From a federal judge upholding the Trump administration's expansion of short-term health plans to Celgene settling a class-action lawsuit for $55 million, here are the latest healthcare industry lawsuit and settlements making headlines.
1. Health plan trained physicians to overbill Medicare, lawsuit alleges
Essence Group Holdings, a St. Louis-based health plan with 60,000 members in Missouri and Illinois, is facing a whistleblower lawsuit and is under scrutiny due to a recent audit by HHS' Office of Inspector General.
2. Celgene to pay $55M to settle class-action suit alleging cancer drug monopoly
New Jersey-based Celgene will pay $55 million to resolve a class-action suit that accused the drugmaker of blocking generic competition in the cancer market at the expense of patients.
3. Former Sutter exec says he reported IT shortfalls but was fired after computer outage
Stuart James, former chief information services operating officer at Sutter Health, claims the Sacramento, Calif.-based health system fired him after he reported management's failure to install backup EHR software that could have aided IT operations during Sutter's computer network outage in May 2018.
4. California patients can sue state over patient dumping, appeals court rules
A federal appeals court ruled California nursing home residents may continue a lawsuit that accuses the state of not taking enough action to prevent patient dumping.
5. Sun Pharma sales rep files retaliation lawsuit: 5 things to know
A former sales representative for Sun Pharmaceuticals filed a retaliation lawsuit against the drugmaker, claiming he was fired for complaining about its marketing tactics.
6. Utah hospital patient died after surgery as blood drained into garbage can, lawsuit claims
The family of a Utah woman is suing St. Mark's Hospital in Millcreek, Utah, alleging she died after surgery because blood drained from her heart into a garbage can below the operating table.
7. Judge upholds Trump's short-term health plans
A federal judge ruled July 19 that the Trump administration's expansion of short-term health plans does not undercut the ACA.
8. Pain clinic chain's owners, ex-CEO committed $25M billing fraud, DOJ alleges
Brentwood, Tenn.-based Comprehensive Pain Specialists, three of its principal owners, its former CEO and a chiropractor are accused of engaging in a false billing scheme that defrauded Medicare and Tennessee's Medicaid program of $25 million.
More article on legal and regulatory issues:
False Claims Act settlements top $750M in first half of 2019
Pennsylvania hospital strikes $2.5M deal in fraudulent billing case
Fraud-prone providers slipping into states' Medicaid programs, OIG says