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Posts Tagged ‘False claims act’

Medicare Advantage plans: Should healthcare organizations care about payer audits, fines? Hint: Yes

By Brian.m | April 1, 2026 | 0

You are a CDI Director at a large integrated healthcare system, with oversight of staff working in acute care hospitals and clinics. You have patients with Aetna and Kaiser Permanente. Then the news hits: Kaiser agrees to pay $556M to settle false claims act (FCA) allegations for inflated risk adjustment coding. Aetna, $117M for similar…

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