US Sues Kaiser Permanente for Alleged Medicare Fraud

US Sues Kaiser Permanente for Alleged Medicare Fraud

The lawsuit said Kaiser entities gamed the Medicare Advantage Plan system, also known as the Medicare Part C program, which gives beneficiaries the option of enrolling in managed care insurance plans, according to a statement from the U.S. Department of Justice. The lawsuit contends that Kaiser “pressured its physicians to create addenda to medical records,” often months or more than a year after an initial consultation with an enrollee, because more severe diagnoses for beneficiaries generally result in larger payments to the plan.

The U.S. Department of Justice lawsuit, filed Thursday in federal court in San Francisco, consolidates allegations made in six whistleblower complaints. Kaiser, based in Oakland, California, is a consortium of entities that together form one of the largest nonprofit health care plans in the U.S. with more than 12 million members and dozens of medical centers. “The integrity of government health care programs must be protected,” Stephanie Hinds, acting U.S. attorney for the Northern District of California, said in the statement. “The Medicare Advantage Program maintains the health of millions, and wrongful acts that defraud the program cannot continue and will be pursued.”

Kaiser defended its practices and called the lawsuit filing disappointing. “Our policies and practices represent well-reasoned and good-faith interpretations of sometimes vague and incomplete guidance” from the agency that oversees Medicare, Kaiser said in a statement to the Sacramento Bee.

If the government wins its case, Kaiser could wind up paying hundreds of millions of dollars in penalties and damages, Edward Baker, an attorney representing a whistleblower in the case, told the Bee. The lawsuit names Kaiser Foundation Health Plan Inc.; Kaiser Foundation Health Plan of Colorado; The Permanente Medical Group Inc.; Southern California Permanente Medical Group Inc. and Colorado Permanente Medical Group P.C.

The News Highlights

  • US Sues Kaiser Permanente for Alleged Medicare Fraud
  • Check the latest update on business news
Disclaimer: If you need to edit or update this news from compsmag then kindly contact us Learn more

For Latest News Follow us on Google News


Latest Headlines
  • Show all
  • Trending News
  • Popular By week
Eagles TE Zach Ertz test positive, placed on reserve list / COVID-19
Eagles TE Zach Ertz test positive, placed on reserve list / COVID-19
The 30-year-old Ertz, a three-time Pro Bowler and Super Bowl champion, started on Sunday in the Eagles’ 17-11 loss to the 49ers, registering one catch for ...
Modifier of the body Brendan Russell spoke with the client on the phone the day before she died after the treatment, according to the court
Modifier of the body Brendan Russell spoke with the client on the phone the day before she died after the treatment, according to the court
Brendan Russell has denied all charges relating to procedures on three women The court has heard a concerned client called Mr Russell the day before she died ...
MECA phone service is down due to an AT&T outage
MECA phone service is down due to an AT&T outage
Karen Blevins, the Director of the Office of Emergency Management who oversees MECA said when the loss occurred about 11 a.m., AT&T was immediately ...
Deals: This Week’s Xbox Sales Include Over 250 Games (September 21-28)
Deals: This Week’s Xbox Sales Include Over 250 Games (September 21-28)
That said, we do have a hundred-or-so new additions in the form of Deals with Gold and Spotlight offers, so we’ve rounded up some of the most notable current ...
Police in Johnson City are warning residents about phone scammers posing as cops
Police in Johnson City are warning residents about phone scammers posing as cops
Russell County Sheriff’s Office investigating explosive device found in residence Once scammers retrieve the card’s information, they hang up. JOHNSON CITY, ...
Deadline for NYS health professionals to receive the COVID vaccine in just one week
Deadline for NYS health professionals to receive the COVID vaccine in just one week
Guthrie Medical adopted the employee vaccine mandate across all of its facilities, including those outside of New York State. All Guthrie employees must be ...
NSAV ACQUIRES 40% SHARES IN PREMIUM OTC CRYPTO TRADING DESK
NSAV ACQUIRES 40% SHARES IN PREMIUM OTC CRYPTO TRADING DESK
NSAV Holding’s vision is the establishment of a fully integrated technology company, which provides turnkey technological solutions to the cryptocurrency, ...
‘Sleepy Webster’s Not So Sleepy’:  News on $320M Development Path Weighs Future |  local business
‘Sleepy Webster’s Not So Sleepy’: News on $320M Development Path Weighs Future | local business
“That’s right,” said Seneca’s Larry Chapman. “At some point you have to decide whether you want to have a change and do the good change brings with it, or you ...
'A lot of people are going to get hurt' in unrecorded encryption exchanges, says the SEC's Gensler
‘A lot of people are going to get hurt’ in unrecorded encryption exchanges, says the SEC’s Gensler
“Public money has a certain place around the globe,” Gensler said. “Private monies usually don’t last long, so I don’t think there’s a long-term viability for ...
Google Meet now has the ability to adjust brightness automatically
Google Meet now has the ability to adjust brightness automatically
Workers are now working from home, students are studying from home, and people are meeting and greeting their family members using video calling apps. Ever ...
Show next
Compsmag - Latest News from tech, business and health
Logo