Medicare and Medicaid
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Kidney Dialysis Provider Accused of Wasting Medicine for Profit
Kidney dialysis provider DaVita has been accused of wasting medicine to increase its profits from Medicare, according to the New York Times. A lawsuit brought by a physician and a nurse who served as a director of a dialysis clinic purchased by DaVita claim that the company used larger vials of medicine than required and then charged Medicare for the unused portion, which was discarded. The suit claims that the alleged practice resulted in hundreds of millions of extra payments from Medicare. DaVita treats nearly one-third of the dialysis patients nationwide.
DaVita Spent More Per Patient on Iron Drugs Than Any Other Provider
The plaintiffs allege the DaVita would make nurses use 10 microgram vials of medicine instead of a 6 microgram dose contained in 3 microgram vials. DaVita would then bill Medicare for the entire 10 micrograms. The practice also involved an iron drug called Venofer, which required 25 milligram doses. DaVita would supply the medicine only in 100 milligram containers and then bill Medicare for 100 milligrams of medicine even though 75 milligrams were wasted. The federal government investigated the claim and decided not to join the suit. Records for 2008 revealed that DaVita spent more per patient on iron drugs than any other provider. The case is now pending in the United States Distict Court in Atlanta.
The physician who brought the lawsuit stated that he and the coplaintiff "saw how ridiculous the whole thing was." He noted that that the coplaintiff "tried on his level" to get the system changed, "and I tried on my level and got zero, zero response." A spokesperson for DaVita responded that using larger containers helped minimize needle sticks and protected patients and nurses from increased exposure to possible infection. He also claimed that doctors chose the amount of the doses.
Medicare Changed Reimbursement Procedure for Dialysis Providers
Medicare has since changed its reimbursement procedure for dialysis providers. It no longer pays separately for drugs but includes both treatment and drugs in one lump payment. Now, if facilities can treat patients for less than the Medicare reimbursement, they get to keep the difference. Not surprisingly, practices at dialysis centers quickly changed, including the size of containers used for medicines.