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Former Tenet exec indicted for alleged role in $400M fraud scheme


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Former Tenet exec indicted for alleged role in $400M fraud scheme

John Holland, former senior vice president of operations at Tenet Healthcare Corp., was indicted for alleged participation in a $400 million scheme to defraud the U.S. government, the Georgia and South Carolina Medicaid programs and prospective patients of Tenet hospitals.

Holland was charged in an indictment filed in the Southern District of Florida with one count of mail fraud, one count of health care fraud and two counts of major fraud against the U.S.

The indictment alleges that Holland, from about 2000 through 2013, engaged in a scheme relating to the payment of bribes and kickbacks in return for the referral of patients to North Fulton Medical Center Inc. and other Tenet hospitals in the Southern states region, including Atlanta Medical Center Inc., Spalding Regional Medical Center Inc. and Hilton Head Hospital.

These kickbacks and bribes allegedly helped Tenet bill the Georgia and South Carolina Medicaid Programs more than $400 million, and Tenet received more than $149 million in Medicaid and Medicare funds based on the resulting patient referrals.

In addition, the indictment claims that Holland took actions to hide the scheme by circumventing internal accounting controls and falsifying the company's books, records and reports.

Also, the indictment alleges that Holland made false and fraudulent statements to the U.S. Department of Health & Human Services' Office of Inspector General relating to Tenet's 2006 corporate integrity agreement, where he falsely certified that the company complied with the terms of participation in the Medicare and Medicaid programs and the terms of the agreement, despite knowing that Tenet was paying for illegal patient referrals.

Tenet received over $10 billion in payments from federal healthcare programs during the term of the corporate integrity agreement from 2007 through 2011.

On Oct. 19, 2016, North Fulton Medical Center and Atlanta Medical Center pleaded guilty to conspiring to defraud the U.S and to violate the Anti-Kickback Statute. Tenet HealthSystem Medical Inc. and its units also entered into a nonprosecution agreement with the government at that time.

Under the terms of the agreement, Tenet HealthSystem and Tenet Healthcare will avoid prosecution if they, among other requirements, cooperate with the government's ongoing investigation and enhance their compliance and ethics program and internal controls.

Tenet also agreed to retain an independent compliance monitor to address and reduce the risk of any recurrence of violations of the Anti-Kickback Statute by any entity owned in whole, or in part, by Tenet. The company and its units also agreed to pay over $513 million to resolve the criminal charges and civil claims arising from the matter.