Redacted Second Amended Complaint — No. 2:17-cv-01694 (Dkt. 38, C.D. Cal.)

Summary

The redacted second amended complaint in United States ex rel. Integra Med Analytics LLC v. Providence Health Services, et al., No. 2:17-cv-01694-PSG-SS, in the U.S. District Court for the Central District of California, filed August 10, 2018 as Document 38, a 100-page qui tam pleading under the False Claims Act, 31 U.S.C. § 3729. The relator alleges that Providence Health & Services and affiliated hospitals, with consultant J.A. Thomas and Associates, used unwarranted Major Complication and Comorbidity secondary codes to inflate Medicare claims. It seeks to recover over $188.1 million, with sections on encephalopathy, respiratory failure and severe malnutrition codes and on the relator's statistical methodology. The prayer asks for treble damages and civil penalties of not less than $10,957 and not more than $21,916 per violation.

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