Kaiser Stops Whistleblowers From Reviving Upcoding Fraud Suit

Two whistleblowers lost their bid to reopen a False Claims Act suit alleging that Kaiser Foundation Health Plan Inc. improperly billed Medicare by upcoding diagnoses for medical conditions, the Ninth Circuit said Wednesday.

A California federal district court properly found that the suit filed by Marcia Stein and Rodolfo Bone was barred by the FCA’s first-to-file rule, which precludes later filed cases from proceeding if other related cases are pending, the US Court of Appeals for the Ninth Circuit said.

The district court reasonably determined that there were no material differences in Stein and Bone’s amended complaint and pending suits ...