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Kaiser Permanente Settles $556 Million Medicare Fraud Case

1/15/2026

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Summary

Kaiser Pays Settlement

Kaiser Permanente's five affiliates will pay $556 million to settle fraudulent Medicare Advantage billing from 2009 to 2018.
The Department of Justice (DOJ) claims Kaiser Permanente added about half a million diagnoses to inflate payments by nearly $1 billion.
Whistleblowers, including a medical coder and a doctor, will receive $95 million from the settlement.
Kaiser Permanente says the settlement reflects industry challenges rather than an admission of wrongdoing.

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Kaiser Pays Settlement

Kaiser Permanente's five affiliates will pay $556 million to settle fraudulent Medicare Advantage billing from 2009 to 2018.
The Department of Justice (DOJ) claims Kaiser Permanente added about half a million diagnoses to inflate payments by nearly $1 billion.
Whistleblowers, including a medical coder and a doctor, will receive $95 million from the settlement.
Kaiser Permanente says the settlement reflects industry challenges rather than an admission of wrongdoing.