A major hospital chain in the U.S., Tenet Healthcare Corporation, along with two of its Atlanta-area subsidiaries, will pay more than $513 million in an attempt to resolve criminal charges and civil claims of a scheme aimed at defrauding the United States and to pay kickbacks for the acquisition of patient referrals.

Apart from that, two subsidiaries of Tenet that go by the names of North Fulton Medical Center Inc. and Atlanta Medical Center Inc., have also agreed to plead guilty to conspiring to defraud the United States and for paying health care kickbacks and bribes while knowingly violation the Anti-Kickback Statute (AKS).

The two subsidiaries will also forfeit more than $145 million to the United States, which represents the amount that was paid to them by the Medicare and Georgia Medicaid programs for services provided to patients referred as part of the scheme.

For the record, both subsidiaries of Tenet owned and operated acute-care hospitals that were situated in the greater Atlanta metropolitan area up until April 2016. Both Tenet subsidiaries were charged in federal court for obstructing the lawful government functions of the U.S. Department of Health and Human Services (HHS) and for violating the AKS, which prohibits payments that are meant to induce patient referrals for services that are paid for by Federal healthcare programs.

A non-prosecution agreement (NPA) was entered into by Tenet HealthSystem Medical Inc. and its subsidiaries (collectively THSM) with the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Northern District of Georgia related to the charges highlighted in the criminal information. Under the civil settlement, Tenet will pay $368 Million to the Federal government, the state of Georgia, and the state of South Carolina for the resolution of claims asserted against it under the federal and Georgia False Claims Acts.

In the words of U.S. Attorney Horn, “Our Medicaid system is premised on a patient’s ability to make an informed choice about where to seek care without undue interference from those seeking to make a profit. Tenet cheated the Medicaid system by paying bribes and kickbacks to a pre-natal clinic to unlawfully refer over 20,000 Medicaid patients to the hospitals. In so doing, they exploited some of the most vulnerable members of our community and took advantage of a payment system designed to ensure that underprivileged patients have choices in receiving care.”