Tenet Healthcare Corporation resolves False Claims Act allegations for over $29 million – Politics & Medicine

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Recently VHS of Michigan doing business as Detroit Medical Center Inc (DMC), Vanguard Health Systems Inc. (Vanguard) and Tenet Healthcare Corporation (Tenet) agreed to pay $29,744,065 to resolve allegations that they allegedly violated the False Claims Act by offering bribes. to referring physicians.

DMC operates several hospitals in the Detroit area, including Sinai-Grace Hospital and Harper University Hospital. DMC operated as a non-profit hospital system until 2010 when it transferred to join Vanguard Health Systems. Then, in October 2013, Tenet acquired hospitals and outpatient facilities owned and operated by Vanguard, including DMC and the two aforementioned hospitals.

The settlement resolves allegations that DMC, Vanguard and Tenet caused false or fraudulent claims to be submitted to Medicare. Specifically, the hospitals, Sinai-Grace and Harper University, leased the services of mid-level practitioners employed by DMC, such as nurse practitioners or physician assistants, to 13 physicians either at no charge or below fair market value, in violation of the Anti-Kickback Statute (AKS).

The government further alleged that the 13 doctors were chosen for this benefit because of the large number of patients referred to the two hospitals involved, and that the purpose of the arrangements was to induce doctors to refer other Medicare patients to DMC institutions. This would have taken place from January 1, 2014 to December 31, 2017.

The case was originally brought under the qui tam provisions of the False Claims Act by a former employee of Wayne State University Medical School, which is affiliated with DMC. This employee will receive more than $5 million as part of the settlement.

The AKS prohibits offering, paying, soliciting, or receiving any compensation to induce the recommendation of items or services covered by Medicare and other federally funded programs.

This finding makes it clear that when physicians refer patients to hospitals, they should do so based on their own professional judgment and the medical needs of their patients, and not for personal financial benefit, said U.S. attorney Dawn. N. Ison for the Eastern District of Michigan. . Our office is ready to review even the most complicated financial arrangements and pursue legal action where appropriate.

A spokesperson noted that the health system as well as the former and current owners do not admit any responsibility in the settlement of the case and once they became aware of the allegations, Tenet and DMC cooperated fully with the government throughout its investigation. The issue has been fully resolved to avoid expense and operational distraction. We remain committed to fully complying with all state and federal health care program requirements and to providing high quality care to serve our community. The spokesperson also noted that no new lease was signed once Tenet took possession of the DMC facilities, indicating that the actions had since ceased.

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