Group Health Cooperative - Healthcare Fraud/Medicare Advantage ($6.375 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Group Health Cooperative (now a subsidiary of Kaiser Permanente) submitted false or inaccurate Medicare Advantage patient diagnosis codes to inflate the reimbursement it received under the Medicare Part C program.  In November 2020, the company agreed to pay $6.375 million to settle the matter.  Our client received a whistleblower award of 25% of the government’s recovery.  Read more — NPR, Seattle Times, DOJ, CC.

Tagged in: FCA Federal, Healthcare Fraud, Managed Care, Medical Billing Fraud, Medicare, Risk Adjustment Fraud, Whistleblower Case, Whistleblower Rewards,