If you think that a hospital suffers financially when it delivers a baby to an illegal immigrant mother, as I used to, think again.
The Justice Department has announced a financial settlement of a complicated civil and criminal case against Tenet Healthcare Corporation in which the company was forced to pay back to the feds more than a half a billion dollars that it had received for providing fraud-related maternity services to illegal alien mothers giving birth to thousands and thousands of instant U.S. citizens over a period of many years.
Half a billion dollars.
Or more precisely "$513,000,000 to resolve criminal charges and civil claims" according to the press release issued by the U.S. Department of Justice. Two of the hospitals agreed in the settlement to plead guilty to criminal fraud charges. Where that leaves the executives of the hospitals was not clear.
These were Medicaid-funded births taking place in for-profit hospitals, primarily in Georgia, but also in North and South Carolina. The Medicaid system regards any birth as a medical emergency and funds it; the baby is immediately eligible for the Medicaid baby program. The court case thus sheds some light on another of the taxpayer costs associated with illegal immigration, the tax-paid medical bills.
Tenet was charged with, essentially, bribing another, much smaller for-profit health care organization, Clinica de Mama, to refer its illegal alien pregnant mothers to Tenet's hospitals. The women had little information and little choice and most of them went to where they were sent. Some, according to the complaint in the PACER files of federal court documents (case 3:09-cv-00130-CDL), were told (erroneously) that the only way that they could access Medicaid assistance was through the hospital favored by Clinica.
The Tenet/Clinica relationship was interesting. Though half a billion dollars was at stake, over the years, the complaint in the PACER file speaks of the bribes as being in the $15,000 to $20,000 a month range; at $17,500 for a month, over five years, this works out to be a shade over a million dollars.
Further — and this shows how creative crooks can be as they work in or near the migration field — Tenet used Medicaid funds to pay the bribes. This Tenet did by charging Medicaid for interpreter services allegedly provided by Clinica; in other circumstances, this would be a legitimate cost item.
The problem, as Ralph D. Williams, briefly the chief financial officer of one of the many hospitals in the case, discovered was that no such services were provided — the payments to Clinica were simply for the illicit referrals of the pregnant women. The Medicaid program, understandably, forbids such practices.
Williams was fired for pointing out the lack of interpreter services, but he more than got his revenge. He brought the court case under the qui tam provisions of the Federal False Claims Act, filing, on behalf of the government, against Tenet and Health Management Associates, Inc., another hospital firm. The settlement indicates this whistle-blower will be rewarded with $84 million for bringing this matter into the courts.
There was an earlier settlement involving a small portion of this overall case. It involved the payment of $595,155 by Health Management Associates and was described in a Justice Department press release on June 4, 2015.
The half-billion charge relates to the federal definition of fraud in these cases; the hospital services were, in fact, provided to the women and their babies, but since there was fraud in the reference process (denied in writing by Tenet) the entire payments for the maternity care services had to be forfeited.
Illegal immigration does not just relate to farm workers wading the Rio Grande; it can mean huge profits for big corporations.