Kaiser Agrees to $1.8 Million Settlement with DOJ

False claims act case blamed on Medicare billing errors

January 6, 2010 -- Kaiser Permanente of the Northwest has agreed to pay the U.S. government $1.8 million to settle False Claims Act liability in connection with Medicare billing errors between 2000 and 2004.

The settlement followed a voluntary disclosure by Kaiser in 2005 that it had on occasion billed for hospice services without first obtaining certifications of terminal illness required under federal law. The settlement does not address whether any of the services were inappropriate.

The hospice care in question was provided by Kaiser Sunnyside Medical Center, Kaiser Foundation Health Plan of the Northwest and Northwest Permanente P.C., Physicians & Surgeons.
 
"By requiring that health care providers comply with Medicare’s standards, we ensure that beneficiaries receive hospice care that is medically necessary and meets appropriate medical standards," said Tony West, Assistant Attorney General for the Justice Department’s Civil Division in a press release. "We encourage disclosures of this nature and we consider them essential to ensuring the protection of the Medicare Trust Fund."
 
Kaiser Permanente says it’s implemented a new auditing process and procedures to ensure paperwork is handled properly.
 
These internal audits have shown 100 percent compliance, said Maryann Schwab, compliance officer.
 
“When we first noticed the billing error, we reported it and moved aggressively to improve our handling of paperwork,” Schwab said in a press release. “I’m confident that we’re in full compliance today.”
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