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

Ruth Bader Ginsburg, liberal giant of the Supreme Court, dies

Justice Ruth Bader Ginsburg, who championed women’s rights — first as a… Continue reading

Four officers found to have committed misconduct escape discipline

Four officers who should have been punished for misconduct escaped discipline because… Continue reading

Breed says limited indoor dining to resume if COVID-19 data improves

Restaurants could open for limited indoor dining as early as the end… Continue reading

Giants clinging to playoff spot as they face off with A’s

The stakes couldn’t be much higher this weekend when the Giants make… Continue reading

Two new contractors charged with bribery in Nuru scandal

Two construction executives are facing federal bribery charges for allegedly giving former… Continue reading

Most Read