DaVita sues Virginia Mason Memorial over alleged discrimination against kidney failure patients

DaVita, a kidney dialysis company, filed a lawsuit against Virginia Mason Memorial hospital, claiming its employee health plan pays less for kidney dialysis after patients have been diagnosed with end-stage renal disease, according to a report from YakTriNews.com.

The lawsuit was filed against the Yakima, Wash.-based hospital in the U.S. District Court for the Eastern District of Washington. It seeks $3.4 million in damages.

Patients are eligible for Medicare within three months of receiving an ESRD diagnosis under federal law. To ensure private payers still bear some of the costs of care for ESRD patients, another law requires private insurers to remain the primary payer for the first 30 months of an ESRD patient's Medicare eligibility, according to the report.

The DaVita suit alleges Virginia Mason Memorial's employee health plan violates both laws because it decreases payments to 125 percent of the Medicare allowable amount once patients qualify for Medicare. Because of this, DaVita claims it was underpaid $1.7 million for the care of one patient alone.

Virginia Mason Memorial confirmed the payment rate but says the case is a simple billing dispute. It said it has a provision in its plan that allows providers to ask for higher reimbursement. The hospital alleges DaVita did not try to negotiate payment rates before escalating to legal action, according to the report. 

Read the full story here.


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