A $400 million fraud and kickbacks case against former Atlanta health care executives under investigation for a decade can finally advance to trial, after federal prosecutors won the right to use statements from 10 alleged coconspirators.
The long-awaited trial against former Tenet Healthcare executives John Holland and William Moore and co-defendant Edmundo Cota was stalled as prosecutors appealed an Atlanta judge’s ruling that blocked out-of-court statements from the alleged coconspirators, including Cota’s ex-wife.
On Sept. 25, the Atlanta-based federal appeals court sided with prosecutors, saying the judge was wrong.
“One need not show that a conspiracy was unlawful to introduce coconspirator statements,” the appellate court said. “So long as those statements were made during and in furtherance of a joint venture that included an opposing party, the statements are admissible.”
U.S. District Judge Amy Totenberg ruled in November 2022 that prosecutors couldn’t present coconspirator statements to a jury without first showing that the defendants knowingly violated the federal Anti-Kickback Statute. She said prosecutors had shown “scant evidence” that Holland, Moore and Cota intentionally orchestrated an illegal kickbacks conspiracy.
When prosecutors’ appeal was argued in November 2023, a judge of the U.S. Court of Appeals for the Eleventh Circuit said the ruling was “shocking,” as Totenberg had accepted in 2014 the guilty plea of Tracey Cota, who helped her then-husband, Edmundo Cota, run medical clinics for predominantly undocumented Hispanic women.
A trial in the case against Holland, Moore and Edmundo Cota had been scheduled to start in April 2023. A new trial date has yet to be set. Prosecutors and attorneys for the defendants did not immediately respond to questions.
Prosecutors alleged that Holland, Moore and the Cotas orchestrated a multimillion-dollar kickbacks scheme to have patients of Clinica de la Mama, run by the Cotas, referred to Tenet hospitals led by Holland and Moore in Georgia and South Carolina.
The plot allegedly resulted in the fraudulent billing of federal health care programs for at least $400 million and the fraudulent receipt of at least $127 million on claims. Prosecutors said Tenet, through Holland and Moore, paid more than $12 million in bribes to Clinica de la Mama to ensure patients gave birth at Tenet hospitals.
Holland, Moore and Edmundo Cota claimed the Tenet payments to Clinica de la Mama were for legitimate services, including the management of a physician residency clinic, translators, the handling of Medicaid eligibility paperwork, community outreach, and marketing.
Totenberg accepted Tracey Cota’s plea of guilty to a single count of conspiracy to pay and receive remuneration in exchange for Medicaid patient referrals, before Holland, Moore and Edmundo Cota were indicted in 2017.
Prosecutors argued that Tracey Cota’s guilty plea and statements to law enforcement, among other evidence, showed a criminal conspiracy underpinned the agreements between Tenet and Clinica de la Mama.
Holland, Moore and Edmundo Cota claimed they had relied in good faith on the advice of attorneys who vetted the contracts at issue.
Tenet, based in Texas, agreed to pay the federal government more than $900 million in 2006 to settle allegations of fraudulent billing and Anti-Kickback Statute violations. In 2016, Tenet and two subsidiaries – Atlanta Medical Center Inc. and North Fulton Medical Center Inc. — agreed to pay $513 million to resolve criminal charges and a civil case that accused the hospitals of paying kickbacks to get patient referrals.
About the Author
