- Tenet and its hospital Desert Regional Medical Center in California have agreed to pay more than $1.4 million to settle allegations they violated the law by implanting unnecessary cardiac monitors in patients from 2014 to 2017 and charging Medicare for the procedures, the U.S Department of Justice said Tuesday.
- Implanting the devices, also known as loop monitors, was not without risk. It subjects patients to “needless peril, and taxpayers end up with the bill,” Timothy DeFrancesca, special agent in charge for the Office of Inspector General of HHS, said in a statement.
- The settlement resolves allegations and there has been no determination of liability in the case, DOJ said in its statement. The allegations stemmed from a lawsuit filed by a medical center employee, Michael Grace, who will share in the settlement and receive nearly $241,000.
A Tenet spokesperson told Healthcare Dive on Wednesday it stands behind its employees. “Our hospital and physicians identified and took steps to address this matter prior to the filing of the lawsuit and remain committed to full compliance with all federal healthcare program requirements,” the company said.
Last year was the 10th consecutive year in which DOJ recovered more than $2 billion from healthcare fraud settlements, recovering funds not only for the federal government but for state Medicaid programs as well.
The False Claims Acts is the primary civil tool the government has to address fraud, the agency has said.
Despite the streak of settlements, HHS is proposing to relax anti-kickback laws as a way to remove barriers as the industry shifts to value-based payment and care arrangements. Providers have argued the laws that were meant to deter physicians from referring patients to other services or places for their financial gain are too rigid for a system that now seeks more coordinated care among providers.
Some even suggested federal regulators could have gone even further in loosening the laws, according to comments submitted in response to the proposed rules.