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HCA Hospital Chain Facing Scrutiny Over Unnecessary Heart Surgeries

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The large HCA hospital chain has been conducting unnecessary heart surgeries and is now being looked at by the U.S. Attorney in Miami, Florida.

HCA Holdings Inc. (HCA), the country’s largest hospital system, has been asked to turn over information regarding the “medical necessity” of the cardiac procedures conducting in Florida hospitals, said Bloomberg Businessweek, citing a regulatory filing. The disclosure was revealed at the same time as The New York Times reported that HCA, which is based in Nashville, Tennessee, investigated a number of cases that involved surgeons conducting unneeded surgeries in its facilities. Results of those probes, said the Times, were never released to patients, medical officials, or insurers.

According to the Times story, it reviewed thousands of pages of internal documents and interviewed physicians and other involved parties. “The problems at HCA went beyond a rogue doctor or two,” the Times wrote; however, the news outlet did not indicate the number of potential cases, said Businessweek. “I think we have to look at it seriously,” Sheryl Skolnick, a CRT Capital Group LLC analyst in Stamford, Connecticut, told Businessweek in a telephone interview.

Businessweek noted that the request from the U.S. Attorney is part of increased federal government actions against alleged health care fraud, noting that in just the past month, Johnson & Johnson, GlaxoSmithKline Plc, and Teva Pharmaceuticals Ltd. all announced actions implemented by the U.S.

HCA’s chief executive officer, Richard M. Bracken, declined to respond to questions about both the probe and the Times article during a recent conference call with analysts, said Businessweek; HCA owns 160 hospitals and 110 surgery centers. Bracken did indicate on the call that the Times might be working on more than one HCA story and had asked about HCA’s wound-care practices, treatment of uninsured patients, and emergency room procedures.

The cardiac procedures—so-called “interventional cardiology”—involve implantation of metal stents or balloons and heart disorder testing, explained Businessweek. Such procedures for the treatment of cardiac illness and strokes are some of HCA’s greatest revenue sources, as is the case in most hospitals, Skolnick told Businessweek.

According to the Times, its review found evidence that HCA cardiologists were performing procedures that they were unable to justify, going back as far as 2002 and as recently as 2010, said Businessweek. In some cases, patients suffered injury and experienced extended hospitalizations; half of all of the cardiac catheterizations—1,200 in all—were performed at one Florida hospital and on patients who were not diagnosed with significant heart disease, said the Times, which cited an HCA memo. Another hospital, found the Times, performed 43 percent of its 355 angioplasties “outside reasonable and expected medical practice,” citing a 2004 memo.

One, but not all of the suspected overuse was discussed with authorities by HCA, and HCA refused to say if it had or had not advised the government, insurers, or even patients who may have been placed at risk, the Times said, according to Businessweek.

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