Feds, State Settle Part of Big Hospital Kickback Scheme

Part of a big Georgia hospital kickback case will be settled for nearly $1 million, while a related criminal investigation into a major national hospital company continues.

The U.S. Department of Justice announced June 4 that the United States has settled a False Claims Act lawsuit with Health Management Associates (HMA) and Clearview Regional Medical Center for $595,155. In addition, HMA and Clearview will pay the state of Georgia $396,770.

Federal investigators and the state of Georgia had alleged that from 2008 to 2009, the hospital paid kickbacks to an obstetric clinic that served primarily undocumented Hispanic women, in return for referral of those patients for labor and delivery at the hospital. The hospital then billed the Medicaid program in Georgia for the services provided to the referred patients.

Clearview in Monroe, Ga., was previously named Walton Regional Medical Center and was owned by hospital operator HMA during the time period relevant to the lawsuit. It is now owned by Community Health Systems.

"The allegations that the defendants in this case took advantage of undocumented pregnant women about to give birth are extremely troubling,” said Georgia Attorney General Sam Olens. “Health care providers’ top priority should be the care of their patients, not their bottom line.”

Meanwhile, a related criminal investigation of four metro Atlanta hospitals owned by Tenet Healthcare Corp. is ongoing, the Department of Justice said. Atlanta Business Chronicle reported June 2 that federal investigators recently ramped up that investigation, issuing a new subpoena to Tenet on May 6.

The hospitals involved include Atlanta Medical Center, South Fulton Medical Center, North Fulton Regional Medical Center and Spalding Regional Medical Center.

On April 10, the Department of Justice informed Tenet that its four hospital subsidiaries have also been designated as targets of the government’s criminal investigation.

The case began with a lawsuit filed by whistleblower Ralph D. Williams.