The judge ordered the dialysis supplier to pay $19.3 million for improper claims submitted to Medicare for home dialysis supplies.
Medicare has two rates of payment to dialysis companies. Companies that operate dialysis facilities are supposed to bill Medicare using “Method I.” Renal Care Group was such a company. Companies that don’t operate facilities, but supply patients with at-home supplies, bill Medicare under “Method II,” which pays 30 percent more.
The judge held that the company showed “reckless disregard” for the law by creating Renal Care Group Co., an at-home dialysis supply company that operated as an extension of RCG. The law requires requires suppliers to be independent of the dialysis facilities where patients are treated.
The suit arose from a whistleblower complaint filed under the qui tam provisions of the False Claims Act.