Senator Requests Tenet Healthcare Probe

By Associated Press

November 7, 2003, 8:20 PM EST

MODESTO, Calif. -- Sen. Chuck Grassley, chairman of the Committee on Finance, has requested an investigation into charges that physicians at a hospital owned by Tenet Healthcare Corp. performed unnecessary surgeries and the facility billed the federal government for them.

Grassley, R-Iowa, made the request Friday to the Office of Inspector General at the U.S. Department of Health and Human Services.

Blue Cross of California recently announced it would no longer cover non-emergency bypass surgeries at the Doctors Medical Center in Modesto after an independent review of 23 operations found that 13 were not medically necessary.

Earlier this year, DMC's parent company, Santa Barbara-based Tenet, paid a $54 million settlement to the U.S. Justice Department for allegedly performing unnecessary cardiac procedures and surgeries at another one of its hospitals, Redding Medical Center. The procedures were billed to the federal Medicare and Medicaid programs. The billing errors were initially found last year during a routine state audit.

In addition, the state Department of Health Services announced Monday that its audit of Redding Medical Center found the hospital was overpaid nearly $12 million through government-funded health programs. The hospital has repaid $8.9 million of the excess payments, DHS said.

Tenet, in a response filed this week with the Securities and Exchange Commission, said Blue Cross has no right to end its contract with DMC based on what Tenet called "scant information."

Blue Cross officials said the insurer had three experts separately review the cases, and each came to the same conclusion.