Dive Brief:
- Tenet Healthcare has offered to pay the government $238 million to settle kickback allegations involving four of its Georgia hospitals.
- The hospitals are accused of paying the Clinica de la Mama for referring undocumented pregnant women to them for deliveries that were paid by Medicaid, in violation of the False Claims Act.
- The news came as the for-profit hospital operator posted a $140 million net loss for the 2015 fourth quarter.
Dive Insight:
The company expects the federal government to make a counterproposal. [T]here can be no assurance that the ongoing discussions to resolve these matters will be successful,” the company stated in the filing, adding, "The terms of a final resolution may require us to pay significant fines and penalties and give rise to other costs or adverse consequences that materially exceed the reserve we have established.”
Tenet’s loss came despite stronger-than-expected revenues of $5.03 billion, up from $4.47 billion in the same period a year ago. The Dallas-based firm had projected revenues of $4.74 billion to $4.94 billion for the final quarter, according to the The Wall Street Journal.
Contributing to the loss was a rise in uninsured patients and unresolved debt at its hospitals, though hospitals in states that expanded Medicaid under the Affordable Care Act saw a drop in uninsured admissions.
Overall, uncompensated care rose 10% to $1.42 billion in the 2015 fourth quarter, compared with $1.27 billion a year ago.
However, in the six Medicaid expansion states where Tenet operates — Arizona, California, Illinois, Massachusetts, Michigan and Pennsylvania, “same-hospital uninsured plus charity admissions” dropped by 187 admissions, or 11.1%, in the fourth quarter, the firm said. Meanwhile, the period saw a 1% rise in Medicaid admission, up by 287.