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Did DaVita Admit Fraud In Suing A Whistleblower?
File this under ‘What were they thinking?’ Since a fair number of whistleblower cases pop up in the pharmaceutical industry, a recent development concerning a whistleblower and DaVita, the second-largest independent provider of dialysis services in the US, might be of interest. Consider the following…
Along with a nurse, a nephrologist and former medical director named Alon Vainer filed a whistleblower lawsuit in 2007 alleging DaVita deliberately wasted medicine in order to gain hundreds of millions of dollars in extra payments from Medicare. They claim DaVita used unnecessarily large vials of different m...
Source: Pharmalot - February 14, 2013 Category: Pharma Commentators Authors: Ed Silverman Tags: Uncategorized DaVita Dialysis False Claims Act Medicare Medicare Fraud Whistleblower Source Type: blogs
The RUC. "an Independent Group of Physicians?" - But It Includes Executives and Board Members of For-Profit Health Care Corporations and Large Hospital Systems
Introduction We just discussed how a major story in Politico has once again drawn attention to the opaque RUC (Resource Based Relative Value System Update Committee) and its important role in determining what physicians are paid for different kinds of services, and hence the incentives that have helped make the US health care system so procedurally oriented. (See the end of our last post for a summary of the complex issues that swirl around the RUC.)The Politico article covered most of the bases, but notably omitted how the RUC may be tied to various large health care organizations, especially for-profit, and how the...
Source: Health Care Renewal - August 28, 2014 Category: Health Management Tags: AMA boards of directors conflicts of interest health care prices healthcare executive hospital systems perverse incentives regulatory capture RUC Source Type: blogs
Top 5 Health Care Trends to Watch in 2015
With a new Congress, health care is once again an issue of tremendous scrutiny and debate. Many of the federal policy debates in 2015 will be largely symbolic, resulting in little more than tweaks to existing law.
However, health care policy is not just a matter for Congress to consider. A range of issues will play out in the states and the private sector, effectively shaping the future. Below are the top trends we’re watching this year.
The Year of Living Interoperably
From electronic health records (EHRs) to clinical measures and decision support tools, providers are inundated with new technologies that automate proces...
Source: Health Affairs Blog - February 25, 2015 Category: Health Management Authors: Susan DeVore Tags: All Categories Big Data Health Care Costs Health IT Innovation Payment Pharma Policy Quality Spending States Source Type: blogs
DaVita Settles Another Lawsuit Amidst Accusations of "Managing Witnesses to Provide False Testimony," After Justice Department Lost Interest in Participating
The Latest Case Less than a year since its last big settlement (look here), DaVita HealthCare Partners, the big for-profit dialysis provider, has to settle again. The basics, according to the Denver Post, were:DaVita HealthCare Partners said Monday it will pay up to $495 million to settle a whistle-blower lawsuit accusing the Denver company of defrauding the federal Medicare program of millions of dollars. The company, which said it does not admit any wrongdoing, has now settled its third whistle-blower lawsuit since 2012, with payouts totaling nearly $1 billion.The civil suit, filed in Atlanta in 2011, revolves...
Source: Health Care Renewal - May 8, 2015 Category: Health Management Tags: DaVita fraud impunity legal settlements Source Type: blogs
Narrative Matters: On Our Reading List
Editor’s note: “Narrative Matters: On Our Reading List” is a monthly roundup where we share some of the most compelling health care narratives driving the news and conversation in recent weeks.
Cut Off From Ambulance Rides
In December 2014, Medicare began a pilot program in Pennsylvania, New Jersey, and South Carolina to require prior authorization for “repetitive, scheduled, nonemergency” ambulance rides — enforcing a long-standing Medicare policy under which beneficiaries needed to require a stretcher before Medicare would pay for the nonemergency rides. But the policy crack-down left Charles Prozzillo, ...
Source: Health Affairs Blog - February 29, 2016 Category: Health Management Authors: Jessica Bylander Tags: Equity and Disparities Featured Medicare Narrative Matters Quality big data On Our Reading List Source Type: blogs
