
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
Skeleton of famed musketeer possibly found in Dutch church25.03.2026 - 2
Europe’s EV Boom Was Real in 2025. The Real Fight Starts In 202631.12.2025 - 3
Cannabis reclassification could 'open the floodgates' for research, scientists say23.12.2025 - 4
Iran denies launching ballistic missiles towards Kurdistan region of Iraq29.11.2025 - 5
AI is making spacecraft propulsion more efficient – and could even lead to nuclear-powered rockets24.11.2025
Ähnliche Artikel
A Manual for Extravagant Vehicles Available in 202405.06.2024
Scientists Just Discovered Japan’s First New Bird Species in Over 40 Years29.03.2026
Which European palace do you fantasy about visiting? Vote!07.06.2024
Vote In favor of Your Favored Web-based Venture Stage05.06.2024
Robyn returns to music with 'Dopamine,' her 1st single in 7 years: 'Came to save music once again'12.11.2025
Shipping: The Corridors of Trade and the Coming of Another Period07.11.2023
They relied on marijuana to get through the day. But then days felt impossible without it25.11.2025
'Wicked: For Good' was filmed at this surreal National Park in Egypt17.11.2025
Gaza receiving over 70,000 cubic meters of water per day, COGAT claims29.03.2026
Hezbollah sees potential win as Israel backs down from disarmament goal04.04.2026













