Oakland, Calif.-based Kaiser Permanente has agreed to pay $556 million to resolve allegations that it violated the False Claims Act by submitting invalid diagnosis codes for Medicare Advantage enrollees to obtain higher payments from the federal government.
According to the Justice Department, multiple Kaiser Permanente affiliates improperly increased risk-adjusted MA payments by pressuring physicians to add diagnoses to patient medical records after visits had occurred — even when those diagnoses were not evaluated or treated during the visit.
The settlement covers Kaiser Foundation Health Plan, Kaiser Foundation Health Plan of Colorado, The Permanente Medical Group, Southern California Permanente Medical Group, and Colorado Permanente Medical Group…