Tenet Healthcare Corp. said it received a civil subpoena from HHS' inspector general's office seeking documents from the company's headquarters and five of its hospitals in California and Nevada.
Tenet said the subpoena covers agreements that the hospitals, one of which is now closed, made with a physician group known as Women's Cancer Center, Los Gatos, Calif., and 10 physicians who are or were members of the group. The investigation does not involve any patient-care issues, said Tenet spokesman Steven Campanini, but he would not provide any other details about the nature of the investigation. Santa Barbara, Calif.-based Tenet faces other investigations and at least one whistleblower lawsuit related to its physician relationships.
The subpoena is not related to any investigation that Tenet previously had disclosed, Campanini said. That includes the probe of physician relationships at Tenet's Alvarado Hospital Medical Center, San Diego, where Women's Cancer Center has an office. The inspector general's office and the Internal Revenue Service raided the 193-bed hospital on Dec. 19, 2002.
"We realize that the only reason that we're talking about this is because of the microscope that we've been under," Campa- nini said. "We're choosing to be very transparent."
In a statement, Tenet General Counsel Christi Sulzbach said civil subpoenas from the inspector general's office "are not uncommon in the highly regulated healthcare industry." Sulzbach said the company would fully cooperate with the subpoena.
Mac Thornton, who served as general counsel to the inspector general from 1990 to 2002, said he wouldn't characterize a civil subpoena from his old office as a common occurrence. "A provider who gets one has definitely got something to worry about," Thornton said. HHS' inspector general's office has stepped up its interest in the financial relationships between hospitals and physicians in the last few years, he said.
Typically, Thornton said, the inspector general's office issues these subpoenas when there is a whistleblower lawsuit under the False Claims Act. The government, he said, is required to determine whether the allegations in such lawsuits have any merit. Such lawsuits are sealed from public view initially, he added, so it is difficult to say whether one exists in a particular case.
Other Tenet legal trouble includes a probe of whether two nonemployed physicians performed medically unnecessary procedures at 188-bed Redding (Calif.) Medical Center and falsely billed Medicare for them.
In a case that may be more similar to the investigation revealed last week, Tenet faces a trial, scheduled to start Oct. 14 in U.S. District Court in Miami, on a 1997 civil False Claims Act lawsuit alleging antikickback and Stark law violations at Tenet's 391-bed North Ridge Medical Center, Fort Lauderdale, Fla. In the lawsuit, a former Tenet executive in South Florida alleged that Tenet overpaid for physician practices and signed physician contracts that exceeded fair market value, in both cases to induce patient referrals (March 4, 2002, p. 17).