In 2016, UnitedHealthcare filed suit against American Renal Associates, alleging the Beverly, Mass.-based dialysis chain engaged in a “fraudulent and illegal scheme” to maximize its own profits. UnitedHealthcare claimed ARA convinced patients to enroll in plans UnitedHealthcare sold on the ACA exchanges instead of Medicare and/or Medicaid coverage. The insurer accused ARA of connecting these patients with the American Kidney Fund to help pay their insurance premiums, according to The Wall Street Journal.
ARA and UnitedHealthcare will negotiate terms of a definitive $32 million settlement by Aug. 1. In conjunction with the agreement, ARA, which operates 228 dialysis clinics nationwide, will enter a three-year network agreement with UnitedHealthcare. The contract is effective Aug. 1, and will include value-based contracting terms.
More articles on legal and regulatory issues:
3 senior home employees charged after recording Snapchat video in dying patient’s room
CFO: Montana hospital engaged in billing fraud, kickback scheme
California hospital settlement reinstalls staff, bylaws, leadership from early 2016
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
