The DOJ has accused members of Kaiser Permanente’s health-care consortium of defrauding Medicare out of about $1 billion. The complaint claims that Kaiser looked for diagnoses to add to patient medical records after visits, including issues that either didn’t exist or were unrelated to the visits, to make it look as if these diagnoses had been newly addressed. Medicare Advantage plans reimburse healthcare providers by a rate which is adjusted based on the patient’s age and medical diagnoses. The complaint stems from six whistleblower lawsuits, the first of which was filed in 2013, that the DOJ decided to join in July.
Source:
