Inactive Case

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

Docket No.
22-15862
Appellate Court
Ninth Circuit

Goal

  • Award damages

Issues

Why This Matters:

Why This Matters:

The Department of Justice joined, in part, a whistleblower case against a group of Medicare Advantage organizations, alleging that these organizations submitted inaccurate, incomplete, unsupported, or otherwise false diagnosis codes for Medicare Advantage enrollees. The whistleblowers and Department of Justice alleged that the health system submitted this false information – also known as upcoding – to improperly obtain millions of dollars in overpayments from the Medicare program. On appeal, the plaintiffs seek to overturn the district court’s dismissal of the case.

Potential Impact:

Potential Impact:

Ensuring accurate reimbursement for Medicare Advantage claims reduces fraud and helps guarantee that taxpayer funds are spent appropriately.

15 Major Filings

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Related Litigation

Current Status

Decision issued

Legal Issues

False Claims Act

Date Filed
June 3, 2022
Case Type
Civil
Court Type
Appellate Court
Court
Ninth Circuit
Judge
Boggs, Danny J.; Thomas, Sidney R.; Forrest, Danielle J.
Plaintiff(s)
Marcia Stein; Rodolfo Bone
Lead Counsel For Plaintiff(s)
The Hanagami Law Firm
Intervenor Plaintiff(s)
United States
Defendant(s)
Kaiser Foundation Health Plan, Inc.; Kaiser Foundation Hospitals; Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of Georgia, Inc.; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Kaiser Foundation Health Plan of the Northwest; Kaiser Foundation Health Plan of Washington; The Permanente Medical Group, Inc.; Southern California Permanente Medical Group; Colorado Permanente Medical Group; The Southeast Permanente Medical Group; Hawaii Permanente Medical Group; Mid-Atlantic Permanente Medical Group; Northwest Permanente, P.C.; Group Health Permanente; Kaiser Permanente
Lead Counsel for Defendant(s)
O'Melveny and Myers LLP