Anti- Kickback Drama and Why it is bad news for all Hospitals

Two of the nation’s largest for-profit Health Systems, Tenet and HMA, got themselves sued by the Federal Government under the Anti-Kickback Statute last week. The Anti-kickback statute, in a nut shell, prohibits Providers from paying for referrals on patients covered under the Federal Medicare or Medicaid program. The allegations of the complaint center around two pregnancy clinics located in Georgia, and the steerage of illegal immigrants from those clinics to these hospitals. The State of Georgia has also joined the lawsuit to recover it’s spent Medicaid funds.
I understand both Health Systems should be given the benefit of the doubt unless and until the allegations are proven true in court. However, the whistleblower in this case is a former CFO of one of these organizations, and these allegations are very severe. How does this happen in 2013? Is it possible that people, or the corporations they represent, believe they can get away with something like this? Wasn’t there one person who stood up and said this isn’t a good idea?
The really sad part is that these sorts of high profile issues are not good press for Hospitals, at a time where the Healthcare System is under attack from all angles. True or not, the allegations lead to the incorrect media and societal perception, that Hospitals are greedy and ruthless and shady. It is bad press that we just do not need in this industry. It also creates legislative pressure that leads to tighter more stringent retroactive appeals by Government payers. This creates an extremely tedious and expensive extra burden on the Hospitals that are playing by the rules, which is the majority.
For that reason, I slap those who are involved in this on the wrist. I’m sure there is an excuse, or maybe even a reason for all of this, but at the end of the day was a little bit of gray really worth the fall out, not only to your organization but to the industry as a whole? May this be a lesson to all Healthcare professionals; you have a duty not only to yourself and your organization, but also to the industry as a whole, to uphold yourself in a highly ethical manner. This industry has enough pressure coming at it from the outside. We don’t need it started from the inside as well.

2 comments Add your comment

Max Sizemore

August 12th, 2013
7:32 am

“Hospitals are greedy and ruthless and shady”? Oh no, surely you jest. They’re just in business to help people, right? Stockholders be damned.

Incidentally, what part of the health care industry do you represent, and how much do those folks pay the AJC to give you a voice? No comments for three days. I guess you are not considered much of a factor.

Elizabeth Richards, healthcare attorney

August 12th, 2013
8:14 am

Thank you for your comment Max. I neither pay, nor am I paid to write for Healthflocker. Healthflocker is a blog written by Healthcare Executives for Healthcare Executives. I’m sorry that you missed the point of my post, which was that a few people give the entire industry a bad name.