Kaiser Permanente affiliates settle $556M Medicare Advantage case; study identifies blood markers tied to future type 2 diabetes risk; severe storms linked to higher long-term mortality in older adults – Morning Medical Update

Kaiser Permanente affiliates to pay $556M in MA coding settlement

Affiliates of Kaiser Permanente have agreed to pay $556 million to resolve federal allegations that they violated the False Claims Act by submitting unsupported diagnosis codes to boost Medicare Advantage (MA) payments. The U.S. Department of Justice (DOJ) alleged Kaiser pressured physicians to add diagnoses to medical records after patient visits — sometimes months later — that were not evaluated or managed at the encounter, contrary to Centers for Medicare & Medicaid Services (CMS) rules.

Federal officials said the case underscores expectations that MA plans provide “truthful and accurate information,” as enrollment in the program now exceeds half of all Medicare beneficiaries. The settlement, covering conduct from 2009 to 2018, includes a $95 million whistleblower share.

Blood metabolite signature may sharpen type 2 diabetes risk prediction

Researchers from Mass General Brigham and Albert Einstein College of Medicine have identified a blood-based metabolomic signature that improves prediction of future type 2 diabetes beyond traditional risk factors. In a large, multiethnic study of more than 23,000 adults followed for up to 26 years, investigators found hundreds of metabolites linked to diabetes risk and developed a 44-metabolite profile that reflected the combined influence of genetics, diet and lifestyle. The findings suggest metabolomics could help identify high-risk patients earlier and support more targeted prevention strategies, though researchers emphasized that clinical validation is still needed. The full results are published in Nature Medicine.

Severe storms raise long-term death risk for older adults

Exposure to severe weather can increase mortality risk for vulnerable older adults long after a storm has passed, according to a new study from the University of Michigan. An analysis of Medicare data tied to Hurricane Harvey — which hit Texas and Louisiana in 2017 — found that adults 65 and older exposed to heavy rainfall faced a 3% higher risk of death in the following year, with even greater risks among those with chronic kidney disease, Alzheimer’s disease and related dementias, diabetes and among Black and Hispanic populations. The findings, published in the Journal of the American Geriatrics Society, suggest official disaster death counts may substantially underestimate longer-term health consequences and highlight the need for targeted post-disaster care for high-risk patients.