
Fresenius Accused of Medical Fraud in New Qui Tam Lawsuit
New York Attorney General Letitia James, Georgia Attorney General Christopher Carr, and New Jersey Attorney General Matthew Platkin have jointly filed a complaint against Fresenius Vascular Care, Inc. (FVC) and several affiliates, including one of its New York-based executives, Gregg Miller, M.D. The complaint alleges that FVC engaged in a scheme to subject Medicaid recipients with end-stage renal disease (ESRD) to unnecessary surgeries and defrauded the New York state Medicaid program.
According to the complaint, the defendants scheduled end state renal disease (ESRD) patients for appointments every three to four months under the pretense of preserving their dialysis access sites. During these appointments, the patients were sedated, and invasive procedures were performed on their veins and arteries, putting these vulnerable patients at an increased risk of severe complications. The complaint alleges many of these patients did not require these surgeries, and FVC’s parent company’s research reportedly showed that these “monitoring” surgeries do not benefit ESRD patients and can even harm their ability to receive dialysis treatment. These procedures carried significant risks, including over-sedation, infection, ruptured blood vessels, and internal or external bleeding. The complaint states that FVC pressured its providers to adopt this scheme, even creating contests to incentivize staff to maximize the number of procedures performed on dialysis patients.
One instance cited in the complaint involves a 41-year-old ESRD patient in New York who underwent at least 27 unnecessary angioplasties between December 2012 and May 2018 at a Fresenius Vascular Access Center in the Bronx. An 80-year-old ESRD patient in Brooklyn reportedly underwent at least 15 unnecessary angioplasties during the same time period.
The lawsuit seeks damages and penalties under the New York False Claims Act and other state laws. The case resulted from a joint investigation with the U.S. Attorney’s Office for the Eastern District of New York and the National Association of Medicaid Fraud Control Units. Two doctors initiated the case which was filed under the qui tam provisions of federal and state false claims acts, allowing average citizens to file civil actions on behalf of the government and share in the proceeds of any recovered funds, and are pursuing claims on behalf of 16 additional states.
Last quarter Fresenius, a leading dialysis provider generated almost $5 billion in sales from its Fresenius Medical Care business unit on a global basis. In the U.S. the company operates Azura Vascular Care, which is a division of Fresenius Medical Care North America, consisting of a network of over 65 outpatient vascular centers and ambulatory surgery centers. They specialize in various medical conditions, including dialysis access management, peripheral arterial disease, uterine fibroids, varicose veins, and varicoceles.