U.S. Attorney in Los Angeles Requests Documents on Cardiology Programs at Three Tenet Healthcare Hospitals
The U.S. attorney's office in Los Angeles has requested documents dating back to 1998 related to coronary procedures and billing practices at three major Los Angeles area hospitals owned by Santa Barbara-based Tenet Healthcare, the Los Angeles Times reports. The hospitals include Daniel Freeman Memorial Hospital and Centinela Hospital Medical Center in Inglewood and USC University Hospital in Los Angeles. Some of the "larger and more profitable" Tenet facilities in California, the hospitals have seen their cardiac services grow in recent years, the Times reports. According to data from the Office of Statewide Health Planning and Development, cardiac procedures at USC University Hospital more than doubled to 442 between 1999 and 2001. At Centinela Hospital, the number of bypass and other cardiac operations rose from 75 in 1999 to 179 in 2001, while cardiac catheterization services more than tripled during the same period to 1,809. Tenet said Friday that it would hand over to federal investigators documents including arrangements with cardiologists who practice at the hospitals. According to sources familiar with the investigation, prosecutors are focusing on whether heart patients received unnecessary treatments and whether the hospitals improperly recruited physicians, the Times reports. The document request came exactly one year after federal agents raided a Tenet's Redding Medical Center and accused two cardiologists at the facility of "needlessly performing bypass operations and other procedures on patients," according to the Times (Vrana/Peterson, Los Angeles Times, 11/1). In August, Tenet officials agreed to pay $54 million to settle allegations that the two physicians performed unnecessary heart surgeries and defrauded Medicare (California Healthline, 9/29). Since October 2002, the Senate Finance Committee, the Securities and Exchange Commission, the HHS Office of Inspector General, the Justice Department and the Federal Trade Commission have launched separate investigations into Tenet related to alleged Medicare fraud and other issues. The company also faces an investigation by the Florida Medicaid Fraud Control Unit (California Healthline, 10/31).
Steven Campanini, a Tenet spokesperson, said, "It is inappropriate for anyone to speculate that this information request for documents is in any way similar to Redding Medical Center. There is no subpoena, there was no raid. This is a letter requesting information." But analysts said it is "apparent that federal prosecutors were widening their investigation" into Tenet, the Times reports. "This is potentially opening a Pandora's box -- people in Southern California worried that they may have had some unnecessary heart surgeries," Andreas Dirnagl, a health care analyst with brokerage firm Harris Nesbitt Gerard, said. "People ... could start questioning heart procedures at all Tenet facilities," he added. The U.S. attorney's office in Los Angeles declined to comment on the investigation, the Times reports (Los Angeles Times, 11/1).
In related news, Blue Cross of California, one of the state's largest health insurers, on Friday announced that a review by independent cardiologists of cardiac procedures at Tenet's Redding Medical Center and Modesto-based Doctors Medical Center showed that a "high percentage" of coronary bypass operations performed on Blue Cross members were "unnecessary," according to the Times. Dr. Woodrow Myers, chief medical officer for Blue Cross, said the review of 52 bypass operations performed at the two hospitals showed that 85% of those performed at Redding and 59% of those performed at Doctors were inappropriate. Myers said that as of the first week in October, Blue Cross will no longer authorize elective bypass operations at the two facilities. Steve Newman, chief executive of Tenet's California operations, said in a statement Friday that Blue Cross "made serious allegations based upon a very small sample of cases." He added that Tenet has proposed further patient safeguards at Redding and Doctors while the company reviews the cases.
The Senate Finance Committee on Friday said that it would subpoena Tenet if the company continued to withhold information related to a report by Mercer Human Resource Consulting on the cardiology program at Redding. In September, the committee requested "a wide range of materials from Tenet," including the report by Mercer, which had been commissioned by Tenet (Los Angeles Times, 11/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.