The Justice Department won its biggest Medicare Advantage fraud settlement yet on Wednesday, notching a $556 million deal with Kaiser Permanente.
The settlement resolves the government’s long-running allegations that Oakland, Calif.-based Kaiser, a roughly $116 billion company that runs dozens of hospitals and covers millions of people under its health plans, artificially beefed up its private Medicare members’ illnesses using inaccurate diagnosis codes that employees added to their charts after patients’ visits. The government pays Medicare Advantage insurers based on how sick their members are, and so companies have found myriad ways to tack on diagnoses.
