From insurers accused of underpaying behavioral health claims to a Georgia man charged with orchestrating a COVID-19 billing fraud scheme, here are the latest healthcare industry lawsuits making headlines.
1. UnitedHealthcare, Cigna sued for allegedly underpaying behavioral health claims
The behavioral health units of UnitedHealthcare and Cigna face four class-action lawsuits claiming the insurers conspired with a third-party company to underpay providers and balance bill patients hundreds of millions of dollars.
2. Feds charge Georgia man with orchestrating COVID-19 billing fraud scheme
Federal prosecutors charged a Georgia man for allegedly conspiring to defraud Medicare and private healthcare benefit programs by submitting fraudulent claims for COVID-19 testing and genetic cancer screenings.
3. Judge: Medicare patients can appeal bills from observation status switch
Patients can now appeal to Medicare for reimbursement for nursing home stays that were initially not covered because their "inpatient" status had been changed to "observation."
4. Judge rejects pharmacies' suit against physicians; Ohio opioid trial stands
A federal judge in Cleveland dismissed an attempt by several large retail pharmacy chains, including CVS and Walgreens, to shift blame for the opioid crisis to physicians.
5. Anthem hit with federal lawsuit alleging Medicare fraud
The Department of Justice sued Anthem March 26, alleging the health insurance company submitted inaccurate diagnosis codes to the federal government to get higher reimbursement.