Lori Fowler and Sandra Emerson, Staff Writers
Posted: 03/29/2013 05:10:03 PM PDT
Updated: 03/30/2013 12:56:37 AM PDT
A group of Inland Valley doctors who say they have not been able to fully treat their patients have filed a lawsuit against Chino Valley Medical Center and its director James M. Lally.
The doctors, who are a part of the Inland Pulmonary Medical Group with offices in Upland and Montclair, allege they are being blackballed because they won’t participate with what they call a scheme to overadmit and overbill patients, according to information from the complaint, filed Wednesday in San Bernardino County Superior Court.
“In a nutshell, Chino Valley is accused of devising and implementing a wrongful scheme that games California’s managed care system by, among other things, wrongfully encouraging managed care providers to needlessly diagnose and/or document conditions that gamer higher Medicare reimbursements,” according to the complaint.
Chino Valley Medical Center is a subsidiary of the Prime Healthcare hospital chain, one of the largest hospital chains in California. According to the complaint, it “operates according to the profit-based model that at times places an emphasis on maximizing profits at the expense of patient care.”
Edward Barrera, communications director for Prime Healthcare, said in an emailed statement that the “baseless” lawsuit filed this week by the Inland Pulmonary Group is repetitive of a lawsuit filed by another group of doctors a few years ago.
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