Gibbs Mura is pleased to announce that Kaiser Permanente has agreed to pay $556 million to resolve allegations of Medicare Advantage risk-adjustment fraud. This is believed to be the largest Medicare Part C qui tam settlement ever reached, and is one of the largest whistleblower settlements brought under the False Claims Act settlements in recent years.
Our firm’s client, Ronda Osinek was the first whistleblower to file a complaint against Kaiser in the long-running litigation, which accused Kaiser of systematically pressuring physicians to alter medical records after patient visits to add or change diagnosis codes that had not been considered or addressed at those visits. This practice allegedly led Kaiser to improperly inflate their claims submitted to Medicare, resulting in higher payments from the government. Other whistleblowers also filed claims, and in 2021, the Department of Justice joined the case.
Gibbs Mura partner Amy Zeman said, “We applaud Ms. Osinek’s courage in coming forward and reporting conduct she believed was defrauding the federal government. I’ve been honored to work with her over twelve years of litigation and help her navigate the repercussions of her decision to step up for honesty and integrity. The results achieved here show that whistleblowers can make a real difference.”
“I value my work in the healthcare industry, which made it especially painful when I saw what I believed to be wrong and fraudulent conduct,” said Gibbs Mura client Ronda Osinek. “It was a difficult decision to speak up initially, but ultimately I am proud that my involvement resulted in achieving justice, and that I played a small part in ensuring our systems are more honest and accountable.”
If you believe you’ve witnessed healthcare fraud, our Medicare fraud whistleblower attorneys can help you understand your rights. Speak with our team, confidential and free: 800-709-4478
In an encouraging signal to whistleblowers, the Department of Justice has emphasized its continued priority to combat healthcare fraud, particularly through the False Claims Act.
We recognize and appreciate the government attorneys and investigators who pursued this matter on behalf of the United States.
About Gibbs Mura, A Law Group
Gibbs Mura is a nationally recognized law firm that represents individuals across the United States who report fraud against the government under the federal False Claims Act and related state qui tam laws. The firm’s attorneys advise and represent whistleblowers who expose misconduct involving healthcare fraud, financial and billing fraud, cybersecurity and data-security violations, and other schemes that result in false or fraudulent claims for taxpayer funds. With extensive experience litigating high-stakes cases against some of the world’s largest corporations, Gibbs Mura’s award-winning lawyers have recovered billions of dollars on behalf of clients nationwide. The firm has been recognized with numerous honors, including “Top Plaintiff Lawyers in California,” “Class Action Practice Group of the Year,” “Best Lawyers in America,” and “Top Boutique Law Firm in California.”
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