Alerts11.17.22
Court Rules U.S.' Medicare Advantage Suit Against Kaiser Permanente May Move Forward
A California federal court partially dismissed the government’s claims against Kaiser Permanente, but permitted claims based on sub-regulatory disease classification guidelines to proceed.
The U.S. District Court for the Northern District of California determined that the United States’ claims against Kaiser Permanente for submission of inaccurate diagnosis codes via addenda may proceed. Although the court narrowed the scope of claims in the action, it determined that both Kaiser’s Medicare Advantage contract with the Centers for Medicare & Medicaid Services (CMS) and the governing federal regulations required Kaiser’s addenda to comply with the International Classification of Diseases (ICD) coding guidelines.
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