News

Affiliates of Kaiser Permanente have agreed to pay $556 million to resolve allegations that they violated the False Claims Act by submitting inaccurate diagnosis codes in connection with Medicare Advantage risk adjustment payments. The settlement announced in January 2026 resolves consolidated government and whistleblower-led complaints, which allege that Kaiser systematically pressured physicians to add diagnoses […]

Federal prosecutors in the Southern District of Texas have secured substantial prison sentences for two healthcare employees convicted in a multimillion-dollar fraud scheme that targeted elderly and vulnerable patients at adult day care facilities. A federal jury found Dr. Osama Nahas and clinic employee Isabel Pruneda guilty of conspiracy to commit healthcare fraud, healthcare fraud,

The Pennsylvania Attorney General’s Office recently secured a prison sentence against a former office manager involved in a substantial Medicaid fraud scheme tied to a Montgomery County home care provider. Barbara Thomas, 46, was sentenced in Montgomery County Court to 9 to 23 months in prison followed by four years of probation after pleading guilty

This is the sixth and final entry in a six-part series on the process and practical realities of being a whistleblower and exposing fraud against the government.