FierceHealthcareFierceHealthITFierceHealthFinanceFierceEMRHospital ImpactFierceMobileHealthcare   FiercePharma

CA hospitals raided on fraud charges

Tools
Tags
Medicaid
Medi-Cal
Los Angeles City Attorney Rocky Delgadillo
insurance fraud
Homeless People
City Of Angels Medical Center

Three hospitals in the Los Angeles area are facing lurid charges that they recruited homeless people on the city's skid row and subjected them to unnecessary tests and procedures in an effort to generate extra income. The hospitals are accused of bilking both Medicare and Medi-Cal, the state's Medicaid program. In addition to facing state and federal charges, the three facilities have also been sued by Los Angeles City Attorney Rocky Delgadillo, whose suit accuses the hospitals of fraudulent business practices.

The alleged scheme appears to have involved the CEO of City of Angels Medical Center, and executives with two suburban facilities, Los Angeles Metropolitan Medical Center and Tustin Hospital and Medical Center. While federal, state and local investigators are still tallying the dollars generated by these schemes, at present it appears that City of Angels alone collected $5 million in federal healthcare reimbursements.

To recruit sham patients, the hospitals used "runners" who canvassed the streets of the city's skid row section. Homeless people were offered $20 to $30 when they finished a needless hospital stay of one to three days. The runner would get $40 for each homeless recruit eligible for Medicare and $20 for each recruit with Medi-Cal benefits, according to Delgadillo's lawsuit. One hospital, meanwhile, worked with a sham "Assessment Center" that reached out to potential patients and attempted to bring them in to City of Angels, offering money, food or even a pack of cigarettes.

To learn more about the scandal:
- read this Los Angeles Times piece

Related Articles:
Los Angeles issues new rule limiting discharges
LA files more patient dumping cases
Hospitals accused of dumping homeless
CA law would ban patient dumping

Comments

I was a nurse at City of Angles Medical Center. The fraud that takes place in the hospital is really bad. Patients are kept for days. I once had a patient with asthma. The put had zero breathing trouble, no wheezing and had never smoked. She could not understand why she could'nt go home. She had only gone for her yearly check up and was hospitalized. The sister hospital, City of Angeles Medical Center, Ingleside Campus is just as bad. Nurses are told to always document in a false manner otherwise payment is denied by medical/medicare.

From a nurse that wants good patient care.

I am a nurse at the City of Angels Medical Center Ingleside Campus and as I still work there I can say with proud that what the above writer told is a LIE. We have never been told to write lies in the patients charts. That cannot happen, we are RNs and holding our licenses, and no one can make us to jeopardize our license.

This is pretty hard to believe. It is hard to reconcile such a practice with the common claims that people who lack health insurance cannot get hospital care. My experience has been that large public general admission hospitals are generally crowded, busy and reluctant to admit uninsured patients but will do so if you can make a good case the the condition requires in-patient rather than out-patient care. It is easy to make accusations - it will be interesting to see if this is actually true or not.

Post new comment

The content of this field is kept private and will not be shown publicly.

More information about formatting options

To combat spam, please enter the code in the image.