Leading Large Dialysis Organization Settled Huge Fraudulent Claims. May Impact CKD Patient Care.


Recently, DaVita HealthCare Partners Inc., was in the news after receiving six subpoenas from the U.S. Department of Health and Human Services' office of the Inspector General. Now, the Denver Post reports that the second Largest Dialysis Provider in the United States, "will pay up to Four-Hundred and Fifty-Nine Million Dollars to settle a whistle-blower lawsuit accusing the Denver company of defrauding the Federal Medicare program of millions of dollars."

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DaVita HealthCare Partners Inc. did not admit "any wrongdoing," but with this most recent settlement, DaVita has paid a total of nearly One Billion Dollars in mandatory payouts in the past three years (2012 to 2015). In October, for instance, DaVita paid Three-Hundred and Eighty-Nine Million Dollars to settle criminal and civil investigations into whether the company "offered kickbacks to kidney doctors for patient referrals," said the Denver Post. Similarly, in 2012 DaVita paid Fifty-Five Million Dollars to the Federal Government for medically overusing and double billing the Government for Epogen (an Anemia Drug). 

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Now, this most recent settlement also has to do with the misuse of medication. Lawsuit documents suggested that DaVita was throwing away good medicine and the company would then submit fraudulent claims to be paid by Medicare and Medicaid. In essence, the settled civil matter proposed that DaVita intentionally created and maximized their waste in order to receive significantly higher reimbursements and revenue for Venofer (an iron supplement) and Zemplar (Vitamin D) usage.

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Hence, if a patient needed 25 milligrams of Venofer, the patient was given that much and the rest of a 100 milligram vial was thrown away. Yet, Medicare would still be billed for the full 100 milligram vial. In another instance, a patient that needed 8 milligrams of Zemplar; DaVita Nephrologists were instructed to a use a 10 milligram vial, instead of four 2 milligram vials.

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DaVita's Chief Legal Officer, Kim Rivera said, "Although we believe strongly in the merits of our case, we decided it was in our stakeholders' best interests to resolve it."  This is likely because violators of the False Claims Act sustain huge penalties of $5,000 to $10,000 for each false claim. Therefore, a DaVita loss during a jury trial could mean it must pay thousands of dollars per claim, which would count every instance a Chronic Kidney Disease or Dialysis patient was given a dose of the drugs in question.

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As part of their current settlement, DaVita is expected to pay the Government Four-Hundred and Fifty Million Dollars, plus reserve an additional Forty-Five Million Dollars to cover fees. The Government will then work to compensate the appropriate parties. 

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Thus, Chronic Kidney Disease patients who conduct Dialysis should remain vigilant to ensure that they receive the best quality care, especially given the recent allegations of Dialysis Facility wrongdoings for profit maximization. While some actions are out of a Chronic Kidney Disease patient's control, a few major areas in which Dialysis patients should remain watchful include: Patient Care Technicians changing their gloves between working with different patients to avoid infection, verifying that the correct amount of medication is being provided to you when possible, and ensuring that medical professionals wash their hands before touching your Dialysis Access Site. 

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As most know, even Large Dialysis Organizations and Hospitals make errors and have oversights, that is why you must be intimately aware of your care so that you may limit negative health outcomes due to otherwise avoidable errors. What do you think about the most recent DaVita settlement? Share your thoughts with the over 20,000 Facebook Fan Page Friends by clicking here. For the latest breaking news and information about how those with Chronic Kidney Disease can better manage and improve their lives, visit KidneyBuzz.com every day as well as Like us on Facebook and Follow us on Twitter. 

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