Congress asking for federal probe into HCA hospital chain

A House oversight committee is asking for a federal investigation of the largest U.S. hospital chain and its admissions practices amid allegations of widespread fraud.

Driving the news: Rep. Bill Pascrell (D-N.J.), chair of the House Ways and Means oversight subcommittee, this week asked the HHS to look into HCA Healthcare’s emergency department admissions.

• Pascrell also sent a letter to the company, asking whether doctors received incentives for patient admissions and how physician performance was measured.

Details: Several large unions last year alleged that HCA was admitting patients who didn’t necessarily need emergency care. There are also allegations the company has "corporate admission targets" and has threatened retaliation against staff who don't meet them.

• The company's facilities have also faced understaffing allegations, as well as press reports of preventable patient deaths, including this one in Denver, and one hospital's potential termination from the Medicare program.
• In the letters, Pascrell also points out how HCA had established a joint venture with a private equity-backed emergency care services firm, which provides emergency physician staffing in “virtually all” of HCA’s hospitals.
• A staffer in Pascrell’s office told Axios that complaints from workers about HCA as well as the congressman’s interest in private equity’s role in health care motivated him to ask for the investigation.

The big picture: HCA owns more than 180 hospitals and is the largest for-profit health care chain in the U.S. In 2021, the chain turned a profit of almost $7 billion.

• The inquiry into admissions practices could extend to other health systems, part of the government's increased focus on private equity investments in health care.

The other side: HCA spokesperson Harlow Sumerford, said in a statement that the company was reviewing Pascrell’s letter and will respond to his requests for information.

• Sumerford added the company had previously faced the same complaints and requests for information from the labor union group and filed their response publicly with the SEC.

• “We believe that our operational processes and procedures are working well and that we are meeting the healthcare needs of our patients and communities,” Sumerford added in the statement.

Flashback: In 2003, HCA had to pay $631 million to the U.S. over allegations that it submitted false claims to Medicare and other federal health care programs in what at the time was the biggest health care fraud case ever settled.

• Sen. Rick Scott (R-Fla.) was previously CEO of HCA during the time the FBI raided company facilities in 1997 to investigate fraud claims. He was ousted before the company settled with the federal government.

Of note: A 2021 study found that those over age 65 were more likely to be admitted to the emergency rooms of for-profit hospitals than nonprofit facilities.