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Tenet, HMA Named in Federal Kickback Suit

John Commins, for HealthLeaders Media, February 20, 2014

A Department of Justice complaint alleges that for more than 10 years, four hospitals in Georgia and one in South Carolina paid kickbacks to Georgia-based Hispanic Medical Management, which operated an obstetric care clinic serving mostly undocumented aliens.

The federal government said it will intervene in False Claims Act suits leveled against hospitals owned by Tenet Healthcare Corp. and Health Management Associates Inc., which have been named in an alleged kickback scheme involving obstetrics services for undocumented aliens.

The Department of Justice complaint alleges that starting in 2000 and continuing for more than 10 years, four hospitals in Georgia and one in Hilton Head, SC paid kickbacks to Georgia-based Hispanic Medical Management, which operated the Clinica de la Mama. The clinic was paid for obstetrics care to mostly undocumented Hispanic women in return for labor and delivery referrals to the hospitals, who then billed the Medicaid programs in Georgia and South Carolina.

In some cases, prosecutors allege, the hospitals obtained Medicare reimbursements based on the influx of low-income patients. Undocumented aliens are not eligible for Medicaid benefits in Georgia and South Carolina under most circumstances. However, some emergency labor and delivery care is reimbursed. The whistleblower suit alleges that false reimbursement claims were made to the Georgia Medicaid's emergency medical assistance program for newborn care.

The three Tenet hospitals in Georgia and one hospital in South Carolina that were named in the whistleblower suit are: Atlanta Medical Center, North Fulton Regional Hospital, Spalding Regional Hospital, and Hilton Head Hospital.

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