
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
Sean Penn lights up, Kylie Jenner gets A-list approval and 7 other moments you didn’t see at the Golden Globes12.01.2026 - 2
Oil magnate’s Venezuela detainment spooks industry26.03.2026 - 3
Monetary Wellness: Planning Tips for Independence from the rat race01.01.1 - 4
Hundreds show fascist salute at rally in Rome in annual ritual07.01.2026 - 5
German finance minister seeks better market access in China talks16.11.2025
Ähnliche Artikel
Experience Is standing by: 10 Pleasant Setting up camp Areas to05.06.2024
Ukraine demands army of 800,000 under peace plan11.12.2025
‘Slender Man’ attacker back in custody. What we know about Morgan Geyser's disappearance and what happens next.24.11.2025
Find the Techniques for Powerful Review Propensities: Opening Your Scholarly Potential13.07.2023
Astronomers may have spotted the 1st known 'superkilonova' double star explosion19.12.2025
This Canadian crater looks like marbled meat | Space photo of the day for Jan. 6, 202606.01.2026
Closets for Your Room: Plan and Utility Features06.06.2024
How did humans evolve, and will we evolve more?22.11.2025
Hamas urges Hezbollah to kidnap Israeli soldiers in wake of Knesset passing death penalty bill31.03.2026
Where America’s CO2 emissions come from – what you need to know, in charts13.12.2025














