Article - May 29, 2008 - Renal Business Today

Missouri court denies Fresenius appeal in Epogen billing investigation

ST. LOUIS—A Missouri federal court denied Fresenius’ appeal to drop or modify a subpoena regarding an investigation into the dialysis provider’s Epogen billing practices toMedicare, according to a May 16 court filing.

The majority of dialysis patients receive Amgen’s Epogen to treat anemia associated with kidney failure, and the bill is largely footed by Medicare. In 2005, Medicare paid approximately $2 billion for Epogen. The drug is often prescribed using algorithms that lowe or raise the dose based on changes in the patient’s blood, and there have been widespread accusations that there is a financial incentive to prescribe more Epogen in order to receive more reimbursement.

Fresenius’ Epogen billing has been investigated for more than a decade, and the company has paid substantial settlements as a result. After the last settlement was paid in 2002 the government formally said it had no plans to further investigate Fresenius.

New Epogen billing claims piqued the interest of federal attorneys, though, and they decided to issue new subpoenas to Fresenius. However, Fresenius argued that the previous investigations already settled precluded the company from having to submit documents before 2002. The court, however, disagreed and upheld the subpoenas. Fresenius appealed the decision, but the appeal was denied, according to a May 16 court filing with the U.S. District Court for the Eastern District of Missouri.

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