Kaiser NW has agreed to pay $1.8 million to settle Justice Department charges that it violated the False Claims Act.
The Oregon-based arm of Kaiser Permanente, which consists of Kaiser Sunnyside Medical Center, Kaiser Foundation Health Plan of the Northwest and Northwest Permanente P.C., Physicians & Surgeons, will pay $1,830,322.41 to settle charges that it billed Medicare between 2000 and 2004 for hospice services that had been provided by the Kaiser Northwest Region Hospice without obtaining written certifications of terminal illness required under the federal healthcare program.
Kaiser officials submitted a report to the Department of Health and Human Service’s Office of Inspector General in June 2005 admitting to the actions.
Medicare hospice care providers are required to obtain written certifications of terminal illness for each beneficiary’s initial certification period (the first 90 days of care) from the medical director of the hospice and the attending physician, if the beneficiary has one. This is required prior to billing Medicare to help ensure that hospice care is medically necessary.
"By requiring that healthcare providers comply with Medicare’s standards, we ensure that beneficiaries receive hospice care that is medically necessary and meets appropriate medical standards," said Tony West, Assistant Attorney General for the Justice Department’s Civil Division. "We encourage disclosures of this nature and we consider them essential to ensuring the protection of the Medicare Trust Fund."