Davita Corporate Integrity Agreement

The trial is entitled United States ex rel. David Barbetta v. DaVita, Inc. et al., no. 09-cv-02175-WJM-KMT (D. Colo.). Claims governed by this Agreement are only allegations; no determination of responsibility has been made. “Health care providers should generate business by providing their patients with high-quality services or more convenient options, not by making contractual arrangements designed to encourage physicians to give referrals,” said Jonathan F. Olin, Assistant Deputy Attorney General of the Department of Justice Civil Division. “The Department of Justice is committed to protecting the integrity of our health care system and ensuring that financial arrangements in the health care market comply with the law.” The government combined the whistleblower`s complaint into a three-part allegation of a corruption scheme. First, DaVita would target physician groups with a large population of patients with kidney disease, and then gather information on whether this group is a “winning practice.” The Justice Department notes that DaVita considered such a practice to be “a winner” because doctors were “young and in debt.” Second, DaVita would address that group with the possibility of concluding a joint venture involving the acquisition of DaVita`s stake in doctor-owned dialysis clinics and/or the sale of DaVita`s stake in its dialysis clinics to doctors.

These transactions would be outside of fair market value. Third, DaVita enters into non-compete obligations to compel the group of physicians to refer patients to competing dialysis clinics. Today, he compares DaVita`s allegations between March 1, 2005 and March 1, 2005. February 2014 Identification of physicians or physician groups with large populations of patients with renal impairment and provides them with lucrative opportunities to partner with DaVita by acquiring and/or selling an interest in dialysis clinics where their patients are referred to dialysis treatment. DaVita also ensured the referral of these patients to the clinics through a number of secondary agreements with the doctors, including the conclusion of agreements in which the doctor agreed not to compete with the DaVita clinic and non-disparate agreements that prevented doctors from referring their patients to other dialysis providers. DaVita Kidney Care will be independently monitored to oversee certain future joint ventures. The agreement also includes a refund to the government and a provision requiring the executive branch to certify quarterly and annual compliance reports. The DOJ`s press release and the unsealed government complaint contain clues about the joint venture activities and contractual agreements that the DOJ found problematic during its investigation. To ensure the future referral of patients to the centres, medical investors had to sign non-compete agreements prohibiting them from inducing or advising a patient to seek treatment at a competing centre. In addition, the non-compete obligations have been structured in such a way that all doctors in a practice group are linked, whether or not the doctor has been part of the joint venture. The government`s complaint identifies a joint venture with a group of doctors in central Florida as one of many examples illustrating DaVita`s scheme to improperly induce patient referrals. The group was previously in a joint venture with dialysis clinics with Gambro, Inc., a dialysis company acquired by DaVita in 2005.

Prior to the acquisition, Gambro had reached a settlement with the United States to clarify alleged corruption allegations that, among other things, forced Gambro to cancel its joint venture agreements. As a result, Gambro acquired the group`s shares in the joint venture`s clinics and agreed to a “spin-off” of the associated non-compete agreement, which allowed the group to open its own dialysis clinic nearby, which it did. Following the acquisition of Gambro, DaVita acquired a majority stake in the Group`s new dialysis clinic and sold a minority stake in three clinics owned by DaVita. Despite the fact that each of the clinics involved was roughly comparable in size and profit, DaVita agreed to pay $5,975,000 to acquire a 60% stake in the group`s clinic, while selling a 40% stake in the three clinics it owned for a total of $3,075,000. As part of this joint venture, the Group has agreed to enter into new non-compete obligations. Finally, DaVita ensured the future referral of patients through a series of secondary agreements with their partner physicians. This included paying doctors as medical directors of joint venture clinics and entering into agreements in which doctors agreed not to compete with the clinic. The non-compete obligations were intended to bind all physicians in a practice group, even though some of them were not part of the joint venture agreements. These agreements also contained provisions prohibiting partner physicians from inducing or advising a patient to seek treatment at a competing dialysis clinic. These agreements were of such importance to DaVita that it would not enter into a joint venture transaction without them.

As part of today`s announcement, the U.S. Attorney`s Office noted that after a thorough review, it is closing its criminal investigation into two specific joint ventures. “Companies that try to increase their profits by paying bribes to doctors for patient referrals – as the government claimed in this case – undermine impartial medical judgment at the expense of patients and taxpayers,” said Daniel R. Levinson, inspector general of the U.S. Department of Health and Human Services. “Expect significant settlements and our ongoing investigation into such unnecessary trade arrangements.” We are proud of our commitment to compliance over our 15-year history. We have worked incredibly hard to get it right, and we believe there was no intentional misconduct. . This agreement illustrates the Government`s focus on combating health care fraud and is another success for the Health Care Fraud Action and Enforcement Team (HEAT) initiative announced by the Attorney General and the Minister of Health in May 2009. The partnership between the two departments has focused efforts to reduce and prevent medicare and medicaid financial fraud through increased collaboration. One of the most powerful tools in these efforts is the False Claims Act.

Since January 2009, the Department of Justice has recovered a total of more than $22.4 billion in cases under the False Claims Act, including more than $14.2 billion recovered in cases of fraud against federal health programs. The OIG has an 8-tier safe haven that would exempt these investment interests from the anti-bribery law. (42 CFR 1001.952 a) (2)). At the heart of this case, the complaint alleges the following measures that would result in interests outside the specific shelter: DaVita, one of the leading providers of dialysis services, accepted one of the largest healthcare regulations of 2014. The Justice Department announced that DaVita will pay $350 million to clarify allegations that the company violated the False Claims Act by paying bribes for doctors to refer patients to DaVita-owned dialysis centers for the treatment of end-stage kidney disease. Save my name, email address, and website in this browser for the next time I comment. McGuireWoods analyzes the complaint and the CIA to identify the practices, procedures and contractual terms of the dialysis joint ventures that the DOJ found problematic during its investigation. We will issue warnings in the near future to discuss further guidance from the Department of Justice. Please contact one of McGuireWoods` registered lawyers if you have any questions about the settlement and how it affects your dialysis practice or joint venture. HHS OIG publishes the final rule to change AKS Discount Safe. See DaVita`s Corporate Integrity Agreement (page 53 for independent oversight responsibilities). .

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