SMP National Resource Center

August 5, 2021

The United States intervened in six complaints alleging that members of the Kaiser Permanente consortium violated the False Claims Act by submitting inaccurate diagnosis codes for Medicare Advantage plan enrollees in order to receive higher reimbursements. Kaiser allegedly pressured physicians to create addenda to medical records after patient encounters, often months or over a year later, to add diagnoses that patients did not actually have and/or were not actually considered or addressed during the encounters. Read a story from The Associated Press and a Department of Justice press release. 

 


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SMP National Resource Center