THE STATE OF HEALTHCARE IN TENNESSEE Heading Into November: Quality, Cost, and Accountability in Tennessee's Hospital Market
President Trump has made healthcare transparency and affordability a centerpiece of his second-term agenda. So here's a question Tennessee lawmakers may not want to answer: Is the state of Tennessee's hospital market something they're proud of?
Start in Memphis, where Dallas-based Tenet Healthcare operates Saint Francis Hospital, a 519-bed acute care facility that holds a one-star rating from the Centers for Medicare and Medicaid Services -- the federal government's own measurement system for hospital quality. The hospital's average Medicare payment across documented procedures runs in the upper bracket nationally, with a value score of D.
Tenet Healthcare's legal record nationally is among the most extensive of any hospital corporation in the country. The most prominent single settlement came in 2006, when Tenet agreed to pay the federal government more than $900 million to resolve False Claims Act allegations related to unlawful billing practices. The U.S. Department of Justice announced the settlement at the time as a reflection of its "continued resolve to hold responsible those who engage in health care fraud in any form."
That wasn't the end of it. The DOJ's criminal fraud docket for United States v. Tenet Healthcare Corporation — tied to a massive multi-state kickback scheme in which Tenet hospitals paid over $513 million to resolve criminal charges and civil claims — was updated as recently as August 20, 2025, according to public department records. The SEC separately charged Tenet and four former senior executives in 2007 with concealing an earnings manipulation scheme that exploited the same Medicare system. Tenet paid a $10 million penalty to settle those charges.
Tenet isn't the only Tennessee hospital story with a federal angle. An active False Claims Act litigation currently playing out in a Chattanooga federal courtroom involves Erlanger Health System.
In March 2026, U.S. District Judge Curtis L. Collier of the Eastern District of Tennessee denied Erlanger's motions to dismiss two major fraud lawsuits, one brought by the DOJ and one by whistleblower relators. The suits allege that Erlanger violated the Stark Law and the Anti-Kickback Statute by paying improper compensation to physicians in exchange for patient referrals and then submitting those claims to Medicare and Medicaid.
The federal government's own star ratings put a major Memphis hospital at one out of five stars. The DOJ's criminal file on Tenet Healthcare was updated last summer. A Chattanooga federal court has refused to dismiss active fraud suits against another Tennessee hospital system.
As lawmakers in Nashville and Washington turn their attention toward November, with healthcare cost and transparency already on the national agenda, Tennessee legislators have not, as a matter of public record, been asked whether they consider any of this acceptable.
