Prem Reddy

Last updated

Prem N. Reddy (born 1 June 1948 in India) is a cardiologist and an owner of Prime Healthcare Services, Inc., which owns 45 hospitals.

Contents

Life and career

Reddy was born in a rural village called Niduguntapalem  [ TE ], Nellore district in southern India. He graduated from Sri Venkateswara University Medical College in 1973. In 1976 Reddy and his wife immigrated to the United States.

Reddy, who holds an MD, FACC, and FCCP, is a board-certified physician in internal medicine and cardiology. He is a Fellow of the American College of Cardiology and the American College of Chest Physicians. During two decades of practice, Reddy performed more than 5,000 cardiac procedures (such as coronary angiography and angioplasty, and permanent pacemaker implantations). [1] Reddy is no longer licensed to practice medicine in California. [2]

Healthcare management and entrepreneurship

In the early 1980s, Reddy founded Desert Valley Medical Group in Victorville, CA and established Primecare Medical Group in 1992. He also founded PrimeRx, with 250,000 managed care patients, generating over $500 million in revenues a headquartered in Las Vegas, Nevada. He established Desert Valley Hospital in 1994 which today stands as the flagship hospital in the California healthcare system known as Prime Healthcare Services. Desert Valley Hospital has been recognized as a Top 100 Hospital in the Nation on numerous occasions. [3]

In 2013 eight Prime Healthcare Hospitals were named in the "Top 100 Hospitals in the Nation" by Truven, formerly Thomson Reuters. In 2021, several hospitals were named in the "Top 100 Hospitals in the Nation." Hospitals that receive these awards are noted for their high clinical standards, "that achieve the highest national scores based on 14 separate measures of hospital performance—operational, clinical and financial—that affect patients as well as the quality of care in the community." [4] Prime Healthcare Services was recognized as a "Top 15 Health System" in 2013, the third time they have been on the list in five years. [5]

Charity

Reddy and his family have established the Prem Reddy Family Foundation, which has supported a number of efforts, including the California University of Science and Medicine, the Dr. Prem Reddy Nursing Laboratory at CSUSB, and the Dr. Prem Reddy Lecture Hall at Western University of Health Sciences. [6]

Controversy

On 8 July 2007, the Los Angeles Times ran a news story that alleged that the policies of Prime HealthCare Services, Inc. resulted in higher than average profits at the possible cost of patient care. According to the Times story, [7]

When Reddy's company, Prime Healthcare Services Inc., takes over a hospital, it typically cancels insurance contracts, allowing the hospital to collect steeply higher reimbursements. It has suspended services—such as chemotherapy treatments, mental health care and birthing centers—that patients need but aren't lucrative.... On four occasions since 2002, inspectors have found that Prime Healthcare facilities failed to meet minimum federal safety standards, placing their Medicare funding at risk.

In 2005, two former nurses at Desert Valley Hospital won a lawsuit in which they claimed they were improperly fired after they accused hospital management of providing inadequate care to save money and Reddy of repeatedly reporting to work while under the influence of alcohol. In February 1999, Reddy was arrested for allegedly attacking Harry Lifschutz at Desert Valley Medical Group. Reddy jumped over a desk in the doctor's waiting room and allegedly attempted to choke him and take a laptop from Lifschutz's office. [7]

Prime Healthcare Services was investigated by the United States Department of Health and Human Services and the California Department of Justice about concerns over a reported spike in sepsis. The investigation centers around whether the spike in sepsis represents a large public health issue or potential Medicare fraud. Six Prime hospitals ranked in the 99th percentile of U.S. hospitals for sepsis and five were in the 95th percentile. [8]

Prem Reddy was personally liable in a negotiated settlement regarding False Claims at 14 Prime Hospitals. [9] Out of the $65 million settlement, he had to pay $3.25 million. [9]

In July 2021 US Department of Justice announced another settlement with Prime Health Care and Prem Reddy concerning kickbacks, overcharging for medical implants, and billing for a non-eligible provider by using another provider's billing identity. The violations directly implicated Dr. Reddy in the kickbacks. Reddy paid $1,775,000; and Prime paid $33,725,000. [10]

See also

Related Research Articles

<span class="mw-page-title-main">Monash Medical Centre</span> Hospital in Victoria, Australia

Monash Medical Centre (MMC) is a teaching hospital in Melbourne, Australia. It provides specialist tertiary-level healthcare to the Melbourne's south-east.

<span class="mw-page-title-main">Omnicare</span> American health care company

Omnicare is an American company working in the health-care industry. It was established in April 1981 as a spinoff of healthcare businesses from Chemed and W. R. Grace and Company. It is currently a pharmacy specializing in nursing homes. In 2015, Omnicare was acquired by CVS Health.

<span class="mw-page-title-main">Universal Health Services</span> American hospital management company

Universal Health Services, Inc. (UHS) is an American Fortune 500 company that provides hospital and healthcare services, based in King of Prussia, Pennsylvania. In 2022, UHS reported total revenues of $13.4b.

Desert Valley Hospital (DVH) is an 148-bed osteopathic acute care facility in the city of Victorville, San Bernardino County, California. It serves the Victor Valley region of the south−central Mojave Desert.

La Palma Intercommunity Hospital (LPH) is a 141-bed acute care facility in La Palma, California, US. LPH is owned and operated by Prime Healthcare Services (PHS), a hospital management company located in Victorville. PHS was founded in 2001 by Prem Reddy, who acts as its present chairman of the board. PHS has operated La Palma Intercommunity Hospital since 2006.

