Dialysis company settles Athens woman's whistleblower lawsuit

[okarol]

Dialysis company settles Athens woman's whistleblower lawsuit

By LEE SHEARERupdated Saturday, May 25, 2013 - 9:35pm

A national dialysis services company will pay $7.3 million to settle an Athens woman’s federal whistleblower lawsuit.
Registered nurse Laura Davis, a Clarke Central High School graduate, had filed the lawsuit more than four years ago after beginning work at a Royston dialysis center owned by Dialysis Corporation of America. The company operated about three dozen outpatient dialysis facilities, but was acquired in 2010 by U.S. Renal Care of Plano, Texas, which agreed to the settlement.
Davis said in her lawsuit, filed by the Phillips & Cohen law firm of Washington, D.C.,that the dialysis company had overbilled Medicare and Medicare patients by millions of dollars for a drug prescribed for dialysis patients.
The intravenous drug, Epogen, is used to treat anemia and comes in vials that are slightly overfilled, because medical workers typically have to leave about 10 percent of the drug in each vial.
But the company was billing Medicare and Medicare patients for all of the drug in each vial, including the portion that didn’t get used, federal attorneys argued in documents filed in Maryland federal court.
Davis will share in the settlement. Under the federal False Claims Act, citizens can collect 15 percent to 25 percent of the amount recovered when the federal government joins in a lawsuit they file on behalf of the United States, according to Phillips & Cohen, the law firm that represented her.
Anger on behalf of Davis' patients motivated her complaint, Davis said.
“Not only were they billing Medicare, but they were turning around and billing my patients. These were people who were living on disability,” she said.
Federal officials announced the settlement in a press release this week.
“Health providers billing for phantom services cheat taxpayers, cheat programs straining to pay for vitally needed care, and cheat patients who pay inflated copayments,” said Nick DiGiulio, Special Agent in Charge, Office of Inspector General, U.S. Department of Health and Human Services for the region including Maryland, in the press release.
• Follow education reporter Lee Shearer at www.facebook.com/LeeShearerABH or https://twitter.com/LeeShearer.

http://onlineathens.com/local-news/2013-05-25/dialysis-company-settles-athens-womans-whistleblower-lawsuit

[Rerun]

I get the double billing is bad.  But, leaving 10% in the bottle?   Wh?  Don't they buy a case of vials and if they use a vial on me and throw away the last 10% I would think I should pay for that... I don't want air.



             

[rocker]

Because of the way the vials are structured, it is extremely difficult to get out the last bit.

[Zach]

I get the double billing is bad.  But, leaving 10% in the bottle?   Wh?  Don't they buy a case of vials and if they use a vial on me and throw away the last 10% I would think I should pay for that... I don't want air.
         

Actually, this is one way the scam works:

Say a patient normally receives 4,000 units per treatment using a 4,000 unit vial of EPO.
At some point the prescription changes to 4400 units, but the patient continues to receive the same amount of EPO in the syringe as before.

--Unless a tuberculin syringe or other type of 1cc syringe is used, there is no way to accurately measure out a dose of 4400 units.
The lawsuit stated the finer syringe was not used.

Medicare was originally billed for 4,000 units.
The fraud came when Medicare was billed for 4,400 units.

[Rerun]

OHHH  ok, got it.

Thanks           

[Zach]

OHHH  ok, got it.

Thanks           

Back at you!