Highlights
Four motions to dismiss the False Claim Act allegations against Kaiser are pending in the U.S. District Court for the Northern District of California
Kaiser is alleged to have violated the False Claims Act by submitting inaccurate diagnosis codes for its Medicare Advantage Plan enrollees in order to receive higher reimbursements
Oral arguments on the pending motions to dismiss will take place on Oct. 14, 2022
Since 2013, six whistleblower lawsuits have been filed in the U.S. District Court for the Northern District of California against Kaiser Permanente Consortium members for alleged violations of the False Claims Act relating to certain Medicare Advantage claims submissions.
There are currently four motions to dismiss the False Claims Act allegations against Kaiser pending in the Northern District of California. Ronda Osinek filed the first action against Kaiser Permanente almost nine years ago, raising allegations about Kaiser’s Medicare Advantage risk-adjustment practices. Following Osinek’s filing, the government spent the next eight years investigating Kaiser as several other private parties (known as relators) filed suits similar to Osinek’s against Kaiser (Taylor, Arefi, Stein, Bryant, and Bicocca) (the Kaiser actions). These cases were consolidated in June 2021. Oral argument on the pending motions to dismiss is set to take place on Oct. 14, 2022.
Background on the Kaiser Actions
In October 2021, the United States partially intervened in the six Kaiser...
University of Rochester Medical Center and a former pathologist resolved a retaliation suit alleging URMC violated the False Claims Act by firing her for calling attention to federal grant fraud. ...