Whistleblower Lawsuit Implicates Several Atlanta Hospitals in Medicaid Fraud Scheme

By Grant Law Office on September 17, 2013

According to a report by islandpacket.com, a federal whistleblower lawsuit alleges that several Atlanta-based hospitals operated by Tenet Healthcare Corp. and Health Management Associates engaged in an elaborate Medicaid fraud scheme. The state of Georgia has filed a coinciding lawsuit.

The suits allege that the hospital companies paid prenatal-care clinics ran by Hispanic Medical Management (HMA) to provide prenatal care to expectant, undocumented Hispanic women. Afterward, the clinics referred the patients to their hospitals for delivery and other newborn care services at Medicaid’s expense.

Under federal and state laws, hospitals cannot have patients referred to them if their procedures are covered by federal healthcare programs such as Medicaid. Although undocumented people are generally not eligible for Medicaid, they do receive coverage for emergency conditions, one of which is childbirth. Hospitals are reimbursed for the care they provide in these situations.

Representatives from the hospitals stated that they believed they were providing important services for people who did not have access to them. However, the U.S. Justice Department and the state of Georgia believe the hospitals’ real motive was always profit-driven.

The whistleblower who came forward with the allegations is Ralph Williams, former chief financial officer for an HMA-owned hospital in Monroe, Ga. The government says his position with the hospital was terminated after he voiced concerns about the referral payments.

If you have been a witness to fraudulent or wrongful actions committed by your company against the government, you should get in touch with the appropriate government officials and an experienced Atlanta whistleblower lawsuit attorney. At The Law Offices of Wayne Grant, P.C., we can help you bring your company to justice. To learn more about your rights and your options, call us at (404) 995-3955.