The settlement resolves allegations that Kaiser Foundation Health Plan of Washington, formerly Group Health Cooperative, submitted diagnoses to Medicare that were not supported by the beneficiaries’ medical records to inflate payments it received.
The allegations were originally brought under the qui tam, or whistleblower, provisions of the False Claims Act by a former employee of the health plan.
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Virginia physician convicted on 52 charges related to billing fraud scheme
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Pennsylvania physician pays $850K to settle false billing case
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