Kaiser plans pay $556M to settle Medicare upcoding allegations
By 
Adrianne Appel2026-01-16T17:49:00
Kaiser Health affiliates have agreed to pay more than $556 million to settle allegations originally made by whistleblowers that they ignored compliance department warnings and unlawfully reworked diagnoses for Medicare patients in order to receive higher payments from the federal government.
Two former physician employees of Kaiser plans alleged in 2013 and 2014 qui tam “whistleblower” lawsuits that, since 2009, five Kaiser plans, in California and Colorado, had engaged in a widespread, intentional scheme to defraud the government by purposefully padding their bills to Medicare.
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