via CNN

It started with a chance conversation between a doctor and a nurse several years ago. But that brief encounter may end up exposing what could be one of the largest Medicare frauds in U.S. history.

Dr. Alon Vainer, a medical director at dialysis clinics in Georgia, was discussing clinic procedures with one of the nurses, Daniel Barbir. The two men say they saw something they believed was very wrong: expensive medicine, and lots of it, was being tossed in the trash. And the clinic workers were being told to do it, the two men say.

“When we sat down and started talking about it and getting into details, we actually realized exactly what was going on,” Vainer said.

The alleged waste was being carried out on a massive scale and, the nurse and the doctor said, they knew why almost immediately. They claim it was a way for their company, DaVita Inc., to defraud the government, overbill Medicare and Medicaid and make a fortune.

“We’re talking in the hundreds of millions, easily,” Vainer said. “The profit this company raked from those two schemes, only from those two drugs, was hundreds of millions of dollars.”

The allegations of massive fraud have implications for all Americans. The alleged fraud would have involved Medicare and Medicaid patients, whose medicine is paid for by U.S. taxpayers.

Vanier explained to CNN how DaVita instructed its nurses to administer a 100-milligram dose of the iron drug Venofor.

“For example, if a patient requires this dose once per week, you’d administer 100 milligrams, waste nothing and charge Medicare for 100 milligrams,” he said.

“But what DaVita did, instead of charge (for) one vial, they give 50 milligrams of this vial (and) put the residual into the trash.” he said. With another vial, he said, the company would give 25 milligrams to a patient and put the rest in the trash, then repeat it with yet another vial, when one vial could have been given without waste.

The more vials DaVita used, the more the company was able to bill the government, the men say. Vainer and Barbir claim they tried to call attention to the massive waste and tried to get it stopped. But instead, they say, they were basically told to stop causing trouble and to continue following the company’s protocols.

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Article courtesy cnn.com

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