Author Topic: Fresenius Ordered to Pay $82.6 Million in Overbilling Case  (Read 7785 times)

cschwab

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(Updates in fifth paragraph with attorney's comments.)

May 26 (Bloomberg) -- Fresenius Medical Care AG, the world's biggest provider of kidney dialysis, was ordered by a judge to pay $82.6 million to resolve a lawsuit by the U.S. government and whistleblowers that it overbilled Medicare.

Fresenius must pay trebled damages of $38.9 million under the False Claims Act and statutory penalties of $43.7 million, U.S. District Judge William J. Haynes ruled yesterday in Nashville, Tennessee. The decision was made public today.

The lawsuit claimed that two companies now owned by Fresenius, Renal Care Group and Renal Care Group Supply Co., overbilled Medicare between 1999 and 2005 for home support dialysis supplies. RCG, a dialysis facility, violated Medicare statutes by billing for home dialysis supplies when it should have billed at the lower rate for clinics, the U.S. claimed.

Terry Morris, a spokeswoman for Fresenius, based in Bad Homburg, Germany, said the company just received the decision and would issue a statement.

"By the imposition of trebled damages and statutory penalties, it demonstrates the deterrent effect of whistleblower cases," said plaintiffs' attorney Eric Young, of Blue Bell, Pennsylvania. "It should put all defendants on notice that if they commit Medicare fraud, there will be serious consequences."

Two Whistleblowers

Young represents the two whistleblowers in the case, Julie Williams and Dr. John Martinez. In 2005, they sued under the False Claims Act, which lets private citizens sue on behalf of the government and share in any recovery. The U.S. Attorney's Office in St. Louis joined the case in 2007 and continued to work on it after it was transferred to Nashville.

In March 2010, Haynes ordered Fresenius to pay $19.4 million. The company asked the 6th U.S. Circuit Court of Appeals to overturn that ruling. That court dismissed the appeal. The government then asked Haynes to impose trebled damages and maximum penalties of $11,000 for each allowable claim under the False Claims Act.

In his ruling, Haynes granted that motion, reducing the overpayment damages from $19.4 million to $12.9 million, which he tripled. He also said the company falsely billed for 3,979 patients over four years.

The case is Williams v. Renal Care Group, 09-cv-738, U.S. District Court, Middle District of Tennessee (Nashville).

--Editors: Stephen Farr, Andrew Dunn.

http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/05/26/bloomberg1376-LLTLUY6VDKHV01-0UI54Q94LEBEIE4MKUPU9QN0RJ.DTL#ixzz1NXdMzkUs
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angieskidney

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Re: Fresenius Ordered to Pay $82.6 Million in Overbilling Case
« Reply #1 on: May 30, 2011, 11:10:10 AM »
Wow those money greedy buggers and then the tax payers have to pay and then in the news you hear how they want to cut cost in dialysis care! If companies were not so greedy than healthcare would be a LOT cheaper!

cschwab

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Re: Fresenius Ordered to Pay $82.6 Million in Overbilling Case
« Reply #2 on: June 01, 2011, 06:49:36 PM »
If companies were not so greedy than healthcare would be a LOT cheaper!

Very true, dialysis is already a money machine for these companies - but they have to push it.

Looks like the whistleblowers might make out though.  See whistleblowers usually get between 15% to 25%.  So figuring it out at 20% it looks like they could make ~$16 million!  Not bad for a good deed.
« Last Edit: June 02, 2011, 07:28:21 PM by cschwab »
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years

angieskidney

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Re: Fresenius Ordered to Pay $82.6 Million in Overbilling Case
« Reply #3 on: June 04, 2011, 08:40:31 AM »
Wow wish I could get paid like that for my good deeds :D

cschwab

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Re: Fresenius Ordered to Pay $82.6 Million in Overbilling Case
« Reply #4 on: June 05, 2011, 01:27:58 PM »
We may have to settle for a warm, fuzzy feeling!
Proud member of DialysisEthics since 2000

DE responsible for:

*2000 US Senate hearings

*Verified statistics on "Dialysis Facility Compare"

*Doctors have to review charts before they can be reimbursed

*2000 and 2003 Office of Inspector General (OIG) reports on the conditions in dialysis

*2007 - Members of DialysisEthics worked for certification of hemodialysis
technicians in Colorado - bill passed

*1999 to present - nonviolent dismissed patients returned to their
clinics or placed in other clinics or hospitals over the years