
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
'Dancing With the Stars' Season 34 finale: Who might win the mirror ball trophy? Where do the remaining contestants rank?24.11.2025 - 2
NASA's Artemis astronauts enter final preparations for Moon mission27.03.2026 - 3
Nature: 10 High priority Setting up camp Spots In Europe05.06.2024 - 4
Abbott issues US device correction for some glucose monitors over faulty readings risk24.11.2025 - 5
5 Bike Brands for Ordinary Use06.06.2024
Ähnliche Artikel
IDF says up to 90% of Iran’s weapons industry could be hit within days28.03.2026
Remain Fit: Powerful Wellness and Work-out Schedules for a Better You06.06.2024
British Columbia's Secret Lakeside Town With Hot Springs Is 'An Oasis Of Arts, Culture And Relaxation'10.01.2026
Uranus's small moons are dark, red, and water-poor08.12.2025
'Set up an Army Radio station at President’s Residence': Source close to Katz slams Herzog13.11.2025
PFAS in pregnant women’s drinking water puts their babies at higher risk, study finds08.12.2025
These 45 exoplanets may be the best places to search for alien life26.03.2026
From Loner to Force to be reckoned with: Individual Accounts of Change22.09.2023
5 Different ways Macintosh is Prepared to Overwhelm Gaming, Even Against Windows30.06.2023
Watch interstellar comet 3I/ATLAS speed away from the sun in free telescope livestream on Nov. 1616.11.2025














