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OIG intends to exclude hospital from federal health care programs

Compliance Monitor, May 10, 2006

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The OIG said it intends to exclude Alvarado Hospital Medical Center (Alvarado) from participation in Medicare, Medicaid, and all other Federal health care programs, according to a written release issued by the OIG. The notice regarding the decision, which was issued to Alvarado and its parent company Tenet HealthSystem Hospitals, Inc., said the exclusion is based on allegations that Alvarado knowingly and willfully paid kickbacks in order to garner patient referrals.

The OIG said that Alvarado helped physician practices by giving them money to relocate new physicians by paying monthly salary and a monthly guarantee for overhead expenses in exchange for referrals.

Alvarado was indicted on these allegations but two jury trials ended with hung juries. The facility now has 30 days to submit documentation related to whether this exclusion is warranted and will have the ability to appeal the exclusion.

"Today's announcement should be a continuing reminder to health care providers that referrals of Federal health care program beneficiaries should be based on the quality of care that is to be provided to the beneficiary, and not as a result of a financial benefit to be realized by the source of the referral or the practitioner providing the services," said Inspector General Daniel R. Levinson in a written release.

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