New Jersey Rep. Bill Pascrell wants federal health regulators to investigate the nation’s largest for-profit hospital operator.

The Democrat sent a letter to HHS Secretary Xavier Becerra this week urging him to launch an inquiry into HCA Healthcare’s emergency department admissions and alleging misconduct.

Pascrell, who is also the chairman of the House Ways and Mean Committee’s subcommittee on oversight, alleged that HCA admissions from the emergency room are not always out of medical necessity.

He claimed HCA sets admissions targets and retaliates against clinicians if those targets are not met.

“Recent reports of systematic, unnecessary inpatient admissions intended to raise more profitable reimbursement rates, in addition to severe understaffing issues, raise disturbing questions about HCA’s corporate policies and practices,” Pascrell said in his letter.

HCA said similar allegations were raised previously by an investment group. The health system responded to those claims in March of last year and after a thorough review and “found nothing to suggest that ER or medical-staff physicians admit patients to our hospitals based upon anything other than their independent medical judgment,” according to a U.S. Securities and Exchange Commission filing.    

The health system said it is reviewing the Congressman’s letter and will respond to his requests for information, according to a statement provided to Healthcare Dive.

HCA reported a profit of about $7 billion in 2021, an increase from $3.8 billion the year prior, according to the health system’s annual filing with the SEC. Admissions for the Nashville-based system were up 4.8% in 2021 from the prior year when comparing the same facilities year over year, excluding those that were divested or acquired.