Tenet Health sets aside $238M to resolve kickback allegations; Adventist Health pays $2M following self-reported violations of chemotherapy billing

> According to a fourth quarter financial report released by Tenet Health, the Dallas-based system has set aside $238 million as a settlement offer for criminal and civil investigations into an alleged kickback scheme. Last year, federal prosecutors began investigating allegations that Tenet hospitals in Georgia and South Carolina paid a local clinic to send undocumented Hispanic women to the hospital for deliveries in order to collect on Medicaid reimbursement. Tenet began settlement negotiations with the Department of Justice and the state of Georgia in January. Report

> Adventist Health System has agreed to pay more than $2 million to settle claims it administered single-dose vials of chemotherapy drugs to multiple patients and upcoded certain infusion services between 2007 and 2011. Adventist self-disclosed the issues to the feds in 2012, and previously repaid more than $800,000. Announcement

> A dental hygienist in Idaho was indicted on charges of healthcare fraud and aggravated identity theft. She is accused of submitting fraudulent claims to healthcare programs from 2012 through 2013. Cherie Dillon worked as a dental hygienist at Dental Healthcare with Heart and Payette, but allegedly performed dental services outside her scope of practice and received payment for those services from health programs such as Medicaid by using the provider number of another dentist in the office. Announcement

Health Payer News

> Government officials showed a rushed and inadequate response to clear signals that Healthcare.gov was in trouble during its 2013 launch, according to a new report by the Office of Inspector General. Investigators credited the rocky start to poor management and leadership, which led to delays in decision-making and less time devoted to website development. Article

> One year after the Anthem hack exposed information of more than 80 million members, consumers, regulators and Anthem officials are still debating the impact of the breach. Anthem says cyber attackers have not sold member information, but a class action suit brought by consumers alleges member information has been used fraudulently and Anthem is liable for "grossly inadequate computer systems and data security practices." Article

And finally… It's no coincidence David Bowie's "Space Oddity" came out that same year. Article

Suggested Articles

The HHS OIG is asking for an additional $23.7 million to support fraud oversight that has benefited from an emphasis on data analytics.

A New York surgeon was sentenced to 13 years in prison for fraud and more physician practice news from around the web.

A federal judge has ruled that the U.S. government’s remaining fraud case against UnitedHealth can move forward.