Are Tenet Healthcare’s False Claims Act Payouts the New Normal?

A rear view window glance of Tenet Healthcare reveals a very long streak of payments when it comes to the False Claims Act.  Tenet Healthcare operates 79 hospitals, more than 470 outpatient centers and has 130,000 employees across the United States.  Tenet’s three main business segments include hospitals, ambulatory care and Conifer Health Solutions, a San Francisco based healthcare management firm.

Tenet is slated for a payout of $514 million to resolve a whistleblower lawsuit involving several Atlanta-area hospitals and a medical clinic. Of that sum, $368 million comprises the civil resolution.

On February 19, 2014 the Department of Justice announced that it was intervening against Tenet Healthcare and four of its hospitals alleging that the hospitals paid kickbacks to obstetric clinics serving primarily undocumented Hispanic women in return for referral of those patients for labor and delivery at the hospitals. The hospitals then billed the Medicaid programs for the services provided to the referred patients and, in some instances, also obtained additional Medicare reimbursement based on the influx of low-income patients.

The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs. The Anti-Kickback Statute is intended to ensure that a physician’s medical judgment is not compromised by improper financial incentives and is instead based on the best interests of the patient.

“The Department of Justice is committed to ensuring that health care providers who pay kickbacks in return for patient referrals are held accountable,” said Assistant Attorney General for the Justice Department’s Civil Division Stuart F. Delery. “Schemes such as this one corrupt the health care system and take advantage of vulnerable patients.”

More information for whistleblowers is located at the Nolan Auerbach & White website.