In October of 2016, Tenet Healthcare Corp. agreed to pay over $513 million, including $368 million to settle a whistleblower-initiated False Claims Act lawsuit. The FCA case alleged the hospital corporation and four of its hospitals in Georgia and South Carolina paid the owner of walk-in obstetric clinics serving primarily undocumented Hispanic women (called “Clinica de la Mama”) to identify and funnel pregnant women to Tenet hospitals for labor and delivery services that would be paid for by Medicaid’s Emergency Medicaid Program. These kickbacks and bribes allegedly helped Tenet obtain more than $145 million in Medicaid and Medicare funds based on the resulting patient referrals.
The lawsuit was filed in 2009 by whistleblower Bill Williams, a U.S. Army veteran and accountant with over thirty years of hospital finance experience. The case was joined by the State of Georgia, and later by the U.S. Department of Justice, after years of investigation and pre-trial work by the whistleblower and his legal team.
U.S. Attorney Michael J. Moore of the Middle District of Georgia said that “Instead of providing health care services to expectant mothers in its area and receiving payment for those services from Medicaid, the hospital participated in a scheme to pay kickbacks in exchange for having pregnant women from outside its market funneled to its facility with the goal of increasing the amount of Medicaid money the hospital could claim.”