Tennessee Healthcare FCA Enforcement
Medicare/Medicaid enforcement data, FCA settlement history, and risk assessment for healthcare providers in Tennessee.
38K
Medicare Providers
$18.6B
Medicare Spending
$280M
FCA Settlements (5yr)
High
Enforcement Risk
Enforcement Landscape
Major hospital company headquarters (HCA, CHS). DOJ Strike Force presence. Significant enforcement against hospital chains and substance abuse facilities.
Hospital chain settled $148M over unnecessary admissions. Lab company settled $68M over unnecessary testing. Multiple substance abuse facilities prosecuted.
Primary Enforcement Targets
Enforcement Statistics
Medicare Spending
$18.6B
Medicaid Spending
$14.8B
FCA Settlements (5yr)
22 cases
Qui Tam Filings (5yr)
34 cases
What This Means for Tennessee Providers
With 38K Medicare providers and $18.6B in Medicare spending, Tennessee represents a major target for healthcare FCA enforcement.
Over the past 5 years, 22 FCA settlements totaling $280M have been reached in Tennessee, with 34 qui tam (whistleblower) lawsuits filed. Primary enforcement targets include: Hospitals, Physicians, Home Health, Substance Abuse, Labs.
Healthcare providers in Tennessee should conduct regular compliance audits, particularly focusing on billing practices for high-volume procedure codes and referral relationship compliance with Stark Law and Anti-Kickback Statute requirements.