Colorado Politics

Denver’s DaVita to pay feds $270M over improper billing practices

A unit of Denver-based health-care giant DaVita Inc. has agreed to pay $270 million to resolve allegations it provided inaccurate information to Medicare, federal prosecutors said Monday.

DaVita Medical Holdings admitted to practices that caused incorrect diagnosis codes to be submitted in order to obtain inflated payments, according to the U.S. Justice Department.

California-based HealthCare Partners, which DaVita acquired in 2012, shared the overpayments with its parent company, prosecutors said.

In one instance, HealthCare Partners sent out improper guidance advising its physicians to use an improper diagnosis code for a particular spinal condition that yielded increased reimbursement.

The settlement also resolves allegations made by a whistleblower that HealthCare Partners engaged in so-called “one-way” chart reviews in which it scoured its patients’ medical records for diagnoses its providers may have failed to record. The company then submitted these “missed” diagnoses to be used in obtaining increased Medicare payments, prosecutors said.

At the same time, officials said, the firm ignored inaccurate diagnosis codes that should have been deleted and that would have decreased Medicare reimbursement.

DaVita, one of the largest dialysis and kidney care providers in the U.S., did not admit wrongdoing. “The settlement announced today reflects close cooperation with the government to address practices largely originating with HealthCare Partners,” DaVita said in a statement.

The settlement will be paid with escrow funds that DaVita required be set aside by the former owners of HealthCare Partners in 2012 during its acquisition, the statement said.

DaVita’s chief executive and chairman, Kent Thiry, has been active in Colorado politics in recent years and this year has been leading efforts to pass a pair of ballot measures intended to prevent gerrymandering and reform the way Colorado draws congressional and legislative electoral district boundaries.

The Associated Press and Colorado Politics contributed.

 Businessman Kent Thiry speaks at Club 20 about ballot measures to help end gerrymandering in Colorado in 2018.
Photo by Joey Bunch/Colorado Politics

PREV

PREVIOUS

Poll finds Polis leading Stapleton by 7 points in Colorado governor's race

Democrat Jared Polis holds a 7-point lead over Republican Walker Stapleton in the race to be Colorado’s next governor, according to a new survey of likely voters by a bipartisan team of Colorado-based pollsters. The survey – jointly conducted by Democratic firm Keating Research and Republican firm Magellan Strategies – was commissioned by the nonpartisan […]

NEXT

NEXT UP

The Colorado Springs Gazette: Pass Amendment 74 and save the economy

Property rights provide the foundation for the U.S. economy. That’s why Colorado voters should pass Amendment 74. Without government protection for private property, few have the trust to invest. One does not grow Facebook, Google or Snapchat without government assurance the brand cannot be copied and hijacked. Few would write a New York Times bestseller, […]


Welcome Back.

Streak: 9 days i

Stories you've missed since your last login:

Stories you've saved for later:

Recommended stories based on your interests:

Edit my interests