John Oliver recently devoted most of his show “Last Week Tonight” to explaining how America funds kidney dialysis. Oliver admitted the topic was likely to make his viewers push the button on your TV remote marked “Dear God Literally Anything Else.”
But it’s an important topic. The United States “continues to have one of the industrialized world’s highest mortality rates for dialysis care,” despite spending more on it than other nations.
Since 1972, the federal government has covered all kidney dialysis. We now spend 1 percent of the federal budget just on kidney dialysis. That’s half as much as we spend on the entire Department of Education!
Why do we spend so much? You can probably guess, fraud and greed. Two large companies, Fresenius Medical Care and DaVita, control 70 percent of the market.
Megallan Handford, a former DaVita employee who was fired for trying to unionize its employees, explained that:
“When I was working at DaVita, the priorities for transitioning patients was to get them on dialysis and get the next patient on as soon as possible,” Handford told Oliver. “You would have sometimes 15, maybe 25 minutes to get that next patient on the machine, so you were not properly disinfecting.”
This focus on profits above patients is reflected in the nearly $1 Billion in False Claims Act Settlements that DaVita has paid out in the last several years:
- $350 Million (plus another $39 Million in forfeiture and $22 Million to states) for paying kickbacks to obtain referrals
- $450 Million for falsely billing for drug waste
- $55 Million for over-prescribing Epogen
Nor do these settlements appear to represent the end of DaVita’s legal issues. DaVita faces a lawsuit and related government subpoenas over use of a non-profit, the American Kidney Foundation to push patients from government healthcare to Healthcare Exchange-offered private plans in order to dramatically increase its reimbursements.
Nor should you think that Fresenius is without blame. For example, in 2000, a team led by Suzanne Durrell secured the largest global settlement to date in a health care fraud case against Fresenius Medical Care. The investigation resulted in a record-setting $101 million criminal fine; an aggregate civil settlement payment of $385 million; and the withdrawal by the company of more than $130 million in pending claims for reimbursement with the Medicare Program.
If you have concerns about patient harm and fraud against the government by a healthcare company, please contact us to discuss how whistleblower laws including those above can protect and reward you and help ensure that the patients and taxpayers are protected.