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DaVita settles unlawful billing case with US Justice Department for $63.7M

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DaVita settles unlawful billing case with US Justice Department for $63.7M

The U.S. Justice Department said DaVita Inc. agreed to pay $63.7 million to resolve claims relating to improper billing practices and unlawful financial inducements to federal healthcare program beneficiaries.

DaVita unit DaVita Rx LLC was being investigated under the False Claims Act for alleged improper billing practices, according to the U.S. Attorney's Office for the Northern District of Texas.

The settlement resolves allegations that DaVita Rx billed federal healthcare programs for prescription medications that were never shipped; shipped but later returned; and did not comply with requirements for documentation of proof of delivery, refill requests, or patient consent.

In addition, the settlement resolves claims that DaVita paid financial inducements to federal healthcare program beneficiaries in violation of the Anti-Kickback Statute.

These allegations relating to improper billing and unlawful financial inducements were the subject of self-disclosures by DaVita Rx and a subsequently filed whistleblower lawsuit. The lawsuit was filed by two former DaVita Rx employees under the whistleblower provisions of the False Claims Act.

DaVita Rx repaid about $22.2 million to federal healthcare programs following its self-disclosure and will pay an additional $38.3 million to the U.S. as part of the settlement agreement. In addition, $3.2 million has been allocated to cover Medicaid program claims by states that elect to participate in the settlement.

DaVita said it takes "full ownership" and will continue to embrace transparency and rigorous compliance. It added that its team discovered and self-disclosed these issues to the federal government in 2015 and 2016 and cooperated with the government in resolving them.

U.S. Attorney Erin Nealy Cox for the Northern District of Texas said, "the U.S. Attorney's Office has and will continue to work cooperatively with providers that bring such issues to light to redress the losses the federal healthcare system has incurred."