The federal government today (May 25) charged Prime Healthcare Services with fraud for billing for medically unnecessary in-patient short-stay admissions that should have been classified on an outpatient/observation status. The suit was filed in federal court in Los Angeles.
Prime was allegedly able to get bloated reimbursements from Medicare and other government health programs, says the suit.
San Diego's Alvarado Hospital is one of the 11 facilities in the Prime chain charged with such activities. The suit charges that Dr. Prem Reddy, founder of Prime, gave instructions that led to the activity.
The whistleblower in the suit is Karin Berntsen, who was director of case management at Alvarado.