One Of Nation’s Largest Dialysis Providers Agrees To $270M Settlement Over Medicare Advantage Fraud
The settlement cites improper medical coding by California-based HealthCare Partners from early 2007 through the end of 2014. According to the settlement, the company, which is part of giant dialysis company DaVita Inc., submitted “unsupported” diagnostic codes that allowed the health plans to receive higher payments than they were due.
Denver Post:
Denver-Based DaVita Reaches $270 Million Settlement With U.S. Department Of Justice
A subsidiary of Denver-based DaVita Inc. will pay $270 million to settle allegations it reported inaccurate information about medical patients’ conditions to the government, leading to higher Medicare reimbursements to insurers — of which the company received a share. The agreement, announced Monday by the U.S. Department of Justice, is the latest in a string of settlements with the government under which DaVita, a dialysis provider, has paid out hundreds of millions of dollars to resolve cases ranging from improper billing to anti-kickback probes. (Seaman, 10/1)
California Healthline:
Feds Settle Huge Whistleblower Suit Over Medicare Advantage Fraud
The settlement by HealthCare Partners Holdings LLC, part of giant dialysis company DaVita Inc., is believed to be the largest to date involving allegations that some Medicare Advantage plans exaggerate how sick their patients are to inflate government payments. DaVita, which is headquartered in El Segundo, Calif., did not admit fault. “This settlement demonstrates our tireless commitment to rooting out fraud that drains too many taxpayer dollars from public health programs like Medicare,” said U.S. Attorney Nick Hanna in announcing the settlement Monday. (Schulte, 10/1)
The Associated Press:
Health Company To Pay $270M Over Improper Billing Practices
California-based HealthCare Partners, which DaVita acquired in 2012, shared the overpayments with its parent company, prosecutors said. In one instance, HealthCare Partners sent out improper guidance advising its physicians to use an improper diagnosis code for a particular spinal condition that yielded increased reimbursement. (10/1)