Medicare Compliance & Reimbursement

Federal agencies gang up on hospital giant. Yet another federal agency is looking into beleaguered Tenet Healthcare Corp.'s billing practices connected with Medicare outlier payments -but the Tenet probe could be just the tip of the iceberg for stepped-up enforcement at hospitals across the country. The Santa Barbara, CA-based chain said July 9 that the Securities and Exchange Commission has begun a formal investigation of the company and has subpoenaed outlier-related documents dating back to 1997. The HHS Office of Inspector General began looking into Tenet's practices last year, and the Department of Justice jumped on board Jan. 2. As things go for Tenet, so may they for other hospitals suspected of abusing the outlier system. Despite the Centers for Medicare & Medicaid Services' recent publication on new rules designed to stifle abuses, watch for the feds to pursue suspicious-looking past claims in coming months. Lesson Learned: Outlier payments aren't just a problem for Tenet - the Centers for Medicare & Medicaid Services has ordered its contractors to look into potential overpayments at hospitals across the country.