Monday, November 17, 2014

DaVita Settlement Omits Role of Two Former CMS Chiefs

DaVita reported in a SEC filing:

Under the Settlement Agreement, the Company will pay $350 million plus accrued interest from February 8, 2014, at the rate of 2.25% per annum to the United States, plus a civil forfeiture of $39 million (together, the “Settlement Payment”). In addition, the Company has agreed in principle to a settlement of certain state Medicaid claims in the amount of $11.5 million plus interest.

Under the Settlement Agreement, the United States agrees to release the Company from any civil or administrative monetary liability arising from allegations that the Company caused the submission of claims to the federal health care programs that were ineligible for reimbursement due to certain violations of the Anti-Kickback Statute in connection with certain of its dialysis center joint venture arrangements. Additionally, under the Settlement Agreement the United States and the relator agree to dismissal of the civil action filed by the relator under the qui tam provisions of the False Claims Act, and the OIG agrees, conditioned upon the Company’s full payment of the Settlement Payment, to release its permissive exclusion rights and to refrain from instituting proceedings to exclude the Company or any Company affiliates from participating in Medicare, Medicaid or other Federal health care programs.

The Settlement Agreement reflects the Company’s disagreement with the United States’ claims and contains no admissions of facts or liability on the part of the Company.

The United States has also informed the Company that it has declined to proceed with any criminal charges in connection with this matter. 

The behavior in question occurred with two ex-Medicare Chiefs sitting on DaVita's Board of Directors.  Both William L. Roper, M.D. and Nancy-Ann DeParle were appointed to the DaVita board in May 2001.   Roper served on the Board compliance committee and DeParle on the audit committee.

In March 2004 the board established two new standing committees, a public policy committee and a clinical performance committee. The public policy committee consists of Ms. DeParle and Dr. Roper, with Ms. DeParle serving as the chair. 
I believe DaVita expected these two to block for the company and its numerous violations, illuminated in the legal complaint.   After ignoring its internal compliance handbook over a decade's time the company said:

We are proud of our commitment to compliance over our 15-year history. We have worked incredibly hard to get things right and it is our belief there was no intentional wrongdoing. 
The legal complaint reads intentional wrongdoing of the repeating kind.  That I believe.   It occurred under the fiduciary oversight of two former Medicare Chiefs and neither the Department of "Just Us" nor the media shared this basic fact.