Attorneys representing American Renal Associates Holdings have filed a request in a U.S. District Court in Southern Florida to dismiss a lawsuit filed by United Healthcare over charges of pushing dialysis patients into UHC plans in order to collect higher payments.
The complaint, filed July 1 in the Southern District of Florida, is “filled with generalized, conclusory statement, misleading half-truths, and material omissions,” says the filing released on Aug 12 by Kobre & Kim LLP of Miami. “…Indeed, it is apparent that United manufactured this lawsuit by making payments in amounts it was not contractually obligated to make. It did so in an effort to justify dropping coverage for chronically ill, low income patients with the pre-existing condition of end-stage renal disease, who require dialysis as an essential life-sustaining treatment and who enrolled in one of its insurance plans.”
In the 39-page complaint, United said ARA launched a “fraudulent and illegal scheme … to unlawfully obtain benefit payments from United for dialysis services rendered to vulnerable patients suffering from chronic kidney disease.” The complaint identifies 27 dialysis patients treated at 12 ARA clinics that United said joined the insurer’s Gold Compass 1500 plan in Florida and its Compass and Navigate Plan in Ohio. United said some of the patients would have qualified for Medicare. “…Many of the patients ARA counseled into dropping Medicaid coverage and switching to a United commercial plan … were also eligible for Medicare coverage at the time they were enrolled in the United plans by ARA employees.”
In addition, it charges in the suit that ARA told patients it would pick up any charges for co-pays or deductibles once they agreed to sign onto the commercial plans.
In a statement, ARA defended its practices.
“At all times, we are dedicated to putting patients first, and we structure all of our relationships within that framework and with the intent to provide patients with the best possible service and quality of care,” said Michael Costa, vice president and general counsel of American Renal Associates Holdings Inc. “We believe this lawsuit is without merit. We intend to vigorously defend this legal action for American Renal and on behalf of all patients who choose and trust us with their care.”
ARA, which went public in April, operates 201 clinics and serves 13,755 patients across 25 states and the District of Columbia. Thirty-nine of those clinics are in Florida.