Hospital's heart diagnoses surge after pay changed

[xchrom]

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/28/MNMO1M33JP.DTL

For three years, a small hospital east of Los Angeles has billed Medicare for the costs of confronting what appears to be a cardiac crisis of unprecedented dimension.

From 2008 through 2010, Chino Valley Medical Center in San Bernardino County claimed that 35.2 percent of its Medicare patients were suffering from acute heart failure - a dangerous, often-deadly breakdown in the heart's ability to pump blood.

That's six times the state average, according to a California Watch analysis of Medicare billing data.

This reported surge of heart failure among older patients entitled the hospital's parent company, Prime Healthcare Services, to bonus treatment payments from the federal government worth thousands of dollars per case, Medicare records show.

Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/11/27/MNMO1M33JP.DTL#ixzz1f1Lr1oQI

[HopeHoops]

1. ICD-9 coding scams go back a LONG way.

The last I worked in a healthcare facility was about 92 and we would get flooded with offers from companies promising to maximize our profits with software that would analyze how to get far more out of a patient by subtle selections of more profitable ICD-9 codes. That wasn't our gig.

My dad had a muscle pain in his chest and the code the doctor picked implied a heart condition (paid more - and he admitted it). My dad wouldn't let him get away with it because he didn't want that on his medical/insurance records. Be thee ware, for there be dragons.

[KamaAina]

2. Get rid of this crap instead of cutting our benefits!

:grr:

[indepat]

6. May I repeat "Get rid of this crap instead of cutting our

benefits!"? :patriot:

[Scuba]

3. It's referred to as "up-coding" and it's both a problem and a symptom of a bigger problem....

... that could easily be resolved through Medicare for All.

[redqueen]

5. Yeah but that was off the table before anyone even got to the damn table.

Despite the fact that most people wanted a plan that went further than the one we ended up with.

:grr:

[pennylane100]

4. I have heard other stories about this hospital

http://articles.latimes.com/2010/oct/12/local/la-me-prime-healthcare-20101012

They sound like a bunch of crooks and they should be closed down and charged with fraud.