
By Jonathan Stempel
Jan 14 (Reuters) - The U.S. Department of Justice said five Kaiser Permanente affiliates in California and Colorado agreed to pay $556 million to resolve claims they illegally pressured doctors to add codes for diagnoses they never considered to patients' medical records, in order to inflate Medicare payments from the government.
Wednesday's settlement resolves two whistleblower lawsuits accusing the affiliates of Oakland, California-based Kaiser of violating the federal False Claims Act.
Kaiser did not immediately respond to requests for comment. The affiliates included Kaiser Foundation Health Plan, Kaiser Foundation Health Plan of Colorado, Colorado Permanente Medical Group, Permanente Medical Group, and Southern California Permanente Medical Group.
Under Medicare Advantage, also known as Medicare Part C, patients who opt out of traditional Medicare may enroll in private health plans known as Medicare Advantage Organizations, or MAOs.
The Justice Department said requiring diagnosis codes helps ensure that the Centers for Medicare & Medicaid Services pays MAOs such as Kaiser's more money for sicker patients.
Kaiser's alleged improper activity included having doctors "mine" patients' medical histories for potential diagnoses to add to medical records, and linking bonuses to meeting diagnosis goals. The alleged wrongdoing occurred between 2009 and 2018.
“Fraud on Medicare costs the public billions annually, so when a health plan knowingly submits false information to obtain higher payments, everyone - from beneficiaries to taxpayers - loses," Craig Missakian, the U.S. Attorney for the Northern District of California, said in a statement.
The settlement resolves claims by former Kaiser employees Ronda Osinek, a medical coder, and James Taylor, a doctor who oversaw risk adjustment programs and coding governance.
They will receive about $95 million from the settlement, the Justice Department said.
The False Claims Act lets whistleblowers sue on behalf of the government, and share in recoveries.
(Reporting by Jonathan Stempel in New York; Editing by Matthew Lewis)
NEUESTE BEITRÄGE
- 1
Australia to offer businesses $693 million in cheap loans to ease fuel cost pressure01.04.2026 - 2
Scientists captured female sperm whales on video working together during a birth to protect the calf26.03.2026 - 3
NMG signs new graphite supply deal with Canadian Government27.03.2026 - 4
This Is Canada's Only Province Without Any Bears28.03.2026 - 5
How C-reactive protein outpaced ‘bad’ cholesterol as leading heart disease risk marker19.12.2025
Ähnliche Artikel
Great DSLR Cameras for Photography Devotees06.06.2024
A few Exemplary Chinese Dishes, Which Are Famous Around the world05.06.2024
The Best Business visionaries Under 3006.07.2023
Figure out How to Stay away from Normal Handshaking Missteps19.10.2023
‘Dying of thirst’: Inside Gaza’s al-Mawasi water crisis07.04.2026
April full moon 2026 dazzles as 'Pink Moon' lights up skies worldwide (photos)02.04.2026
We may have less control over how long we live than previously thought06.04.2026
The Significance of Health Projects in Senior Protection.19.10.2023
Watch Rocket Lab launch Japanese technology-demonstrating satellite to orbit tonight06.12.2025
Shipping: The Corridors of Trade and the Coming of Another Period07.11.2023














