Kaiser Affiliates Agree to $556 Million False Claims Settlement

Kaiser Permanente affiliates have agreed to pay $556 million to resolve False Claims Act allegations the affiliates submitted invalid diagnosis codes while billing Medicare patients in order to receive higher payments, the US Department of Justice announced Wednesday.

The deal will resolve claims that between 2009 and 2018 Kaiser sought to increase its Medicare reimbursements by pressuring physicians to alter medical records after patient visits. Whistleblowers in two cases, two former Kaiser employees, will receive $95 million of the recovery, the DOJ’s press release said.

• “Multiple major health plans have faced similar government scrutiny over Medicare Advantage risk adjustment standards ...