Hospital Owner Makes $43 Million Medicare Settlement

Tenet Healthcare Corp., which owns and operates , reached a $42.75 million settlement over allegations that it overbilled the federal Medicare program for inappropriate admissions to inpatient rehabilitation facilities.

The U.S. Attorney's Office for the Northern District of Georgia announced that the United States has reached an agreement with Tenet Healthcare over allegations that it violated the False Claims Act. 

The settlement resolves allegations pertaining to twenty-five inpatient rehabilitation facilities that Dallas-based Tenet has owned and operated throughout the country.  These facilities are designed for patients who need an intense rehabilitation program that requires a multidisciplinary, coordinated team approach to improve their ability to function. Because the patients treated at these facilities require more intensive rehabilitation therapy and closer medical supervision than is provided in other settings, such as acute care hospitals or skilled nursing facilities, Medicare generally pays at a higher rate for rehabilitation care.

The Justice Department alleged that, between May 15, 2005, and Dec. 31, 2007, Tenet improperly billed Medicare for the treatment of patients at these facilities when these patient stays did not meet the standards to qualify for admission.  Today’s settlement is the United States’ single largest recovery pertaining to inappropriate admissions to inpatient rehabilitation facilities. 

North Fulton Hospital offers inpatient rehabilitation services.

Sally Quillian Yates, U.S. Attorney for the Northern District of Georgia, said, “This settlement demonstrates our office’s continued commitment to protect crucial Medicare dollars from fraud and abuse. Inpatient rehabilitation facilities are expensive, and Medicare dollars should be reserved for patients who need the services–not for hospitals seeking to make money through improper billing.”