Dive Brief:
- Tenet Healthcare agreed to pay $29.7 million to the government to settle allegations it had paid kickbacks to doctors to refer Medicare patients to its Detroit Medical Center facilities, according to a statement from the Department of Justice.
- The DOJ alleged that two DMC hospitals, Sinai Grace Hospital and Harper University Hospital, offered the services of mid-level practitioners for free or below market value to 13 physicians in exchange for patient referrals between 2014 and 2017, violating the Anti-Kickback Statute. The agency said the physicians were selected because of their large number of referrals to these hospitals.
- The settlement resolves allegations made under the whistleblower provisions of the False Claims Act by Jay Meythaler, a former employee of DMC-affiliated Wayne State University Medical School. He’s set to receive $5.2 million as part of the settlement.
Dive Insight:
The settlement with Tenet comes as federal prosecutors increasingly use the FCA — which targets people who knowingly and falsely claim money from the government — to stifle healthcare fraud.
During the 2022 fiscal year, settlements and judgements under the act exceeded $2.2 billion — with more than $1.7 billion related to the healthcare industry.
“Physicians should evaluate where to send patients for medical services based on the quality of care the patients will receive, not the financial benefits that the physicians will reap,” Deputy Assistant Attorney General Michael D. Granston of the Justice Department’s Civil Division said in a statement.
In March, the American Hospital Association and health insurance lobby AHIP argued in an amicus brief to the Supreme Court that the government's expanded use of the FCA could threaten “legitimate business activities of every government contractor, hospital, healthcare provider, health insurance provider and grant recipient in the nation.”
The settlement with Tenet also names DMC and Vanguard Health Systems, which previously owned DMC and was acquired by Tenet in 2013. Tenet did not immediately respond to a request for comment.
In a statement to The Detroit News, DMC spokesperson Brian Taylor said DMC, Tenet and Vanguard admitted no liability.
“Once we became aware of the allegations, Tenet and DMC fully cooperated with the government throughout its investigation. The matter was resolved fully to avoid the expense and operational distraction. We remain committed to full compliance with all state and federal health care program requirements and providing high-quality care to serve our community,” Taylor said.
