Financial Crime Weekly: DaVita Agrees To Pay $34.5M For Kickbacks, Hospice Provider Doles Out $19.4M For False Claims - CNH Industrial (NYSE:CNH), DaVita (NYSE:DVA) (2024)

DaVita Inc. DVA, a Colorado-based kidney dialysis provider, agreed to pay $34.5 million for allegedly paying kickbacks to a competitor for making referrals to DaVita Rx, a former subsidiary that provided pharmacy services for dialysis patients.

DaVita also allegedly paid kickbacks to nephrologists and vascular access physicians to get patient referrals to DaVita's dialysis centers, the U.S. Department of Justice (DOJ) said on Thursday.

The DOJ said DaVita violated the False Claims Act’s Anti-Kickback Statute, which prohibits providing any payments that are intended to induce referrals of patients or items or services covered by Medicare, Medicaid and other federally funded programs.

The U.S. alleged DaVita paid kickbacks to the competitor under the agreement that Davita Rx would serve as a "central fill pharmacy," or prescription fulfillment provider, for that competitor's Medicare patients' prescriptions.

In exchange, DaVita paid to acquire certain European dialysis clinics and agreed to extend a prior commitment to purchase dialysis products from the competitor, the DOJ said.

The U.S. further alleged DaVita provided management services to vascular access centers owned by physicians in a position to refer patients to DaVita's dialysis clinics. DaVita would not charge management fees to the physicians in exchange for referrals to DaVita's dialysis centers.

Finally, DaVita allegedly paid kickbacks to a large nephrology practice for referrals to DaVita's dialysis clinics. According to the DOJ, DaVita gave the practice a right of refusal to staff the medical director position at any new dialysis center that opened near the nephrology practice and paid the practice $50,000 for not staffing the medical director position for those clinics.

Gentiva Health Services, a Georgia-based hospice provider and successor to Kindred at Home, has agreed to pay $19.4 million for Kindred at Home allegedly knowingly submitting false claims and keeping overpayments for hospice services given to patients who were ineligible for hospice benefits under federal health care programs.

Gentiva's hospice operations include entities that previously operated Kindred at Home hospice locations under the names Avalon, Kindred, SouthernCare and SouthernCare New Beacon, the DOJ said.

A 2021 joint complaint the U.S. and Tennessee alleged that, from 2010 to February 2020, Kindred filed false claims for hospice services provided to Avalon hospice patients in Tennessee who were ineligible for the Medicare or Medicaid hospice benefit because they were not terminally ill.

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The settlement also resolved allegations that Kindred improperly concealed or avoided Avalon's obligation to repay those hospice claims.

Certain Kindred, SouthernCare and SouthernCare New Beacon hospice locations also allegedly submitted false claims for hospice services provided to patients who were ineligible for hospice benefits. Those hospice facilities were Kindred locations in Rhode Island, Texas and Missouri; SouthernCare New Beacon's location in Alabama; and SouthernCare's locations in Alabama, Indiana and Ohio.

The settlement also resolves allegations that those Kindred, SouthernCare and SouthernCare New Beacon locations knowingly and improperly concealed or avoided obligations to repay the foregoing hospice claims, according to the DOJ.

SouthernCare New Beacon also allegedly violated the Anti-Kickback Statute by paying kickbacks to a consulting physician, between October 2016, and October 2022, to send hospice referrals of Medicare beneficiaries to its Gadsden, Alabama, location.

Hemisphere GNSS (USA) Inc., a satellite global positioning system manufacturer in Arizona that was purchased by CNH Industrial N.V. CNH in 2023, has agreed to pay $2.6 million for allegedly violating the False Claims Act by providing false information to apply for and receive forgiveness for a Paycheck Protection Program (PPP) loan.

Congress created the PPP in March 2020, as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act, to provide emergency financial support to Americans suffering the economic effects caused by the pandemic.

In February 2021, Hemisphere applied for a second-round PPP loan and certified that it was eligible to receive the loan, though it was ineligible because it falsely certified that a Chinese company did not hold at least 20% interest in the company and a resident of China was not sitting on its board of directors.

For this reason, Hemisphere was not eligible for the second round PPP loan that it received and then sought and received forgiveness of the total loan amount.

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Photo: Shutterstock

© 2024 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.

Financial Crime Weekly: DaVita Agrees To Pay $34.5M For Kickbacks, Hospice Provider Doles Out $19.4M For False Claims - CNH Industrial (NYSE:CNH), DaVita (NYSE:DVA) (2024)
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