Kaiser Foundation Health Plan of Washington to pay $6,375,000 over allegations of inflated Medicare Advantage claims

From the Department of Justice

Kaiser Foundation Health Plan of Washington, formerly known as Group Health Cooperative (GHC), agreed to pay $6,375,000 to resolve allegations that it submitted invalid diagnoses to Medicare for Medicare Advantage beneficiaries and received inflated payments from Medicare as a result, the Justice Department announced on Monday, November 16, 2020. 

Kaiser Foundation Health Plan was formerly based in Washington but is now headquartered in Oakland, California.

“When insurance providers take advantage of Medicare and falsely claim that they are entitled to repayment for unsupported diagnoses, American taxpayers suffer in the form of higher costs,” stated U.S. Attorney James Kennedy, Jr. of the Western District of New York. “We will continue to work to ensure that these programs are not defrauded and that monies are not paid for unwarranted claims.”

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