VHS of Michigan Inc. (doing business as, The Detroit Medical Center Inc. (DMC)), Vanguard Health Systems Inc. (Vanguard), and Tenet Healthcare Corporation (Tenet) all agreed to pay a total of $29,744,065 to the federal government for providing kickbacks some referring physicians. The Department of Justice (DOJ) announced the settlement on May 31. Tenet bought Vanguard, which owned and operated several hospital and outpatient facilities, which included DMC.
How it worked
The government alleged that DMC, Vanguard and Tenet submitted false claims to Medicare from January 2014 through December 31, 2017, when it submitted fraudulent bills by providing mid-level DMC staff for free or below market value wages to 13 physicians. This type of staffing violates the Anti-Kickback Statute. Investigators further allege that the physicians were selected because they provided a large number of referrals to DMC-owned and operated Sinai Grace Hospital and Harper University Hospital. The hospital system admitted providing staff to physicians to get additional referrals for the DMC facilities.
“The Justice Department will pursue improper arrangements that have the potential to compromise physicians’ medical judgment,” Deputy Assistant Attorney General Michael D. Granston of the Justice Department’s Civil Division said in a statement. “Physicians should evaluate where to send patients for medical services based on the quality of care the patients will receive, not the financial benefits that the physicians will reap.”
This firm was not involved in this case, but it can work with those who identify similar attempts to defraud Medicaid or Medicare or violate the Anti-kickback Statute. Some who come forward wish to do so anonymously or with help from an attorney who handles these situations.