ST. LOUIS (CN) – Renal Care Group and Fresenius Medical Care must pay the United States $19 million for fraudulent Medicare billing. The companies recklessly disregarded federal law when billing Medicaid for home dialysis equipment between 1995 and 2005, a federal judge ruled in Tennessee.
The whistleblower complaint was filed in St. Louis, then transferred to Tennessee in August 2009.
Several Renal Care employees expressed concerns, such as, “I do not wish to go to jail,” over the company’s billing practices, court papers state.
The court also found that Renal Care failed to follow its own lawyers’ advice in operations, and an internal audit found that 100 percent of Renal Care’s files were missing information required for Medicare billing.
Renal Care merged with Fresenius.
Renal Care allegedly set up a sham billing company so it could bill Medicare for home dialysis supplies.
Federal law states that the Medicare program pays companies that provide dialysis supplies to end-stage renal disease patients only if the companies that provide the supplies are truly independent from dialysis facilities and the end-stage renal disease patient chooses to receive supplies from the independent supplier.
Renal Care’s billing company was not independent and Renal Care forced patients to use the billing company.
This is the second Medicare fraud case involving the dialysis industry and brought in St. Louis Federal Court. In December 2005, Gambro Healthcare paid the United States $310.5 million to resolve civil liabilities stemming from alleged kickbacks paid to physicians, false statements made to procure payment for unnecessary tests and services and payments made to Gambro Supply, a sham durable medical equipment company.