." 

HCA, the largest for-profit hospital operator in the U.S., noted that more COVID-19 patients have been cared for at its facilities than at any other health system. HCA also returned its portion — about $6 billion — of Coronavirus Aid, Relief and Economic Security Act funding to the government. 

HCA reported revenue of $14.82 billion in the second quarter of this year, up from $14.44 billion in the same period last year. HCA's net income totaled $1.16 billion in the second quarter of 2022, down from $1.45 billion in the same period a year ago. HCA said same-facility admissions declined 1.2 percent year over year in the second quarter of this year. Emergency room visits were up 7.3 percent year over year. 

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