Tenet has offered to settle the Clinica de la Mama criminal and civil cases — for a lot more money than it had earlier set aside to cover losses. The health care giant is boosting "aggregate reserve" from $20 million to $238 million "to reflect an offer it made in February 2016 to resolve the matter," according to a recent statement.

But there's, "no settlement yet, it's our offer," the company informed the Atlanta Business Chronicle.

At issue are allegations that the health care giant's four hospitals and Health Management Associates kicked money back to Clinica de la Mama in return for referrals of Medicaid patients. The clinics give prenatal care to mainly Atlanta and Hilton Head, S.C., undocumented Hispanic women, noted the publication.
The boost in reserve dropped $184 million or $1.86 per diluted share in 2015 Q4. The company began working out a deal in January with the U.S. Department of Justice and the State of Georgia over the Clinica de la Mama criminal and civil proceedings.

"Tenet is strongly committed to complying with all government health program requirements and being a leader in ethical business practices. As we have disclosed previously in our public filings, the investigation relates to contracts between four of our hospitals in Atlanta and Hilton Head, South Carolina, and a local prenatal care provider," a company source told the Chronicle.

"We have fully cooperated during the entirety of the government’s investigation and will continue to do so. Since this is an ongoing matter, we don’t have any additional comment beyond what has been provided in our public filings,” they continued.

The scheme led to guilty pleas from Clinica's executives Tracey Cota and Gary Lang in a "conspiracy to violate the Anti-Kickback Statute by paying and receiving illegal remuneration in exchange for Medicaid patient referrals" according to a Department of Justice statement on the 2014 case.

“Our federal health care programs depend on providers exercising independent judgment in the best interests of patients,” said U.S. attorney Sally Quillian Yates.

“These illegal referral arrangements resulted in women being steered to deliver their babies at hospitals on the basis of Clinica’s and the hospitals’ financial self-interest, regardless of whether it was in the women’s best interest,” she noted.

This scheme was uncovered in a 2009 whistleblower suit against Tenet, according to Bloomberg. The accusation was that the hospital had paid local clinics for the referrals, stated the news service, adding that Tenet facilities in Georgia and South Carolina, were “designated as targets of the government’s criminal investigation.” A Tenet spokesman told Bloomberg at that time that the company had “disclosed this investigation in our public filings for some time.”

The hospitals involved were the Atlanta Medical Center; Hilton Head (S.C.) Hospital; North Fulton Hospital, Roswell, Ga.; and Spalding Regional Medical Center, Griffin, Ga.

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