5 Tenet, HMA Hospitals Face False Claims, Anti-Kickback Allegations

A federal judge has ruled a lawsuit alleging violations of the False Claims Act and the Anti-Kickback Statute against five healthcare facilities located in Georgia and South Carolina owned by Tenet and Health Management Associates will proceed.

HMA's Georgia subsidiary, HMA Monroe, is named as a defendant in the lawsuit. In addition, four of Tenet's subsidiary facilities are named in the lawsuit: Atlanta Medical Center; Roswell, Ga.-based North Fulton Hospital; Griffin, Ga.-based Spalding Regional Medical Center; and Hilton Head (S.C.) Hospital.

The lawsuit alleges the hospitals paid illegal kickbacks to clinics that referred undocumented pregnant patients to them for Medicaid-paid deliveries. Undocumented patients are not eligible for regular Medicaid coverage. However, they typically qualify for emergency medical assistance when they deliver their babies. 

The lawsuit also alleges the hospitals violated the False Claims Act by submitting fraudulent and improper cost reports to the government for reimbursement.

The lawsuit was originally filed in 2009 under the qui tam, or whistle-blower, provision of the False Claims Act. The whistle-blower, Ralph Williams, was an employee of an HMA hospital in Georgia when he filed the lawsuit. The government intervened in the lawsuit in February.

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