Kaiser to pay $3.75M to resolve false claim allegations

Four Kaiser Permanente health care entities in California have agreed to pay the government about $3.75 million to resolve allegations of false Medicare and Medicaid payment claims, the U.S. Justice Department announced this week.

U.S. Attorney Joseph Russoniello of San Francisco said the government alleged that from 1996 to 2002, the Kaiser entities reported that certain services were provided by teaching physicians when in fact the services were provided by medical residents without the supervision of teaching doctors.

Russoniello said teaching physicians must be present during key portions of services provided by residents to ensure the quality of patient care and the senior doctors' presence must be reflected in patient records for purposes of Medicare and Medicaid billing.

The four entities, all part of or affiliated with Oakland-based Kaiser Permanente, are Kaiser Foundations Hospitals Inc., Kaiser Foundation Health Plan Inc., and the Permanente Medical Group Inc., all of Oakland; and Southern California Permanente Medical Group, based in Pasadena.

Russoniello said Kaiser voluntarily disclosed the misconduct to the U.S. Department of Health and Human Services under a voluntary self-disclosure program created by the department's inspector general's
office.

Kaiser Permanente spokesman John Nelson said, “We are pleased to have reached this settlement, and will continue to work on behalf of our members to maintain the integrity and billing processes.”

Nelsons said Kaiser Permanente discovered insufficient payment documentation for residents' work during an internal review and disclosed the problem to the federal and state governments in 2005.

If you find our journalism valuable and relevant, please consider joining our Examiner membership program.
Find out more at www.sfexaminer.com/join/

Just Posted

Traffic on 19th Avenue. (Photo courtesy Shutterstock)
Construction on 19th Avenue to begin Monday, traffic delays expected

Officials encourage drivers to take alternate routes, factor in longer travel times

Those who stick around San Francisco on long holiday weekends can enjoy a slower pace, uncrowded streets and beloved institutions like cable cars. <ins>(Kevin Hume/S.F. Examiner)</ins>
These empty San Francisco streets: A holiday dream

We’re here because we can be, and because we have nowhere else to be

Quarterback Nick Mullens is expected to get his third straight start Sunday. Mullens is 46 of 73 for 538 yards with two touchdowns and three interceptions in his other two starts this season. <ins>(Chris Victorio / Special to S.F. Examiner).</ins>
49ers trying to turn season around in Sunday’s prime-time faceoff with the Rams

49ers at Rams When: Sunday, 1:05 p.m. Where: SoFi Stadium, Inglewood TV:… Continue reading

Psilocybin magic mushrooms (Shutterstock)
‘Magic mushrooms’ moving into the mainstream

Efforts to decriminalize psychedelics could follow several different paths

The 2020 Census has concluded taking responses sooner than expected. (Courtesy photo)
What does California have to lose if undocumented immigrants are excluded from the census?

By Kim Bojórquez The Sacramento Bee If The U.S. Supreme Court rules… Continue reading

Most Read