(Thanks to Angie from Angie's Kidney Korner for making us aware of the following article)
Lawyers for two whistleblowers filed an amended complaint Monday afternoon in Federal court in Atlanta accusing dialysis providers DaVita Inc. and Gambro Healthcare Inc. of deliberately wasting hundreds of millions of dollars of medications in order to fraudulently boost reimbursements from Medicare and Medicaid. A complete copy of the amended complaint can be found here.
According to the suit, the companies designed multiple sets of directly conflicting internal
protocols dictating how specific drugs should be administered based on how the costs for such drugs were reimbursed by the government. The suit also charges that these "dosing grids" were designed to increase volume rebates and discounts to the defendants from the manufacturers of the medications.
"The complaint makes clear that for years, DaVita has used different sets of rules to game the Medicare system and illegally inflate their government reimbursements at taxpayer and patient expense," said L. Lin Wood, attorney for the whistleblowers. "Taxpayers and patients should feel a sense of outrage when they read the complaint and learn how DaVita has become a multi-billion dollar business due in large part to corporate strategies and protocols focused on extracting every dollar possible from the government rather than on improving the care of chronically ill patients."
The scheme centered on three drugs routinely administered to patients during dialysis: Venofer, Zemplar, Epogen.
In the case of Venofer and Zemplar, the suit alleges that the government reimbursed the defendants for "necessary wastage," such as medication that remained in a vial after the vial dose was administered. According to the suit, company protocols were designed to maximize the amount of drug wasted because the government paid DaVita for the amount of drug administered to the dialysis patients and the amount intentionally wasted and thrown away. For example, instead of using three 2 mcg vials to administer a 6 mcg dose of Zemplar with no waste, DaVita
