Renal Care Group faces suit for false Medicare billing

Renal Care Group faces suit for false Medicare billing

St. Louis Business Journal - 2:33 PM CDT Tuesday, July 17, 2007

The United States filed a civil complaint against Renal Care Group, Renal Care Group Supply Co. and Fresenius Medical Care Holdings Inc. alleging that the firms fraudulently billed the Medicare program for supplies and equipment provided to End Stage Renal Disease patients, U.S. Attorney Catherine Hanaway said Tuesday.

The lawsuit was filed as a qui tam lawsuits, which are filed by private individuals on behalf of the government. These type lawsuits are normally sealed and are often associated with whistleblower accusations.

End-Stage Renal Disease (ESRD) is a life threatening condition in which a patient's kidneys are unable to remove toxins from the blood, thus necessitating some form of dialysis treatment. The government's Medicare program generally provides coverage for ESRD patients.

The Government's complaint alleges that between January 1999 and December 2005, RCGSC submitted claims to the Medicare program for home dialysis supplies provided to End-Stage Renal Disease patients for reimbursement of the supplies and equipment. All of these claims, as well as related claims for support services rendered by RCG dialysis clinics were false because the defendants were prohibited from and not qualified to bill Medicare for these home dialysis patients.

Under federal law, the Medicare program pays companies that provide dialysis supplies to ESRD patients only if the companies that provide the supplies are truly independent from dialysis facilities and the ESRD patient chooses to receive supplies from the independent supply company.

Due to the false claims presented to the United States by defendants, the United States has suffered damages and is seeking multiple damages under the False Claims Act, to be determined at trial, plus a civil penalty of $5,500 to $11,000 for each fraudulent claim presented for payment.

Renal Care Group, (RCG), a for-profit corporation and dialysis provider, recently merged with competitor Fresenius Medical Care. Fresenius Medical Care Holdings Inc. (FMC), based in New York, is the American subsidiary of Fresenius Medical Care AG, a German corporation. FMC acquired RCG and Renal Care Group Supply Co. (RCGSC) by merger in March 2006, and assumed all of their liabilities and responsibilities.

RCG had its principal place of business in Nashville, Tenn., and had locations throughout Missouri, including multiple facilities in the St. Louis metropolitan area, according to a release.