Summary: DaVita Healthcare Partners has agreed to a $450 million settlement for overcharging the government for their drugs.
DaVita Healthcare Partners Inc., the largest kidney dialysis services provider in the United States, has agreed to pay $450 million to settle a whistleblower case claiming they’ve bilked the government by deliberately requiring dialysis facilities to use too large a dose of medicine only for the excess to be discarded, but nevertheless to be billed for. The settlement was announced Wednesday.
The success of the case comes as a relief to nephrologist Dr. Alon Vainer and registered nurse Daniel Barbir, former employees of DaVita who took on the medicine provider without the support of the federal government. This has been the largest such settlement in the history of the nation’s federal False Claim Act without government intervention. The two whistleblowers were represented by Atlanta lawyers Marlan Wilbanks and L. Lin Wood.
“Through personal sacrifice and courage, two whistleblowers exposed knowingly wasteful practices designed simply to increase profits and improperly drain the government’s resources,” said Acting U.S. Attorney John Horn. “This settlement returns hundreds of millions of dollars to the Treasury that had been improperly obtained by DaVita through these wasteful practices.”
Two abuses by DaVita were pursued, one in which a kidney dialysis medicine was purposely prescribed based on “dosing grids,” that provided the med in single-use vials giving extra medication, which was discarded by administrators, yet billed for. When in 2011 the Centers for Medicare and Medicaid Services changed their protocol for billing, making this wastage no longer profitable for DaVita, they subsequently changed their drug dosage.
Nevertheless, the company’s chief legal officer said last month that though executives “believe strongly in the merits of this case,” they nevertheless decided, “It was in our stakeholder’s best interest to resolve it.”
They had therefore set aside $495 million to settle the case, with $45 million to cover legal fees.
News Source: Law.com