Former Tenet exec indicted in $400 million Medicaid fraud case

[[{"fid":"22310","view_mode":"default","type":"media","attributes":{"height":208,"width":270,"style":"float: right; margin-left: 10px; margin-right: 10px;","alt":"John Holland.jpg - John Holland, former senior vice president for Tenet Healthcare","title":"John Holland, former senior vice president for Tenet Healthcare","class":"media-element file-default"}}]]John Holland, a former senior vice president for Tenet Healthcare’s southern region, has been charged with allegedly taking part in a scheme to pay bribes in exchange for patient referrals and resulting in $400 million in fraudulent Medicaid billings.

According to the U.S. Department of Justice, the scheme ran from 2000 to 2013, with bribes and kickbacks being paid in return to Miami-area clinics in return to referring pregnant Medicaid beneficiaries to facilities such as Atlanta Medical Center.

As outlined in an earlier criminal case against Tenet, pregnant women were told Medicaid would only cover their delivery services if they had their baby at a Tenet hospital. Expectant mothers were then forced to travel long distances when the delivery could’ve been covered at another hospital closer to their homes.

The DOJ said Holland “took affirmative steps to conceal the scheme” by getting around Tenet’s internal accounting and falsifying its records.

The kickbacks allegedly helped Tenet bill Medicaid programs for more than $400 million, obtaining more than $149 million in Medicaid and Medicare funds based on the resulting referrals.

“Medicaid patients have the right to seek healthcare without fearing that care is tainted by bribes and illegal kickbacks,” said David J. LeValley, Special Agent in Charge for FBI’s Atlanta Division.  “Not only did patients suffer because of these alleged actions, but this kind of alleged abuse threatens to drive up the cost of healthcare for everyone.  The FBI is committed to ensuring that federal laws related to the healthcare industry are enforced, and this case is an example of that commitment.”

Holland has pleaded not guilty to the charges, which include one count of mail fraud, one count of health care fraud and two counts of major fraud against the United States.

Tenet admitted wrongdoing in settling these charges for $513 million in October 2016. In a statement to Reuters, Holland’s attorney said he believed the earlier settlement “should have ended the matter.”