The settlement resolves a lawsuit filed by former hospital employee Michael Grace saying that Tenet and Desert Regional violated the federal False Claims Act, the U.S. Department of Justice said in a news release.
The lawsuit alleged the medical center charged Medicare after cardiologists unnecessarily implanted cardiac monitors commonly known as loop recorders in patients between 2014 and 2017 at the hospital in Palm Springs. Medicare only reimburses services and treatments that are reasonable and medically necessary.
“Invasive medical procedures, such as implanting heart monitors, are not without risk,” said Timothy B. DeFrancesca with the Office of Inspector General of the U.S. Department of Health and Human Services. “Therefore, when these procedures are medically unnecessary, as contended in this case, people in government health programs are put at needless peril, and taxpayers end up with the bill.”
The claims resolved by the agreement are allegations only, and there has been no determination of liability, the Justice Department statement said. Tenet acknowledged it settled the lawsuit “related to a portion of cardiac loop recorder devices implanted from 2014 to 2017” at Desert Regional Medical Center.
“We stand behind the efforts of our team – our hospital and physicians identified and took steps to address this matter prior to the filing of the lawsuit and remain committed to full compliance with all federal healthcare program requirements,” Tenet said.
Provisions of the False Claims Act allow private individuals to sue for false claims on behalf of the government and to share in any recovery. Under the law, Grace will receive about $240,000 as his share of the government’s recovery, officials said.