Kaiser Permanente Affiliates Paying $556M to Resolve False Claims Act Allegations.

The article focuses on an integrated healthcare consortium affiliated with Kaiser Permanente, which has agreed to pay $556 million to settle allegations of violating the False Claims Act by submitting invalid diagnosis codes for Medicare Advantage Plan enrollees. The U.S. Department of Justice claims that from 2009 to 2018, Kaiser pressured physicians to alter medical records post-visit to include diagnoses that were not addressed during the consultations, thereby inflating their Medicare reimbursements. The allegations specifically involve practices in California and Colorado, where Kaiser allegedly developed methods to identify and add unsupported diagnoses to medical records to increase risk adjustment payments from the Centers for Medicare & Medicaid Services (CMS). [Extracted from the article]