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The hospital chain operator Tenet Healthcare has dished out hundreds of millions of dollars to settle investigations and litigation related to allegations that it manipulated the Medicare billing system before 2003. Among the recipients of these payments have been the Department of Justice, the Securities and Exchange Commission and Tenet shareholders. But one group of plaintiffs that have not received any money is a collection of several thousand competing hospitals. And after the 11th Circuit’s decision on Sept. 4 (pdf) that affirmed a summary judgment in favor of Tenet, it looks more doubtful that they will ever get any money.

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