• HHS' surprise-billing appeal on hold

    HHS requested a hold on its appeal of a Texas federal court ruling that voided part of the arbitration process outlined under the No Surprises Act. 
  • Fired Mercyhealth exec sentenced for wire fraud, tax evasion

    A former vice president of Janesville, Wis.-based Mercyhealth was sentenced to 3 ½ years in prison May 4 for wire fraud and tax evasion in relation to a $3.1 million kickback scheme, according to the U.S Justice Department.
  • Tennessee health system must face nurse practitioner's false claims retaliation suit

    Memphis, Tenn.-based Baptist Memorial Health Care Corp., and its physician group must face a retaliation lawsuit filed by a nurse practitioner who claimed the organization violated the False Claims Act by retaliating against her for raising billing fraud concerns, a Tennessee district court ruled May 2. 
  • CALL TO ACTION: Modernize your huddle, decentralize your command center

    Your current huddle model needs a major update. Learn how University Hospitals was able to align board and bed-level goals by modernizing its huddle model here.
  • Michigan physician barred from billing Medicare for 3 years

    A Michigan physician is banned from submitting claims to Medicare for three years as part of a settlement to resolve allegations of performing unnecessary surgeries and submitting false claims to physicians, according to the Justice Department. 
  • How to Assess Your Vendor’s Use of AI

    As we look to the future of healthcare, artificial intelligence (AI) can impact every aspect from care delivery to pharmaceutical operations to organizational operations, and we expect to see rapid advancements in these technologies over the next few years. AI is readily accessible by most businesses and could make great improvements in the healthcare industry in delivering better patient experiences and outcomes while reducing the cost of care, which is aligned with the “Triple Aim”.
  • Attorneys seek to revive $411M antitrust suit against Sutter

    Attorneys representing employers and health plan enrollees in a long-running antitrust suit against Sacramento, Calif.-based Sutter Health filed a notice of appeal April 26. 
  • Humana lawsuit against drugmaker can move forward, judge says

    A federal court in New Jersey ruled that Humana's lawsuit against Celgene can move forward, but must prove its claims that the drugmaker engaged in conduct that led to artificially high prices, Bloomberg reported April 28. 
  • Telehealth app used unsafe prescribing practices to keep patients, lawsuit says

    A former executive at Cerebral claims he was fired in part for raising concerns about prescribing practices at the telepsychiatry company, The Wall Street Journal reported April 29. 
  • Houston ER physicians say they were urged to avoid COVID tests, work sick

    A group of emergency room physicians filed a lawsuit in March alleging representatives for their employer, American Physician Partners, discouraged them from testing for COVID-19 and pressured them to work while ill, according to the Houston Chronicle. 
  • Deal reached to raise cap on California medical malpractice payouts

    California healthcare, legal and consumer advocates have agreed on legislation increasing the cap on monetary awards for medical malpractice lawsuits, CalMatters reported April 27. 
  • Air ambulance company sues federal agencies over No Surprises Act

    A Texarkana, Texas-based air ambulance company is suing HHS and other federal agencies over the No Surprises Act. 
  • California physician sentenced for defrauding Medicare, repackaging & reusing catheters

    A California physician was sentenced to 93 months in prison April 28 after being convicted of a $12 million Medicare fraud scheme and reusing single-use catheters on patients.   
  • Former Yale health system worker pleads guilty to $116K embezzlement scheme

    A former Yale New Haven Health Systems payroll worker admitted April 27 to her role in an embezzlement scheme that defrauded more than $100,000 from the health system. 
  • 7 recent healthcare industry lawsuits

    From Tenet Healthcare suing the Labor Department's Occupational Safety and Health Administration to hospitals suing HHS over a Medicare billing calculation, here are the latest healthcare industry lawsuits making headlines. 
  • New York physician pays $564K to resolve false billing claims

    A New York physician agreed to pay $564,217 to resolve allegations of submitting false claims to Medicare, the Justice Department said April 27. 
  • Tenet sues to block OSHA inspection of Texas hospital

    Dallas-based Tenet Healthcare has filed a lawsuit to prevent the Labor Department's Occupational Safety and Health Administration from inspecting the Hospitals of Providence Transmountain location in El Paso, Texas, to determine whether workers there are vaccinated against COVID-19 in compliance with CMS' vaccination mandate, Bloomberg Law reported.
  • Mississippi pharmacist sentenced to 10 years in $180M fraud scheme

    A Mississippi pharmacist was sentenced to 10 years in prison over his role in an $180 million fraud scheme, the Justice Department said April 26.
  • Man arrested in attack of Ochsner nurse

    Police have arrested a man in connection to the Jan. 27 attack of an intensive care unit nurse at Ochsner Medical Center-West Bank in Gretna, La., according to nola.com. 
  • HHS appealing Texas judge's surprise billing ruling

    HHS April 22 filed a notice of appeal regarding a Texas federal judge's ruling that sided with providers in a lawsuit over the No Surprises Act. 
  • Philips subpoenaed by DOJ over sleep apnea device

    The Dutch multinational healthcare conglomerate Royal Philips NV has been issued a subpoena by the Department of Justice regarding a recall of a sleep apnea device, reported The Wall Street Journal April 25. 

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