Prime Healthcare Disputes the Claims of California Watch and the Union

ONTARIO, Calif., July 23, 2011 /PRNewswire/ -- It is unfortunate that California Watch continues to rely on manipulated data and unsubstantiated allegations fed by Service Employees International Union (SEIU) to publish fraudulent and defamatory statements about Prime Healthcare. California Watch is nothing more than a mouthpiece for SEIU in its smear campaign against Prime Healthcare.

California Watch's "analysis" is so deeply flawed, it includes the following obvious errors:

• It fails to consider that at least 142 non-Prime hospitals with ER admission rates among Medicare patients greater than California Watch's State Average of 40.9% including several well known non-profit hospitals. According to California Watch's "analysis," Cedars-Sinai Medical Center alone was overpaid more than $ 70 million in 2009.
• Using California Watch's methodology, the hospitals above the "state average" would have received more than $1 billion dollars too much in 2009, which further demonstrates the absurdity of California Watch's claims.
• Taking the state average is not a fair way of reviewing admission rates as admissions patterns vary widely based on a lot of factors such as geography, average age of the seniors, how sick the seniors are, whether the patients come from nursing homes and board and care, belong to Medicare HMOs or not, and how busy the ER is and how often it closes. Hospital admissions are done by qualified independent physicians using nationally accepted medical necessity criteria of Interqual and Milliman CareGuidelines. Over 4,000 independent physicians practice at Prime Healthcare hospitals. All Medicare admissions are routinely audited concurrently and retrospectively by Medicare contracted agencies like Health Services Advisory Group (HSAG), Healthcare Data Insights (HDI), etc.
• California Watch fails to disclose that the same OSHPD data which it relied upon also reveals Prime Healthcare hospitals admit and care for the highest percentage of uninsured patients and offer more charity care than most other California hospitals.  Especially, given the economic downturn, more and more Californians are losing their health insurance and seeking care in the emergency departments of the hospitals.
• Contrary to California Watch's biased presentation of the facts surrounding the dispute between Prime Healthcare and other HMOs including Kaiser, Prime Healthcare has prevailed on almost every dispute brought to the Administrative Law Judges and/or Centers for Medicare and Medicaid Services (CMS). Prime Healthcare is informed that CMS is investigating the patient transfer policies and improper payment practices of HMOs including Kaiser and Heritage, levying substantial penalties against them.
• California Watch's claim that there is an ongoing Federal investigation of Prime Healthcare is false and defamatory.  Prime Healthcare is not aware of any Federal investigation. Recently, SEIU made similar false allegations against Prime Healthcare which were rejected by the United States Bankruptcy Court after receiving comments from representatives of Medicare and the California Attorney General's Office.
• Almost all its hospitals were in severe financial distress and/or in bankruptcy when acquired by Prime Healthcare and without its intervention most of these hospitals would have closed their doors. Under Prime Healthcare's management these hospitals have been recognized as Top 100 Hospitals in the Nation and Prime Healthcare has been ranked Top 10 Healthcare System in the Nation by Thomson Reuters. Prime Healthcare is the only for-profit healthcare system and the only system west of Mississippi to receive this coveted recognition. Prime Healthcare employs over 9,000 Californians and pays its due share of taxes.
• Personal attacks and defamatory statements against the Chairman of Prime Healthcare, Prem Reddy, MD, FACC, FCCP, of certain alleged incidences that occurred nearly a decade ago, are highly malicious. Dr. Reddy donated hundreds of millions of dollars to charity and two of Prime Healthcare's hospitals were donated to Prime Healthcare Foundation, a non-profit public charity founded by Dr. Reddy.

As long as California Watch continues its knowing misrepresentation of the record, Prime has no alternative but to proceed with its efforts to expose California Watch as nothing more than the propaganda arm of the SEIU.  In order to expose California Watch's wrongful conduct, Prime has commenced litigation against California Watch.

SOURCE Prime Healthcare