Healthcare Roundup—Fresenius to pay $231M to settle DOJ bribery charges

Wooden gavel and gold legal scale that appear to have sunlight falling on them
According to the DOJ, Fresenius is accused of paying bribes to publicly employed health or government officials to obtain or retain business in Angola and Saudi Arabia between 2007 and 2016. (Getty Images/William_Potter)

Fresenius agrees to pay $231M

Germany-based kidney care company Fresenius Medical Care agreed to pay approximately $231 million to resolve bribery allegations by the Department of Justice and the Securities and Exchange Commission. 

According to the DOJ, Fresenius is accused of paying bribes to publicly employed health or government officials to obtain or retain business in Angola and Saudi Arabia between 2007 and 2016. In Angola and Saudi Arabia, Morocco, Spain, Turkey and countries in West Africa, Fresenius is accused of failing to implement reasonable internal accounting controls over financial transactions and failed to maintain books and records that accurately and fairly reflected the transactions, the company admitted.

“Fresenius doled out millions of dollars in bribes across the globe to gain a competitive advantage in the medical services industry, profiting to the tune of over $140 million,” said Assistant Attorney General Benczkowski in a statement. “Today’s resolution, under which Fresenius has agreed to retain an independent compliance monitor for at least two years, reflects the Department’s firm commitment to both rooting out bribery and promoting the kind of effective corporate compliance programs that will prevent misconduct going forward.” (Release)

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Growth in telehealth visits outpaces other venues of care: study

Telehealth use grew 53% from 2016 to 2017, outpacing any other venue of care, according to Fair Health’s FH Healthcare Indicators white paper.

FAIR Health studied utilization rates based on its database of more than 28 billion privately billed healthcare claim records. From 2016 to 2017, private insurance claim lines for services rendered via telehealth as a percentage of all medical claim lines grew 53% nationally, while the national usage of urgent care centers increased 14%, usage of retail clinics increased 7% and usage of ambulatory surgery centers rose 6%. Usage of ERs, on the other hand, actually decreased by 2%.

Telehealth utilization in urban areas grew almost twice as fast (55%) in 2017 compared to rural areas (29%).

The top diagnostic categories associated with telehealth in 2017 were injury (e.g., contusions and open wounds), acute respiratory infections and digestive system issues, each of which constituted 13% of claims. General signs and symptoms (e.g., fever and headache) were the fourth most common diagnostic category in 2017. Mental health reasons, which had been the top telehealth diagnostic category in 2016, ranked fifth in 2017. (White paper)

UnitedHealthcare exits Iowa's Medicaid managed care program 

UnitedHealthcare will leave Iowa’s Medicaid managed care program, where it manages two-thirds of beneficiaries. 

UHC is the second insurer to exit the state’s Medicaid program since Iowa privatized it. The insurer was paid about $2 billion in both state and federal funds to manage its Medicaid patient population. 

Gov. Kim Reynolds' office said it broke off the deal with UnitedHealthcare due to “unreasonable and unsustainable” demands from the insurer. UHC said in a statement that “persistent funding and program design challenges” made it impossible for the payer to continue in the program. (Des Moines Register)

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