An employee whistleblower claims Ontario, Calif.-based Prime Healthcare Services submitted $50 million in false claims for patient stays, according to a Law 360 report.
The whistleblower, Karin Berntsen, claims employees of PHS and PHS-affiliated Alvarado Hospital Medical Center in San Diego ordered hospital personnel to add comorbidities and complications to patients' records to increase Medicare payments. Ms. Berntsen also alleges PHS got rid of utilization reviews that would have caught the falsified information.
Ms. Berntsen worked for PHS in roles related to quality and risk management, case management and performance improvement at Alvarado Hospital Medical Center.
Note: This story was updated on 1/14 at approximately 8 a.m. CST to correct the reported false claims allegation value.
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