Sen. Elizabeth Warren (D-Mass.) pressed Agrawal on another topic: providers who stayed in the program despite repeated transgressions. “Instead of kicking big-time bad actors out of Medicare, the government settles with a fine and the company enters into a corporate integrity agreement,” she said.
Warren cited the case of Tenet Health, a $5.8 billion corporation with 81 hospitals and several hundred outpatient centers. “In 1994, [Tenet] paid a $379 million fine for illegal kickbacks to doctors, and signed a corporate integrity agreement. Then in 2006, Tenet got caught fraudulently billing Medicare and paying illegal kickbacks to doctors, and paid a $900 million fine.”
“In 2012, Tenet admitted breaking the law again, and paid a $42 million fine. Just a year later, they got a $4 million slap on wrist for misconduct,” she continued. “So if a big company can commit major fraud and be fined and promise to be good, and move on, I’m not sure there’s an incentive not to break the law. When is it that you say, ‘Enough is enough’?”
Agrawal responded that settlements are not handled by his office but by the Justice Department and the Health and Human Services Office of Inspector General (OIG)…