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2 ex-Tenet units admit Medicaid fraud scheme


North Fulton Hospital, in Georgia.

Two  former  Tenet Healthcare Corp.’s subsidiaries admitted to conspiring to defraud Medicaid by using referral contracts for translation services to funnel pregnant patients to the hospitals. Tenet agreed to pay a $514 settlement to end the case, which again reminded people that  for-profit hospitals tend to have more cases of such corruption because of pressure from senior executives to boost revenue and profit — and stock price.

Atlanta Medical Center and North Fulton Hospital in Georgia each pleaded guilty to one count of conspiracy to violate federal anti-kickback laws and defraud the United States, Tenet said.

In 2014, the U.S. Justice Department joined a whistleblower lawsuit accusing Tenet and four of its hospitals of allegedly making illegal payments to clinics run by Clinica de la Mama and Hispanic Medical Management in exchange for Medicaid patient referrals. Such referrals violate the federal anti-kickback statute and Stark law.

Modern Healthcare reported that the federal government alleged  that Tenet made payments to Hispanic Medical Management under the ruse of commissioning translation, marketing and Medicaid-eligibility determination services.

“The federal government acknowledged that individuals at the hospitals withheld information from Tenet about the agreements and circumvented Tenet’s policies and procedures to prevent such illegal conduct,” the publication reported.

To read the Modern Healthcare article, please hit this link.

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