Features

Tenet to audit Medicare

By Gary Gentile The Associated Press
Thursday November 07, 2002

LOS ANGELES — The federal government is investigating whether Tenet Healthcare Corp. hospitals overbilled Medicare millions of dollars for costly procedures, the company said Wednesday. 

The U.S. Department of Health and Human Services will audit Tenet’s accounts at several hospitals. The probe was triggered by an insurance company reporting concerns over billings for a higher-than-average number of procedures, such as heart surgeries, that qualify for special payments. 

The so-called “outlier” payments are meant to reimburse hospitals for expenses over and above the flat fee Medicare pays for certain conditions. 

“We’re seeing indications of a problem there and want to see how extensive it is,” said Katherine Harris, a spokeswoman for the inspector general’s office of the health department. 

The payments in question were made over a period of months this year, Harris said. 

“We’re going to visit hospitals to be sure Medicare claims complied with Medicare regulations and were based on usual and customary charges for private pay patients,” Harris said. 

“We are pleased to cooperate with this audit, as we are confident that it will demonstrate that our hospitals did, in fact, obey the rules,” said Jeffrey Barbakow, chairman and chief executive officer of the Santa Barbara-based company. 

Last week, federal agents searched the office of two doctors who practice at a Tenet hospital in Redding. Tenet also is investigating allegations that the two performed unnecessary heart surgeries. 

The California medical board is seeking a restraining order against the two doctors, saying the evidence to date constitutes probable cause that the pair performed unnecessary invasive heart surgeries.