1. UPMC sues Pennsylvania AG, says state can’t interfere in Highmark dispute
UPMC claimed Pennsylvania’s attempt to compel the health system to work with rival Highmark after a state-brokered agreement expires is an overstep of authority.
2. Financial analyst gets prison time for embezzling $46K from West Virginia hospital
A former financial analyst for Pleasant Valley Hospital in Point Pleasant, W.Va., was sentenced to three months in prison after pleading guilty last year to embezzling more than $46,000 from the hospital.
3. Aetna settles claims denial lawsuit for $6.2M
Aetna agreed to settle a class-action lawsuit that accused the health insurer of categorically denying depression treatment claims.
4. Ex-CEO accused of defrauding eHealth Technologies
A federal grand jury issued a 15-count indictment charging the former CEO of eHealth Technologies, a Rochester, N.Y.-based health IT company, with wire fraud, money laundering and filing a false tax return.
5. Bank sues Tennessee hospital for $2M
A local bank is suing Lauderdale Community Hospital in Ripley, Tenn., to recoup loan payments.
6. Patient recruiter pleads guilty to $1.2M kickback scheme
A patient recruiter in Michigan pleaded guilty to participating in a kickback scheme that led to about $1.2 million in fraudulent Medicare claims.
7. BCBS of North Dakota fires back at patients in air ambulance lawsuit
Blue Cross Blue Shield of North Dakota rejected claims in a lawsuit filed by a couple questioning the insurer’s reimbursement policy for medical flights.
8. Testimony gives insight on key aim of Amazon-Berkshire-JPMorgan venture
In a testimony unsealed Feb. 20, one of the core missions of the healthcare venture launched by Amazon, Berkshire Hathaway and JP Morgan Chase was revealed: It’s looking to redesign insurance.
9. Louisiana physician, medical billing supervisor plead guilty to Medicare fraud
A Louisiana physician and his medical billing supervisor pleaded guilty to participating in a Medicare fraud scheme.
10. Insurers win more legal fights over ACA payments
Two judges with the Court of Federal Claims ruled that health insurers should receive unpaid cost-sharing reduction payments, which were established under the ACA to help insurers subsidize the cost of coverage for low-income Americans.
More articles on legal and regulatory issues:
Nurses sue CHI over on-call pay: 4 things to know
Intermountain: Whistle-blower provisions of False Claims Act are unconstitutional
Physician gets 75 months in prison for role in false billing scheme
