SHERMAN OAKS—On Tuesday, October 19, figures released by United Healthcare Workers, a Service Employees International Union (SEIU) subsidiary, indicate a substantial rise in reported cases of a medical condition called septicemia throughout a chain of hospitals administered by Prime Healthcare Services, which has hospitals throughout Southern California including in Sherman Oaks.

Septicemia is a form of blood-poisoning, which can be fatal, according to the National Institutes of Health.

The reason for the increase in cases of septicemia remains unclear.  In a statement to Canyon News, Marketing and PR Manager of Prime Healthcare Services Steven Brand claimed that the recent surge in septicemia infections is not a “serious health problem,” saying that the large numerical increase in infections results from “Prime Healthcare hospitals seeking sicker patients as a result of their emphasis on emergency departments, strict compliance with Medicare coding guidelines, and the early detection and treatment of septicemia so as to improve patient care outcomes.”

Conversely, representatives from the SEIU contend that the increase is linked to Medicare fraud. On this basis, the SEIU released a study entitled “Septicemia at Prime Hospitals,” by which it claims to have documented instances of Medicare fraud.  In a conversation with Canyon News, SEIU representative Lisa Hubbard directed those interested in the SEIU’s position to consult the aforementioned study.  According to the study, “Comparing all 111 U.S. health systems of comparable size or larger, Prime’s septicemia rate (15.7 %) was 70 % higher than the second highest health system (9.2 %).”  Allegedly, a Prime-operated hospital in Sherman Oaks has a particularly high incidence rate of septicemia.  Furthermore, the report maintains that, “In 2008 alone, Prime was reimbursed some $18 million more than expected from Medicare.”

In Prime Healthcare’s statement to Canyon News, Steven Brand countered SEIU charges, stating that “the data relied upon by the SEIU focuses on the patient’s condition upon presentation to the emergency department, not conditions acquired at the hospital.”

The Prime Healthcare question reaches beyond the initial research done by the SEIU, gaining the attention of Representative Henry Waxman of the 30th District of California, and Representative Pete Stark of the 13th District of California, who reportedly contacted federal health officials.  Karen Lightfoot at Representative Waxman’s office provided Canyon News with a copy of the original communication.  The document references the SEIU study, in essence echoing the SEIU’s findings, stating that “far more Medicare patients are diagnosed with septicemia, or blood infections, at Prime-operated hospitals than any other hospital chain in the country.” Citing the SEIU’s claim that “a system-wide pattern of up-coding”¦may have led to $18 million in excess Medicare payments,” the communication urges an immediate investigation.

In a brief statement, Don White, spokesperson at the Inspector General’s Office of the Heath and Human Services, confirmed that Representatives Waxman (D-CA) and Stark (D-CA) had “requested a review” of Prime Healthcare Services, but declined to confirm the accuracy of the charges, i.e., the allegations of fraud.  White was careful not to impugn Prime Healthcare, saying that there is a world of difference between a “review and an investigation.”

As of press time the case is still under investigation.