Department of Justice Seal Department of Justice
FOR IMMEDIATE RELEASE
MONDAY, FEBRUARY 10, 2003
WWW.USDOJ.GOV
CIV
(202) 514-2007
TDD (202) 514-1888

FIVE TENET HOSPITALS IN FLORIDA PAY UNITED STATES $4.3 MILLION
FOR ALLEGEDLY VIOLATING FALSE CLAIMS ACT


WASHINGTON, D.C. Tenet HealthCare, the nation's second largest for-profit hospital chain, has paid the United States $4.3 million to settle allegations that five of its Florida hospitals submitted fraudulent claims to Medicare, the Justice Department announced today. The five hospitals are Coral Gables Hospital, Parkway Regional Medical Center in North Miami Beach, Hollywood Medical Center, Hialeah Hospital and Florida Medical Center in Fort Lauderdale.

The settlement resolves allegations that all five hospitals violated the False Claims Act by upcoding pneumonia diagnosis codes and that two of the facilities - Parkway Regional Medical Center and Hollywood Medical Center - upcoded septicemia diagnosis codes for in-patient claims submitted for reimbursement. Upcoding is the practice of improperly assigning a diagnosis code to a patient discharge that is not supported by the medical record for the purpose of obtaining a higher level of reimbursement from Medicare for that hospital discharge than the hospital would otherwise receive.

Three of the hospitals were named defendants in a False Claims Act qui tam or whistleblower suit filed by Health Outcomes Technologies, Inc. As a result of the settlement, Health Outcomes Technologies will receive $309,303 of the government's recovery. Under the qui tam or whistleblower provisions of the False Claims Act, a private individual or concern can file suit on behalf of the United States and receive a portion of the settlement if the government takes over the case and reaches a monetary agreement with the defendants.

The claims in this suit are similar to allegations brought by the United States against 104 Tenet hospitals in an action filed in the federal court on January 9, 2003 in Los Angeles. The case is entitled United States ex rel Health Outcomes Technologies, Inc. v. Parkway Regional Medical Center, Coral Gables Hospital and Hollywood Medical Center, Case No. 01-3332-CIV-Jordan. The suit was filed in Miami in the United States District Court for the Southern District of Florida.

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