Morning Briefing
Summaries of health policy coverage from major news organizations
DaVita To Pay $450M Settlement For False Claims, While Probed About Coding
The Wall Street Journal: DaVita HealthCare Subpoenaed Over Medicare Coding
DaVita HealthCare Partners Inc. has been subpoenaed by the U.S. Department of Health and Human Services, in connection with how the company codes diagnoses for Medicare Advantage patients. In a regulatory filling, the Denver-based company said the subpoena covers the period from Jan. 1, 2008, through the present and seeks documents from the company and its subsidiaries. DaVita specializes in kidney care and is one of the largest U.S. providers of dialysis services. (Beilfuss, 6/24)
Reuters: DaVita Healthcare Partners To Pay $450M For Violating False Claims Act: Justice Department
DaVita Healthcare Partners Inc, the largest provider of dialysis services in the United States, has agreed to pay $450 million to resolve claims that it violated the False Claims Act, the U.S. Justice Department said on Wednesday. It said the Denver-based company, whose largest shareholder is Warren Buffett's Berkshire Hathaway Inc., knowingly created unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients, and then billed the federal government. (Beech, 6/24)
The Denver Post: U.S. Government Subpoenas DaVita Over Medicare Coding
Denver-based DaVita HealthCare Partners Inc. disclosed Wednesday that it was subpoenaed by the U.S. Department of Health and Human Services for how patient diagnoses were coded under Medicare. The subpoena, which covers the period from Jan. 1, 2008, to the present, relates to HealthCare Partners, the medical and doctors network that DaVita acquired for $4.4 billion in 2012, and HealthCare Partners' subsidiaries, DaVita said Wednesday in a regulatory filing with the U.S. Securities and Exchange Commission. (Wallace, 6/24)
Modern Healthcare: Feds Expand Probe Into DaVita's Medicare Advantage Practices
The federal government has expanded its investigation into DaVita HealthCare Partners' Medicare Advantage risk-adjustment practices, DaVita revealed in a Securities and Exchange Commission filing Wednesday. DaVita said in the filing that HHS' Office of Inspector General recently issued a subpoena seeking documents related to DaVita and its subsidiaries' services to Medicare Advantage plans and organizations and “related patient diagnosis coding and risk adjustment submissions and payments” from 2008 to present. The company operates a large multispecialty medical group in addition to its main dialysis business. (Schencker, 6/24)
Meanwhile, Modern Healthcare reports how many dialysis patients do not get the best treatment method -
Modern Healthcare: Dialysis Patients Get Substandard Care Despite Guidelines
Many kidney failure patients continue to receive critical dialysis treatments through catheters, a vein access method that is widely known to increase the risk of serious infections, blood clots and even death. The best method (an arteriovenous fistula) is not always the first resort, despite more than 20 years of evidence and national best-practice campaigns encouraging its use. It's a problem some associate with poor access to care, misaligned reimbursement incentives and geographic disparities. (Rice, 6/24)
