Tenet Settles Yet Another FCA claim

Tenet Healthcare Corporation has agreed to settle yet another False Claims Act lawsuit. The healthcare giant is no stranger to such litigation, having settled a number of claims in the past few years.

On Feb. 11, Tenet and its affiliated hospital, Desert Regional Medical Center in Palm Springs, California, agreed to pay $1.41 million to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for implanting unnecessary cardiac monitors, according to a Justice Department press release.

The cardiac monitors, or loop recorders, were implanted by hospital cardiologists from 2014 to 2017. They are heart-monitoring devices that record a patient’s heart rhythm continuously for up to three years.

The settlement resolves allegations filed in a whistleblower lawsuit in March 2017 by  Michael Grace, a former hospital employee. The qui tam action was filed in the Central District of California (ex rel. Grace v. Tenet HealthCare Corp.; St. Francis Hospital-Memphis; Desert Regional Medical Center; and Apollo MD, Case No. 17-CV-1481).  As part of this settlement, Grace will receive $240,789 as his share of the government’s recovery.

Tenet is no stranger to healthcare fraud litigation. Last November, the company reached a tentative settlement to pay $66 million to resolve claims that it had billed for services provided to patients referred to it by physicians who had improper financial and kickback relationships with an Oklahoma hospital owned by Tenet. The settlement was revealed in quarterly SEC filings. The company said it had set aside $68 million and that a final resolution was subject to negotiation and final approval of a settlement agreement with the DOJ and any other definitive documentation required by OIG or other government agencies. “We believe this could be completed as early as the first quarter of 2020, at which time the monetary component of the resolution would be paid,” the company noted in the filing.

In October 2016, Tenet and two of its Atlanta-area subsidiaries agreed to pay more than $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the United States and to pay kickbacks in exchange for patient referrals. The subsidies, Atlanta Medical Center Inc. and North Fulton Medical Center Inc., agreed to plead guilty to conspiracy to defraud the United States and to pay healthcare kickbacks and bribes in violation of the Anti-Kickback Statute (AKS).

The scheme involved mostly undocumented, pregnant Hispanic women who were told at prenatal care clinics in Georgia and South Carolina that Medicaid would cover their costs if they gave birth at one of the Tenet hospitals. The clinics received bribes and kickbacks from the hospitals and involved about 20,000 women who received Medicaid benefits, according to the Department of Justice.

Last year, a federal judge in Atlanta refused to dismiss a fraud case against a former Tenet executive and two co-defendants involved in that case. John Holland, a former vice president and CEO of LHP Hospital Group in Plano, Texas, and co-defendants William Moore and Edmundo Cota are accused of taking part in the kickback scheme that led to some $400 million in allegedly fraudulent billing to state Medicaid programs.

One of largest hospital operators in the country, Tenet has spent hundreds of millions of dollars in fines and settlements involving healthcare fraud over the last two decades. No amount of compliance training or fines seems to have stemmed the tide.

The Health Law Offices of Anthony C. Vitale assists clients in filing and defending whistleblower claims.  If you have any questions contact us at 305-358-4500 or email us at info@vitalehealthlaw.com.

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The Health Law Offices of Anthony C. Vitale