The U.S. Justice Department has joined a series of whistleblower lawsuits alleging that Kaiser Permanente engaged in a yearslong scheme to defraud the federal government out of Medicare payments.
The suits allege that since 2009 the company systematically pressured doctors to amend medical records by adding “diagnoses that patients did not actually have” in order to receive higher Medicare reimbursements, according to federal prosecutors.
The original suit, filed under the False Claims Act in 2013 by a Kaiser data specialist in San Rafael, claims the company also used data mining to “retroactively change patient medical records.”
“Today’s action sends a clear message that we will hold health care providers and plans accountable if they seek to game the system by submitting false information,” Deputy Assistant Attorney General Sarah Harrington said.
The suits seek an unspecified amount of money in damages plus attorney fees and court costs.
Recommended for you
Kaiser has denied all allegations of wrongdoing.
“We are confident that Kaiser Permanente is compliant with Medicare Advantage program requirements and we intend to strongly defend against the lawsuits alleging otherwise,” according to a statement posted on the company’s website Thursday.
“Our policies and practices represent well-reasoned and good-faith interpretations of sometimes vague and incomplete guidance from (Centers for Medicare & Medicaid Services),” the statement reads.
A case management conference is scheduled for Oct. 22 via Zoo
Keep the discussion civilized. Absolutely NO
personal attacks or insults directed toward writers, nor others who
make comments. Keep it clean. Please avoid obscene, vulgar, lewd,
racist or sexually-oriented language. Don't threaten. Threats of harming another
person will not be tolerated. Be truthful. Don't knowingly lie about anyone
or anything. Be proactive. Use the 'Report' link on
each comment to let us know of abusive posts. PLEASE TURN OFF YOUR CAPS LOCK. Anyone violating these rules will be issued a
warning. After the warning, comment privileges can be
revoked.
Please purchase a Premium Subscription to continue reading.
To continue, please log in, or sign up for a new account.
We offer one free story view per month. If you register for an account, you will get two additional story views. After those three total views, we ask that you support us with a subscription.
A subscription to our digital content is so much more than just access to our valuable content. It means you’re helping to support a local community institution that has, from its very start, supported the betterment of our society. Thank you very much!
(0) comments
Welcome to the discussion.
Log In
Keep the discussion civilized. Absolutely NO personal attacks or insults directed toward writers, nor others who make comments.
Keep it clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't threaten. Threats of harming another person will not be tolerated.
Be truthful. Don't knowingly lie about anyone or anything.
Be proactive. Use the 'Report' link on each comment to let us know of abusive posts.
PLEASE TURN OFF YOUR CAPS LOCK.
Anyone violating these rules will be issued a warning. After the warning, comment privileges can be revoked.