Dallas-based Tenet Healthcare and two of its hospitals will pay approximately $514 million to settle criminal charges and civil claims in connection with illegal kickbacks for referrals, along with another $3 million in related expenses. 

A U.S. Department of Justice investigation stemmed from a civil lawsuit in which four Tenet hospitals were accused of paying kickbacks to pre-natal clinics in Georgia and South Carolina that referred thousands of undocumented patients to the hospitals for Medicaid-covered deliveries. Non-U.S. citizens typically are not eligible for Medicaid coverage, but under the Emergency Medicaid Program undocumented pregnant women can receive hospital services during labor and delivery.

Two of the hospitals—Atlanta Medical Center and North Fulton Medical Center— agreed to plead guilty to conspiracy to defraud the U.S. and other charges. 

In separate news, as of Sept. 30, Tenet terminated its network agreement with Humana for Medicare Advantage, commercial, Medicaid, individual health plans offered through the public exchange and Tricare products, according to Becker’s Hospital Review, because the companies were unable to negotiate a new contract. 

Leave a comment