December 04, 2009
KAISER ENTITIES AGREE TO SETTLE MATTER BROUGHT UNDER HHS-OIG VOLUNTARY SELF DISCLOSURE PROTOCOL
SAN FRANCISCO – Four Kaiser entities in Northern and Southern California have agreed to pay the government $3,752,000 to resolve allegations that they submitted false claims to the United States in connection with payments from the Medicare and Medicaid programs, U.S. Attorney Joseph P. Russoniello announced.
The government alleges that, from 1996 through 2002, Kaiser falsely reported that services had been provided by teaching physicians when in fact the services were provided by resident physicians without the supervision of teaching physicians. Teaching physicians must be physically present during key portions of services rendered by residents in order to insure that patient care meets a certain level of quality. The teaching physicians’ presence must be reflected in the patients’ records in order to bill for that type of service.
Kaiser voluntarily disclosed the misconduct to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) in San Francisco, pursuant to the voluntary self-disclosure protocol of HHS-OIG. The self-disclosure protocol is intended to resolve matters that, in the provider’s self-assessment, potentially violate federal criminal, civil or administrative laws. It is an effective government tool for combating healthcare waste and abuse without litigation. The disclosing entities are Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc., The Permanente Medical Group and Southern California Permanente Medical Group.
Assistant U.S. Attorney Gioconda R. Molinari handled the matter on behalf of the U.S. Attorney’s Office, with the assistance of Legal Assistant Kathy Terry.
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