Nurse’s Allegations about Medicare Lead to $7.3 Million Settlement

May 23, 2013

A nurse’s allegations about excessive charges to Medicare led to a $7.3 million settlement between a Plano, Texas-based firm and the U.S. Justice Department.

Whistleblower Laura Davis’ complaint involved charges for Epogen, an anemia drug used to treat dialysis patients. A “qui tam” whistleblower lawsuit filed on her behalf in Baltimore alleged that Dialysis Corporation of America billed Medicare and other government healthcare programs for more Epogen than was used.

Epogen is an intravenous medication that is used to treat anemia, a common condition afflicting patients with end-stage renal disease. Epogen vials contain a small amount of medication in excess of the labeled amount, known as “overfill,” to compensate for medication that may remain in the vial after extraction and in the syringe upon administration.

The United States contends that from January 2004 through May 2011, DCA billed for 10-11% overfill whenever it administered Epogen. However, because of the types of syringes DCA used, the United States alleges that DCA was not able to withdraw and administer 10-11% overfill every time it administered Epogen to patients, and thus submitted false claims to Medicare that overstated the amount of Epogen that it was actually providing.

Dialsysis Corporation was acquired by U.S. Renal Care, which is headquartered in Plano, in June 2010.

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