The settlements resolve allegations that Dignity, Twin Cities and Sierra Vista knowingly submitted false claims to Medi-Cal for "enhanced services" provided for the adult expansion patients between Feb. 1, 2015, and June 30, 2016, and that Twin Cities and Sierra Vista provided for those patients between Jan. 1, 2014, and April 30, 2015.
Tenet and Dignity deny any wrongdoing, but say they settled to avoid costly and lengthy litigation.
Dignity Health and Tenet Healthcare Corporation subsidiaries will pay California and the federal government a combined $22.5 million to settle separate false claims allegations made for Medi-Cal "enhanced adult services," state and federal prosecutors announced.
Named in the settlement were Dignity Health's three hospitals and one clinic in Santa Barbara County and San Luis Obispo County and Tenet subsidiaries Twin Cities Community Hospital and Sierra Vista Regional Medical Center in San Luis Obispo.
Prosecutors say the settlements resolve allegations that Dignity, Twin Cities, and Sierra Vista ran an "organized scheme to wrongfully retain federal funds" from Medi-Cal's Adult Expansion program. California will get $2.25 million of the settlement.
The California Department of Health Care Services requires a California county organized health system to spend at least 85% of the funds it received for the Adult Expansion...
Over the last year, beyond traditional healthcare and federal procurement matters, the government has pursued federal False Claims Act (FCA) investigations and enforcement across high-risk areas, ...