Fresenius to pay $5.2M to settle Medicare whistleblower charges

Fresenius Medical Care will pay $5.2 million to resolve whistleblower allegations that it ran Hepatitis B tests on dialysis patients more frequently than medically necessary and overbilled Medicare, according to the U.S. Justice Department.

A Medicare-established schedule determines when dialysis patients at high risk of contracting hepatitis B should be tested and reimburses dialysis clinics for the tests. But dialysis clinic operator Fresnius  also gave those tests to patients who were immune to the infection and therefore didn't need them, the Justice Department alleges.

Fresnius, based in Germany, conducted the tests on immune patients from Feb. 10, 2003 to Dec. 31, 2010, according to the Justice Department.

"In many cases, Fresenius performed and billed Medicare for these tests for immune patients against their treating physicians' orders and without any accompanying documentation of medical necessity," the department added. "These tests were not eligible for Medicare reimbursement under Medicare's testing frequency schedule, and the government alleged that Fresenius's bills for these tests were false."

The $5.2 million settlement resolves allegations originally brought through a whistleblower lawsuit filed under the False Claims Act. The whistleblower, a former Fresenius employee, will receive 27.5 percent of the recovery.

 

More articles on legal and regulatory issues:

Pennsylvania surgeon settles false billing allegations for $4.25M
New York BCBS plans allegedly overpaid hospitals by $85M
Physicians, medical group CEO pay $6.7M to settle billing fraud case in California

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months