Be Careful What You Sign!

With the filing of a lawsuit against the former General Counsel of Tenet Healthcare Corporation, the Justice Department sent a message to in-house counsel and corporate compliance officers around the nation: Be Careful What You Sign!

The government alleges that Christi Sulzbach, who was Tenet's associate general counsel and corporate integrity program director, reviewed, signed and submitted false certifications to the Department of Health and Human Services that allowed Tenet to bill Medicare for millions of dollars in claims that it was not entitled to receive.

According to the complaint that was filed in federal court, Sulzbach, who became Tenet's general counsel in 1999, signed certifications that were submitted to HHS and resulted in almost $18 million of Medicare claims. Specifically, the government believes that Sulzbach signed the certifications attesting that Tenet was in compliance with all federal program legal requirements despite being advised by Tenet's outside counsel that some of the contracts at issue violated the Stark Act.

Although the government entered into a $22.5 million dollar settlement with Tenet relating to these physician contracts in 2004, that agreement did not release Sulzbach's liability.

This case is an example of why it is important, especially with increasing emphasis on Stark Act compliance, to critically analyze all financial arrangements between hospitals and referring physicians. The government recently released the "Phase III" Stark final rules, effective December 4, 2007, which the government portrays as an attempt to "simplify the rules and provide additional guidance" on compliance with the prohibitions on certain physician self-referrals. These ongoing efforts to provide guidance to the health care community will inevitably lead to even less tolerance for providers who fail to comply.