CityMD agreed to pay the federal government $12 million to settle fraud allegations related to COVID-19 tests, according to the Justice Department.

A lab owner from Morton Grove, Ill. is accused of submitting more than $60 million in false claims to Medicare as part of COVID-19 testing fraud scheme, the Chicago Tribune reported June 7. 

A California sleep clinic owner was sentenced to 46 months in prison for submitting more than $1.5 million fraudulent claims to Medicare and Medi-Cal. 

From a judge denying the FTC's attempt to block a two-hospital deal in North Carolina to two former high-ranking employees filing a False Claims Act complaint against Erlanger Health System, here are 12 lawsuits, settlements and legal developments Becker's has reported since May 28. 

Los Angeles-based Prospect Medical Holdings is suing Yale New Haven Health, demanding that the Connecticut health system honor its contractual obligations to acquire Eastern Connecticut Health Network and Waterbury Hospital.

A majority panel for the U.S. Court of Appeals for the Ninth Circuit has reversed a 2022 jury verdict in favor of Sacramento, Calif.-based Sutter Health in a class action alleging the health system used its market power to charge supracompetitive rates to major insurers, which resulted in higher premiums for members, according to court documents accessed by Becker's. 

A federal judge has rejected the Federal Trade Commission's request for a preliminary injunction to bar Winston-Salem, N.C.-based Novant Health from its $320 million acquisition of two North Carolina hospitals from Franklin, Tenn.-based Community Health Systems.

Portland, Ore.-based Legacy Health will pay an undisclosed amount to settle a lawsuit with parents of a burn victim from an apartment fire, The Oregonian reported June 4.  

From a Massachussettes hospital settling allegations it knowingly billed for procedures that didn't follow Medicare rules to the conviction of a Texas physician in a $70 million scheme, here are 10 healthcare billing fraud cases Becker's has reported since May 10:

The manufacturer of Ozempic and Wegovy filed nine additional lawsuits against businesses in six states that allegedly sold unapproved compounded versions of the popular drugs. 

The former CEO of Williamson (W.Va.) Memorial Hospital has admitted stealing hospital funds for personal use and without authorization, according to the Justice Department.

Doctors Medical Center in Modesto, Calif., has been cited for immediate jeopardy by CMS, the California Department of Public Health confirmed to Becker's May 30.

A national trade group representing laboratories filed a lawsuit against the FDA on May 29, arguing the agency's recent final rule to treat laboratory-developed tests as medical devices exceeds its statutory authority. 

Vermont Sen. Bernie Sanders and Oregon Sen. Ron Wyden are seeking information from MultiPlan after an April 7 New York Times report found that major insurers made millions in fees by using the data analytics firm to determine how much to pay for out-of-network claims. 

The Medical Group Management Association said that as the number of Medicare Advantage beneficiaries continues to grow, "it is imperative that the MA program ensures adequate and transparent coverage to patients, timely payment to medical groups and remains a viable pathway for medical groups to participate in value-based payment arrangements."

On May 28, representatives from three states introduced a federal bill to amend the 340B program by recognizing contract pharmacies, restricting pharmacy benefit managers and tightening eligibility criteria. 

DuBois, Pa.-based Penn Highlands Healthcare has agreed to pay the federal government $735,000 to resolve a whistleblower suit alleging Physician Self-Referral Law violations from claims submitted to Medicare and Medicaid.

Two former high-ranking employees have filed a False Claims Act complaint against Chattanooga, Tenn.-based Erlanger Health System.

Louisiana is the first state to define medication abortion, an FDA-approved two-drug regimen, as a controlled substance, meaning possession of unprescribed abortion pills can lead to imprisonment. 

A Fredericksburg, Texas physician was convicted for causing the submission of more than $70 million in fraudulent claims to Medicare for medically unnecessary orthotic braces and genetic tests ordered through a telemarketing scheme.