12 latest healthcare industry lawsuits, settlements

From a Michigan health system agreeing to pay $84.5 million to settle false claims allegations to a physician sentenced to prison for his role in a $30 million billing fraud scheme, here are the latest healthcare industry lawsuits and settlements making headlines.

1. Cigna prevails in Texas hospital's suit over $50M in unpaid claims
Cigna defeated a lawsuit filed by North Cypress (Texas) Medical Center accusing the insurer of underpaying medical benefit claims.

2. Physician sentenced to prison for role in $30M billing fraud scheme
A physician was sentenced to 18 months in prison Aug. 1 for his role in a $30 million scheme to defraud Medicare and New York's Medicaid program.

3. Prime Healthcare, CEO to pay $65M Medicare fraud settlement
Ontario, Calif.-based Prime Healthcare Services, as well as its nonprofit arm, consulting subsidiary and CEO, agreed to pay $65 million to the federal government to resolve allegations hospitals submitted false Medicare claims and admitted patients who only needed cheaper, outpatient care.

4. Beaumont Health to pay $84.5M to resolve claims of improper physician relationships
Southfield, Mich.-based Beaumont Health agreed to pay the federal government and state of Michigan $84.5 million to resolve allegations that three of its hospitals submitted false claims to Medicare, Medicaid and Tricare.

5. Cardiologist gets prison time for submitting 350 fraudulent claims
A New Jersey physician specializing in cardiology and electrophysiology was sentenced to 20 months in prison July 31 for billing the Veterans Affairs program for services he didn't perform.

6. Humana sues drug manufacturers, alleges price-fixing
Humana filed a lawsuit Aug. 3 against nearly 30 pharmaceutical companies, alleging they united to fix the prices of widely used generic drugs, forcing the health insurer to pay inflated prices.

7. Owner of Florida medical biller gets 8 years in prison for fraud scheme
The owner of Billing USA, a medical billing office in Miami, Fla., was sentenced to eight years in prison after pleading guilty for his role in a fraud scheme.

8. Steward Health Care, BCBS settle 5-year antitrust lawsuit: 3 things to know
Boston-based Steward Health Care and Blue Cross and Blue Shield of Rhode Island reached a settlement over a lawsuit claiming the health insurer obstructed Steward's attempted $40 million takeover of a Rhode Island hospital.

9. ER physician blames patient he restrained, tested without consent, claims immunity in lawsuit
An emergency room physician with Charlottesville-based University of Virginia Medical Center is claiming immunity in a lawsuit, alleging he acted in good faith in sedating and restraining a woman to conduct medical tests against her will.

10. Third assisted living worker arrested in case of dementia patient duct-taped to chair
A third employee was arrested on a charge of elderly neglect Aug. 3 in relation to the case of an elderly dementia patient who was allegedly duct-taped to a chair at an assisted living facility in Florida.

11. HCA hospital sued by surgeon claiming age led to firing
A 68-year-old surgeon filed a lawsuit against Portsmouth (N.H.) Regional Hospital, its parent company, Nashville, Tenn.-based HCA Healthcare, and an affiliated medical group, claiming he was forced out of his job because of his age and subsequently defamed by a letter sent without his knowledge to colleagues claiming he retired.

12. Mississippi hospital fined $1.1M for fake group therapy sessions
Grenada (Miss.) Lakes Medical Center, which has been operated by the University of Mississippi Medical Center at various times, will pay over $1.1 million for fraudulently billing Medicare for intensive outpatient psychotherapy sessions.

More articles on legal and regulatory issues:

CHS faces investigation related to EHR incentive program
Medicare hospice flaws, recommendations highlighted in inspector general report
New York hospital orders employees to undergo drug testing after vials of narcotics go missing

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