United States et al. ex rel. Mazik v. Kaiser Foundation Health Plan Inc. et al.

Docket No.
2:19-cv-00559
District Court
California Eastern

Goal

  • Award damages
  • Block defendant action

Issues

Why This Matters:

Why This Matters

A whistleblower filed a lawsuit against Medicare Advantage organizations alleging that the defendants violated the False Claims Act, as well as state laws in California, Colorado, the District of Columbia, Georgia, Hawaii, Maryland, Virginia, and Washington, by submitting inaccurate, incomplete, unsupported, or otherwise false diagnosis codes for Medicare Advantage enrollees. The whistleblower alleges that the defendants submitted this false information – otherwise known as upcoding – to improperly obtain millions of dollars in overpayments from the Medicare program.

Potential Impact:

Potential Impact

Ensuring accurate compensation for Medicare Advantage organizations prevents fraud, protects taxpayer dollars, and keeps health care costs low for patients. The False Claims Act is the government’s primary tool to combat health care fraud, and whistleblower lawsuits play an especially important role in protecting patients and consumers by curbing unnecessary and harmful medical treatments, reducing wasteful spending, and deterring fraud to the tune of nearly 10 times the amount that is recovered.

46 Major Filings

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Related Litigation

Current Status

Briefing is ongoing

Important Date

All Motions Due

Legal Issues

False Claims Act, California State Law, Colorado State Law, District of Columbia Law, Georgia State Law, Hawaii State Law, Maryland State Law, Virginia Commonwealth Law, Washington State Law

Date Filed
April 1, 2019
Case Type
Civil
Court Type
District Court
Court
California Eastern
Judge
Drozd, Dale A. Appointed By: Barack Obama
Plaintiff(s)
Jeffrey Mazik
Lead Counsel For Plaintiff(s)
Pollock Cohen LLP
Defendant(s)
Kaiser Foundation Health Plan Inc.; Kaiser Foundation Hospitals Inc.; The Permanente Medical Groups (The Permanente Medical Group Inc.; Southern California Permanente Medical Group; Colorado Permanente Medical Group P.C.)
Lead Counsel for Defendant(s)
O'Melveny & Myers LLP