
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
Watch comet C/2026 A1 plunge toward the sun online this week02.04.2026 - 2
WHO suspends Gaza medical evacuations after contractor killed by Israeli troops07.04.2026 - 3
Factbox-Artemis II crew includes first woman, Black astronaut and Canadian ever flown to moon01.04.2026 - 4
Insane Realities That Will Make You Reconsider How you might interpret History30.06.2023 - 5
Early Thanksgiving week forecast: Where Americans can expect cold, rain and snow for the holiday18.11.2025
Ähnliche Artikel
Tracking down the Right Equilibrium: Charges versus Personal Costs in Senior Protection.19.10.2023
Eurasian cargo hub expands to capture Europe-Asia freight flows03.04.2026
AfD in Brandenburg takes back suit against the intelligence service02.01.2026
Purchases of iPhone 17 Pro soar across Gaza amid 'limited' humanitarian aid27.12.2025
Rick Steves' Favorite Time To Visit Spain Has Lower Prices And Fewer Crowds21.12.2025
Building a Flourishing Business: Illustrations from Business people25.09.2023
Hamas set to elect new terror leader with Hayya, Mashaal in pole position27.12.2025
Coalition led by Iraqi PM al-Sudani wins parliamentary elections12.11.2025
Chinese construction workers in Israel: 'I’d rather be bombed than live in poverty'07.04.2026
The most effective method to Pick a Campervan That Offers Something else for Less05.06.2024














