December 15,2003

Grassley on Progress in the Tenet Healthcare Investigation

M E M O R A N D U M

To: Reporters and Editors
Re: Finance Committee Subpoenas Findings About Alleged Unnecessary Heart Operations at Tenet Hospitals
Da: Monday, Dec. 15, 2003

Today the Senate Committee on Finance, chaired by Sen. Chuck Grassley, subpoenaed documents from Blue Cross of California. The subpoena came as part of the committee’s investigation of allegations of unnecessary heart operations and procedures performed at TenetHealthcare Corporation’s Redding Medical Center, among other Tenet hospitals. The committee issued the subpoena at the request of Blue Cross.

Last month, Blue Cross publicly suggested that doctors at Tenet's hospitals in Redding and Modesto performed unnecessary heart surgeries. Specifically, “a review by independent cardiologists of 52 bypass operations at those hospitals had concluded that 85% of the surgeries at Redding had been unnecessary and that 59% at Tenet's Doctors Medical Center in Modesto had been unwarranted,” according to the Los Angeles Times. Blue Cross recently announced it was “satisfied that appropriate care will be facilitated for its members (at Modesto) with regard specifically tocoronary surgeries.”

Grassley, on behalf of the committee, is seeking the findings of that independent review;details of any changes Tenet is making to keep its contractual relationship with Blue Cross; and any information suggesting that Tenet has changed its practices at the Modesto facility to satisfy BlueCross.

Grassley also has asked the Department of Health and Human Services, Office of Inspector General, to investigate whether unnecessary cardiac procedures and surgeries, paid for under federal health care programs, may have been performed at Modesto. The Inspector General has several ongoing investigations involving Tenet hospitals. Last week, Tenet announced it is selling its Redding Medical Center in lieu of having the facility shut out of federal health care programs. Grassley made the following comment on today’s subpoena.

“I was alarmed when Blue Cross announced its concerns about Modesto, especially in lightof what happened at Redding Medical Center. Determining whether Redding is the only hospitalwhere Tenet may have placed profits ahead of patients is a primary concern. Apparently, Tenet has taken steps to satisfy Blue Cross that it’s delivering ‘appropriate care’ in Modesto. I’m interested to learn exactly what steps Tenet has taken. Patients and taxpayers deserve to know.”

Details from the subpoena follow.

December 15, 2003

Mr. David Helwig
President
Blue Cross of California
1 Wellpoint Way
Thousand Oaks, CA 91362

ATTACHMENT A

1. The findings and results of the independent study commissioned by Blue Crossregarding coronary artery bypass graft (CABG) surgeries conducted at Tenet hospitals, including butnot limited to Redding Medical Center and Doctors' Medical Center of Modesto.

2. A copy of the letter from Dr. Jeffrey Kamil to Dr. Newman regarding the outline ofprograms and processes that would be necessary for Tenet to implement to make a continuedcontractual relationship possible with Blue Cross.

3. All document correspondence relating to any actual or proposed commitment madeby Doctors’ Medical Center of Modesto, which satisfied Blue Cross that “appropriate care will befacilitated to its members with regard specifically to coronary surgeries.”