Categorized | Colorado News, National News, News

DaVita Medical Group Reaches Settlement with DOJ

The medical practice division of DaVita, Inc., DaVita Medical Group, has agreed to a $270 million settlement with the Department of Justice over inaccurate reporting of claims data.

The allegations stem from a whistleblower case filed in 2009 by a former employee of an insurer.  The case alleges the systematic, inaccurate, diagnosis coding of claims data that was reported by former corporate owner, HealthCare Partners, to insurers managing Medicare Advantage plans.    The inaccurate data resulted in inflated “risk adjustment” payments to the insurers and thus to the provider.

DaVita reported the problem to the Department of Justice following its acquisition of California-based HealthCare Partners in 2012.  The settlement will be paid from funds secured at the time of sale and placed in escrow in anticipation of a judgement.

In late 2017, the Optum Division of UnitedHealth Group announced plans to acquire DaVita Medical Group for $4.9 billion.  The sale is anticipated to close by year’s end.

Read more at Reuters.

Read more in the Colorado Spring’s Gazette.

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