CNN - DaVita Medicare Fraud

Specialties Urology

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Specializes in RN, BSN, CHDN.

This is not true dialysis clinic's get paid one amount if the patients gets meds or doesnt get meds

You cannot bill for meds anymore since Jan 1st 2011 when bundling came in

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Specializes in Geriatrics, Home Health.

A doctor and a nurse have filed a whistleblower lawsuit against Davita, accusing the company of Medicare and Medicaid fraud.

It started with a chance conversation between a doctor and a nurse several years ago. But that brief encounter may end up exposing what could be one of the largest Medicare frauds in U.S. history.

Dr. Alon Vainer, a medical director at dialysis clinics in Georgia, was discussing clinic procedures with one of the nurses, Daniel Barbir. The two men say they saw something they believed was very wrong: expensive medicine, and lots of it, was being tossed in the trash. And the clinic workers were being told to do it, the two men say.

"When we sat down and started talking about it and getting into details, we actually realized exactly what was going on," Vainer said.

The alleged waste was being carried out on a massive scale and, the nurse and the doctor said, they knew why almost immediately. They claim it was a way for their company, DaVita Inc., to defraud the government, overbill Medicare and Medicaid and make a fortune.

"We're talking in the hundreds of millions, easily," Vainer said. "The profit this company raked from those two schemes, only from those two drugs, was hundreds of millions of dollars."

The allegations of massive fraud have implications for all Americans. The alleged fraud would have involved Medicare and Medicaid patients, whose medicine is paid for by U.S. taxpayers.

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Specializes in Nephrology, Cardiology, ER, ICU.

Merged threads. Agree that there is more to his then meets the eye.

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Merged threads?

Two separate stories? (I am not where it is convenient to download the vid posted in the OP).

Dr. Vainer brought whistleblower allegations a couple years ago and it was (magically--surprise!) dismissed by the Feds. This looks like the same issue the plaintiffs vowed to ? The original lawsuit included bilking Medicare for Zemplar as well as Venofer.

"...The lawsuit says that until January, for example, DaVita required nurses to use one 10-microgram vial of Zemplar, a vitamin D drug, instead of a six-microgram dose in three two-microgram vials,. It then billed Medicare for all 10 micrograms even though four went unused...

...Dr. Daniel Coyne, a nephrologist at Washington University School of Medicine who treats some patients at DaVita clinics, said it was “absolutely true” that the iron drug was given a bit at a time to make more money.In 2008, the latest year for which figures are available, DaVita spent more per patient on iron drugs than other dialysis chains, according to figures from a government-funded program that tracks dialysis. DaVita also had the highest expenditures on vitamin D drugs and Epogen.

“How could it possibly be that patients in DaVita facilities were getting so much more iron than patients in other facilities and not getting iron overload?” said Dr. Coyne, who is not associated with the lawsuit. “The answer is the iron wasn’t going into them. It was being thrown away to make a profit.”

http://www.nytimes.com/2011/07/26/health/26dialysis.html?pagewanted=1&_r=2&

I thought this CNN quote from this article regarding the lawsuit was humorous:

"The dialysis empire is run by CEO Kent Thiry, who dresses like one of the Three Musketeers, has adopted a company slogan of 'One for all and all for one' and in company staff meetings leads his employees, who he calls villagers, in cheers of "DaVita!"..." :)

Dialysis company accused of giant Medicare fraud - CNN.com

Ooops there's more.

Another suit this year:

"...The lawsuit was filed by Ivey Woodard, a former Amgen employee who claimed that DaVita allowed Amgen employees to, among other things, review charts of patients, which led to increased dosages of Epogen in some cases, according to the suit. The federal government declined to intervene in the suit and is not pursuing the matter, according to DaVita's latest annual report.

Fresenius Medical Care, Waltham, Mass., was dismissed as a defendant in the suit in 2010, according to court documents.

DaVita still faces investigations in other states that are mainly related to the company's dealings with physicians and joint ventures, according to its annual report. DaVita also is under investigation in New York by HHS' Inspector General's Office by the U.S. Attorney's Office for the Eastern District of New York, regarding its Medicaid-backed care."

Read more: DaVita settles False Claims case for $55 million | Modern Healthcare http://www.modernhealthcare.com/article/20120703/NEWS/307039967#ixzz2Dqa31M2N

?trk=tynt

Oh dear.

C'mon Trauma, get real. "More than meets the eye?" I'll say.

And let's not forget who our Obama-appointed Health Czar is, DeParle ... a coikidink in these DaVita lawsuits that the Feds "choose not to pursue?" I think not. Corporate America and the Feds... it's one big circle-jerk.

"...Among DeParle’s corporate connections: DaVita Inc., which owns and operates kidney dialysis centers, has been the subject of several government probes into its billing and drug-prescribing practices, most recently in December by Justice Department investigators in Georgia. DeParle joined the DaVita board in May 2001 and resigned in July 2008 “to devote more time to her other business activities,” according to the company. She earned more than $2 million in compensation and stock sales, according to records at the Securities and Exchange Commission...

...Five of the corporations whose boards DeParle served on have paid a total of $566 million since 2003 to settle fraud or product liability cases, often involving tax dollars paid by Medicare."

Obama health czar led companies in trouble - Health - Health care | NBC News

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Deleted. Duplicate.

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Well, all those musketeer costumes ain't cheap.

...or the champagne fountains at the corporate parties in Vegas, complete with bikini-clad waitresses and diamond encrusted politicians as keynote speakers...don't ask me how I know.

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As far as I know, with the current Fe protocol, that's the way FMC does it too....
Not when I worked there. Fmc did not do this. And I am not a fan of FMC at all. They do a lot of things I think are questionable, but nowhere near the scale of this.
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kudos

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This is not true dialysis clinic's get paid one amount if the patients gets meds or doesnt get meds

You cannot bill for meds anymore since Jan 1st 2011 when bundling came in

Bundling... yes, unfortunate.

I know, let's launch corporate-owned pharmacies and divert the patients there.

Oh, wait.

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Specializes in Nephrology, Cardiology, ER, ICU.

And then let's send the meds to the dialysis clinics so they can play pharmacist....

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This is absolutely true and not only at DaVita. If you report it, you get "removed". After "bundling", algorithms were adjusted to increase the use of less expensive medication, and decrease the use of more expensive medications. Acceptable hemaglobin values were also lowered to combat the cost.

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This is absolutely true and not only at DaVita. If you report it, you get "removed". After "bundling", algorithms were adjusted to increase the use of less expensive medication, and decrease the use of more expensive medications. Acceptable hemaglobin values were also lowered to combat the cost.

That may have been par for the course and coinkidink, but regardless we have to cut DaVita some slack here.

A few recent studies have indicated higher mortality/morbidity from cardiac disease in (especially diabetic) patients whose HgB levels are "normalized" by throwing excess EPO at them, or at hypo-responders. Higher stroke risk as well. It's one reason (besides the sensitizing risk) that we see less transfusions too.

As far as being (cough) "removed", I'd believe it.

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