North Fulton Hospital, Georgia
A former senior executive of Tenet Healthcare Corp. has been indicted for allegedly allowing the illegal billing of over $400 million to Medicaid in return for patient referrals.
Tenet obtained more than $149 million in Medicaid and Medicare funds based on the illegal patient referrals, according to the Department of Justice.
John Holland, 60, of Dallas, formerly served as a senior vice president of operations for Tenet's southern states region, and CEO of North Fulton Medical Center in Roswell, Georgia.
Holland allowed for the payment of bribes and kickbacks in return for the referral of patients to North Fulton Medical Center and other Tenet hospitals including Atlanta Medical Center, Spalding Regional Medical Center and Hilton Head Hospital, according to the indictment.
Tenet maintained and operated an affiliated billing center in Boca Raton, Florida, that assisted in the processing, payment and Medicaid billings for the hospitals.
Holland allegedly took steps to skirt internal accounting controls and falsify Tenet's books, records and reports to conceal the kickbacks that helped Tenet bill the Georgia and South Carolina Medicaid Programs over $400 million, according to the charges.
Holland allegedly made false and fraudulent statements on Tenet's 2006 Corporate Integrity Agreement to the Health and Human Services Office of the Inspector General by certifying Tenet was in compliance with the terms of participation in the Medicare and Medicaid programs.
On Oct. 19, 2016, North Fulton Medical Center and Atlanta Medical Center pleaded guilty to conspiring to defraud the United States and violating the anti-kickback statute.
Tenet subsidiary Tenet HealthSystem Medical and its subsidiaries entered into an agreement to avoid prosecution for cooperating with the government's investigation and enhancing their compliance and ethics program and internal controls.
Tenet and its subsidiaries also agreed to pay over $513 million to resolve the criminal charges and civil claims arising from the matter, the DOJ said.
Holland was indicted on Jan. 24 in Florida and appeared in court on Feb. 1. He is charged with one count of mail fraud, one count of healthcare fraud and two counts of major fraud against the United States.