Archive for October, 2013
Tuesday, October 29, 2013 | By Scott | No Comments
On June 27, 2012 the FDA recalled the two leading bicarbonate additives used during kidney dialysis since 2003. These products, GranuFlo and Naturalyte, can cause cardiac arrest and stroke in dialysis patients. If you or a loved one are on kidney dialysis and suffered cardiac arrest or stroke after 2003, please call 1-800-279-6996 and fill out the contact form at www.dialysisrecall.com to determine whether you have a claim.
This office is also investigating the stock losses which occurred to the company selling these products: Frenesius Medical Care AG & Co. KGAA (stock symbol: FMS). If you own shares of FMS, please call the same number and fill out the contact form to determine your right to recover your losses.
Please complete a contact form at www.dialysisrecall.com or call 1-800-279-6996 if you need more information and to join the lawsuit.
Joseph R. Santoli, Esq.
340 Devon Court
Ridgewood NJ 07450-1810
Tuesday, October 29, 2013 | By Scott | No Comments
Here is a brief description of the type of ambulance fraud we have been seeing.
Medicare will pay for emergency and non-emergency ambulance services only when a beneficiary’s medical condition at the time of transport is such that other means of transportation, such as taxi, private car, wheelchair van or other type of vehicle is contraindicated (i.e. would endanger the beneficiary’s medical condition). Medicare does not cover any means of transport other than transport by ambulance.
Non-emergency transportation by ambulance is appropriate and covered only when a patient is bed-confined and his/her condition is such that transportation by ambulance is medically required. Medicare defines bed confinement as: unable to get up from bed without assistance; unable to ambulate; and, be unable to sit in a chair or wheelchair.
Much of the income for many ambulance companies is generated by providing non-emergency ambulance transport to Medicare recipients to medical centers, such as dialysis clinics.
The companies transport patients who could walk or be transported by other means (i.e., taxi or paratransit van), falsely representing to Medicare that these patients medically required transportation by ambulance. For example, patients are directed to get onto a stretcher or were placed onto a stretcher by ambulance company employees, when the patients were able to walk or to be moved by wheelchair. Alternatively, some patients simply walk to and from the ambulance. This also permits the ambulance company to transport 2-5 patients at once in the ambulance, rather than just one patient on a stretcher.
The ambulance company then bills Medicare for the transport of these patients by ambulance, claiming it was a medical necessity. The majority of dialysis patients need to attend dialysis treatments three times per week, thereby allowing the ambulance company to bill extensively for these patients. For a round-trip transport, Medicare can pay between $400-800 per person depending on the area of the country and the patient’s needs.
Kickbacks may be involved in this process:
- KBs from ambulance company to dialysis clinic employees who recruit, solicit or identify potential patients for the ambulance company. Dialysis clinic employees, esp. admissions staff, often see the patients walking, etc. from the ambulance and know which ones are complicit in the fraud.
- KBS to physicians who will sign a certificate claiming that a patient requires transport due to a medical necessity.
- KBs to the patients themselves who are supposed to receive ambulance transport and do not need it. Patients are often paid “signing bonuses” for agreeing to be transported by an ambulance company, or from switching from one company to the next. There is considerable competition between ambulance companies for these patients.
Damages from these cases can range from the six figures up to $5-10 million depending on the size of the company.
Friday, October 25, 2013 | By Scott | No Comments
The New York Times
Dialysis company officials say federal drug payments should be maintained because they help the companies with other costs not sufficiently covered by the government reimbursements.
WASHINGTON — Eight months ago, Congress ordered the Obama administration to eliminate a stark example of federal government waste: more than $500 million a year in excessive drug payments being sent to dialysis clinics nationwide.Diane Wish worries that federal cuts in reimbursements may result in the closing of her nonprofit chain of dialysis centers.
But in a demonstration of just how hard it is to curb spending in Washington, more than 100 of the same members of Congress who voted in January to impose the cut are now trying to push the Obama administration to reverse it or water it down.
READ THE ENTIRE ARTICLE
Friday, October 18, 2013 | By Scott | No Comments
Listening to CNN this morning with Sean Spicer RNC, it appears that they are petitioning for Kathleen Sibelius to be fired. She has been aware of the termination of services and abuses case by case, and refuses to raise a finger to resolve any terminations, nor making CMS supporting the patients
Nancy Anne DePearle took my complaint in 1998 as a high ranking worker in CMS. After that she went and made millions of stock being a Board Member of Davita. Now she is the Czarina of Obama Care. Dangerous in my opinion.
Thomas Skully was the Chair of Davita, and was given the key position under Tommy Thompson in the Bush Administration. He oversaw dialysis.
In my opinion, she has not done her job. By appointing Nancy Anne DeParle…look at what a mess dialysis and ignoring patients, she is a key player who made millions off of dialysis patients.
I worry about the oversight of Obama Care. I believe that insurance is an necessity, however, I worry that the oversight will be self policing as it is in dialysis…Industry oversight and no appeals.
Research these players yourself.
Wednesday, October 16, 2013 | By Scott | No Comments
Listen to frank discussions with patients, family, Doctors, and Dialysis health care workers about the state of Dialysis in America. Rev. Dr Floyd D. Harris, Jr. is the International President Of The National Network In Action a civil & human rights organization that fights for justice for all people. Dr. Harris is known all over world and speak truth to power.
Visit this BlogTalkRadio site to view Upcoming Broadcasts and Archived Episodes concerning the current situation of Dialysis health care in America.
Here are some of the past broadcasts focusing on Dialysis Care:
We encourage patients and family members to stand up for their rights and a better quality of care.
If you haven’t listened to any of these broadcasts live, these interviews have excellent information to help patients, families, and caregivers improve the state of Dialysis care.
Wednesday, October 2, 2013 | By Scott | No Comments
This is and excerpt from a letter written by an assistant facility administrator operated by DaVita in Wausau, WI.
…Medicare plays a central role in the kidney care community, and even more cuts could be devastating. Under the newly proposed rule, Medicare reimbursements would decrease from $246.57 per three- to four-hour dialysis session to only $216 for the same treatment.
A $30 reduction may not seem like much, but these proposed cuts would decrease reimbursements well below the cost of care. Considering that those on dialysis require multiple treatments per week, $30 less per session is a substantial cut that could force facilities to consolidate services, reduce staff, trim operating hours, or in some cases close.
…Medicare’s End Stage Renal Disease program has served as a model for excellent care and we hope readers will contact Sens. Tammy Baldwin and Ron Johnson to ask for their support as well.
ON THE OTHER HAND
DaVita profits were $478,000,000 in 2012, up 17.8% over 2011.
Additionally, DaVita HealthCare has had to fork over more than $350 million over the past year to settle various fraud cases. Nevertheless, CEO Kent Thiry made the top 25 highest-paid list in 2012 with more than $26 million in total compensation.
Our government continues to pay a company who is guilty of fraud with our tax dollars.
Is anyone else out there scratching their heads?