The most prevalent form of fraud in the health care system entails the commission of Medicare and Medicaid fraud and abuse committed by doctors or other health care providers. Enacted during the 1960’s, Medicare and Medicaid’s main purpose was to serve the elderly and the poor. At the time of their enactment, there were no concerns for fraud, however by the mid 1970’s, this had changed and continues to be a problem today. One recent article that has exhibited more than one form of fraud involves the company DaVita, formally known as Total Renal Care (TRC).
In 1999, Kent Thiry took over Total Renal Care, who was on the verge of bankruptcy, renamed it to DaVita and built it up substantially to where they now own and operate over 2,000 clinics around the U.S. (Smallteacher, 2015). In 2007, a former clinical director Daniel Barbir and a medical director Dr. Alon Vainer joined together to file a whistleblower lawsuit against the company claiming that they were involved in “shady” practices that allowed DaVita to increase sales and make a profit off of Medicare and Medicaid recipients; their principle customers. This was done by giving a patient who required 100 milligrams of a medication half of their dose from one vial, throwing that vial away, opening up another vial for the remaining dosage and then billing the government for both of …show more content…
False Claims Act. Under the act, anyone who files a whistleblower suit would receive an incentive of 15% of their fines assessed or more (Smallteacher, 2015). The U.S. government joined Barbetta’s lawsuit, which meant that victory was certain. However, they refused Barbir and Vanier’s suit, which meant they both would have proceed without the backing of the U.S. government. In May of 2015, DaVita settled out of court with Babir and Vanier for a whopping $495 million dollars, making their lawsuit one of the biggest False Claim Act lawsuits filed without U.S. backing (Smallteacher,
In 1999, Kent Thiry took over Total Renal Care, who was on the verge of bankruptcy, renamed it to DaVita and built it up substantially to where they now own and operate over 2,000 clinics around the U.S. (Smallteacher, 2015). In 2007, a former clinical director Daniel Barbir and a medical director Dr. Alon Vainer joined together to file a whistleblower lawsuit against the company claiming that they were involved in “shady” practices that allowed DaVita to increase sales and make a profit off of Medicare and Medicaid recipients; their principle customers. This was done by giving a patient who required 100 milligrams of a medication half of their dose from one vial, throwing that vial away, opening up another vial for the remaining dosage and then billing the government for both of …show more content…
False Claims Act. Under the act, anyone who files a whistleblower suit would receive an incentive of 15% of their fines assessed or more (Smallteacher, 2015). The U.S. government joined Barbetta’s lawsuit, which meant that victory was certain. However, they refused Barbir and Vanier’s suit, which meant they both would have proceed without the backing of the U.S. government. In May of 2015, DaVita settled out of court with Babir and Vanier for a whopping $495 million dollars, making their lawsuit one of the biggest False Claim Act lawsuits filed without U.S. backing (Smallteacher,