<span class="mw-page-title-main">Paradise Valley Hospital (California)</span> Hospital in California, United States

Paradise Valley Hospital is a 291-bed acute care facility in National City, California. It began operation in 1904 as a sanitarium and is currently under the ownership and operation of Prime Healthcare Services, a hospital management company located in Ontario, California. Paradise Valley Hospital is the largest private employer in National City, with a workforce of approximately 1,200 employees.

Sherman Oaks Hospital (SOH) is a 153-bed acute care facility on Van Nuys Boulevard in the city of Los Angeles neighborhood of Sherman Oaks, California. It had 3,995 admissions during the most recent year such data was made available.

In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.

Prime Healthcare Services is a United States privately held healthcare company. It was established in 2001, by chairman and CEO Prem Reddy, MD, and operates 45 hospitals in 14 states. It is affiliated with the nonprofit Prime Healthcare Foundation.

Sutter Health is a not-for-profit integrated health delivery system headquartered in Sacramento, California. It operates 24 acute care hospitals and over 200 clinics in Northern California.

Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.

Shasta Regional Medical Center, formerly known as Redding Medical Center and Memorial Hospital, is a general acute care hospital that is located in Redding, California. It opened in 1945 and currently has 226 beds with a basic emergency department.

An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to patients and third-party payers for the quality, appropriateness and efficiency of the health care provided. According to the Centers for Medicare and Medicaid Services, an ACO is "an organization of health care practitioners that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it".

St. Rose Hospital is an independent, non-profit hospital located in Hayward, California. It is a designated cardiac arrest receiving center in the Alameda County emergency medical services system, and provides basic emergency medical services.

Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare or equivalent State programs. The manner in which this is done varies, and persons engaging in fraud are always seeking new ways to circumvent the law. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

<span class="mw-page-title-main">VITAS Healthcare</span>

VITAS® Healthcare is a provider of end-of-life care in the United States. Operating 50 hospice programs in 14 states and the District of Columbia, VITAS employs 10,000 professionals and serves an average daily census of more than 19,000 patients, according to the company's website.

Michael Drobot is a convicted felon who pleaded guilty to orchestrating the largest fraud in California history. Between 1978 and 2013, Drobot managed 28 hospitals along the East Coast, including the Mount Sinai Roosevelt in New York. He also owned eight hospitals, including Pacific Hospital of Long Beach, and two health maintenance organizations.

A safety net hospital is a type of medical center in the United States that by legal obligation or mission provides healthcare for individuals regardless of their insurance status or ability to pay. This legal mandate forces safety net hospitals (SNHs) to serve all populations. Such hospitals typically serve a proportionately higher number of uninsured, Medicaid, Medicare, Children's Health Insurance Program (CHiP), low-income, and other vulnerable individuals than their "non-safety net hospital" counterpart. Safety net hospitals are not defined by their ownership terms; they can be either publicly or privately owned. The mission of safety net hospitals is rather to provide the best possible care for those who are barred from health care due to the various possible adverse circumstances. These circumstances mostly revolve around problems with financial payments, insurance plans, or health conditions. Safety net hospitals are known for maintaining an open-door policy for their services.

<span class="mw-page-title-main">DaVita</span> American dialysis provider

DaVita Inc. provides kidney dialysis services through a network of 2,816 outpatient dialysis centers in the United States, serving 204,200 patients, and 321 outpatient dialysis centers in 10 other countries serving 3,200 patients. The company primarily treats end-stage renal disease (ESRD), which requires patients to undergo dialysis 3 times per week for the rest of their lives unless they receive a donor kidney. The company has a 37% market share in the U.S. dialysis market. It is organized in Delaware and based in Denver.

<span class="mw-page-title-main">Kavitha Bhatia</span> Indian-American physician

Kavitha Bhatia is an Indian-American physician who is the president and chair of the Prime Healthcare Foundation.

References

  1. ↑ My Life Shows American Dream Is Achievable Archived 2007-08-09 at the Wayback Machine , India Tribune , 17 May 2003.
  2. ↑ "Medical Board of California: License A36292". Department of Consumer Affairs Search. Retrieved 11 September 2018.
  3. ↑ Desert Valley Hospital recognized again, hospital, reddy, hospitals - Local News - Victorville Daily Press Archived 2012-03-25 at the Wayback Machine
  4. ↑ "100 Top Hospitals from Truven Health Analytics". Modern Healthcare. 6 February 2012. Retrieved 13 August 2013.
  5. ↑ "Operator Of Two Local Hospitals Rates Highly". UTSanDiego.com. 17 April 2013. Retrieved 13 August 2013.
  6. ↑ "Dr. Prem Reddy | Prime Healthcare | Southern California". Dr. Prem Reddy Family Foundation. Retrieved 3 September 2018.
  7. 1 2 "Hospital group rejects system and cashes in". Archived from the original on 7 July 2012. Retrieved 27 February 2011.
  8. ↑ William, Lance; Christina Jewett (11 October 2010). "Hospital chain's high infection rate leads to fraudulent billing concerns". California Watch.
  9. 1 2 "Prime Healthcare Services and CEO to Pay $65 Million to Settle False Claims Act Allegations". U.S. Dept. of Justice. 3 August 2018. Retrieved 29 August 2018.
  10. ↑ "Prime Healthcare Services and Two Doctors Agree to Pay $37.5 Million to Settle Allegations of Kickbacks, Billing for a Suspended Doctor, and False Claims for Implantable Medical Hardware". U.S. Department of Justice. 19 July 2021. Archived from the original on 19 July 2021. Retrieved 20 July 2021.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.