NEW YORK – The US Attorney's Office for the District of Massachusetts said this week that kidney dialysis firm Fresenius Medical Care Holdings has agreed to pay $5.2 million to settle allegations that it tested dialysis patients unnecessarily for hepatitis B surface antigen and then billed Medicare for the tests.
Patients with end stage renal disease and chronic renal disease need dialysis three to four times weekly, and some patients with either condition are at risk for contracting HBV. Medicare established a testing frequency schedule for dialysis clinics to follow for reimbursement, which provided for reimbursement of monthly HBV surface antigen tests for patients who are not immune to HBV.
According to DOJ, however, Fresenius also tested patients it knew to be immune to the virus and billed Medicare. In some cases, the company tested immune patients against their treating physicians' orders and billed Medicare without any accompanying documentation of medical necessity. According to DOJ, those tests were not eligible for Medicare reimbursement.
The alleged improper actions occurred between Feb. 10, 2003 and Dec. 31, 2010.
A former Fresenius employee, Christopher Drennen brought the allegations to light through a whistleblower lawsuit. As part of the $5.2 million settlement, he will receive 27.5 percent of the recovered amount, DOJ said.
Fresenius is based in Bad Homburg, Germany. Its North American division is headquartered in Waltham, Massachusetts.