Medicare recently altered its payment policy to pay one fixed amount per specific treatment, instead of paying separately for each drug used to cure a patient's illness. In this new system, a clinic can earn money by treating the patient for less money that the amount paid by Medicare, but it also runs the risk of losing money if it spends more on a patient than Medicare's allotted payment. In light of its new policy, clinics drastically changed its dosages of medicine, prompting a lawsuit against one of the nation's largest providers of kidney dialysis for purposefully wasting medicine to earn extra money (Pollack). .
A clinic nurse and doctor alerted authorities to DaVita's malpractice. According to their allegations, DaVita used vials of medicine that were intentionally larger than needed so that Medicare would be forced to pay for the wasted amount. For instance, before the new payment plan, DaVita required nurses to administer six-micrograms of Zemplar to patients. However, Zemplar only comes in 10-microgram vials, forcing Medicare to pay for four wasted micrograms. Myers claims that the larger vials of Zemplar minimized needle sticks and helped to reduce possible infections. A similar situation occurred with an iron drug, Venofer, which forced Medicare to pay for 75 wasted milligrams of each dose. Smaller doses of Venofer actually increased needle sticks. DaVita denies these accusations (Pollack). .
There was "no clinical reason" and "no safety reason" for Venofer's smaller doses, according to Dr. Michael Auerbach, an expert at Georgetown University. Dr. Daniel Coyne, a nephrologist at Washington University School of Medicine, agreed with Auerbach that it was "absolutely true" that Venofer's dosages were amiss to increase revenue (Pollack). .
"How could it possibly be that patients in DaVita facilities were getting so much more iron than patients in other facilities and not getting iron overload?" said Dr.
