Reply #13: Carol Lam, brought two successive expensive and extensive criminal prosecutions against Tenet [View All]

[L. Coyote]

May 11, 2006 - Health Care Law Blog - by Mr. Greg Piche, an attorney at Holland & Hart LLP where he specializes in health care law.
TENET MEDICARE EXCLUSION – BEING PECKED TO DEATH BY FEDERAL DUCKS
http://hollandhart.typepad.com/healthcare/2006/05/tenet_medicare_.html

On May 8, the Office of Inspector General announced its intention to exclude a Tenet Healthcare Corp. hospital in San Diego from Medicare and other federal programs. The U.S. attorney in San Diego, Carol Lam, brought two successive expensive and extensive criminal prosecutions against Tenet, Alvarado Hospital Medical Center and a former administrator at the hospital.

The allegations were basically that Alvarado used an aggressive physician recruiting incentive program to funnel cash to existing physicians practices in order to induce referrals from these physicians. Both cases took many months to try. Both ended in mistrials when the juries deadlocked.

Congress first mandated the exclusion of physicians and other health care practitioners convicted of program-related crimes in the 1977 Medicare-Medicaid Anti-Fraud and Abuse Amendments. In 1981 Congress enacted the Civil Money Penalties Law, which authorizes the HHS and OIG to impose civil money penalties and program exclusions against individuals and entities who submit false or fraudulent, or otherwise improper claims for Medicare or Medicaid payment. The Medicare and Medicaid Patient and Program Protection Act of 1987 established certain mandatory and discriminatory exclusions for stated types of misconduct.

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