From the Justice Department charging 455 defendants as part of its 2026 National Healthcare Fraud Takedown to an Oklahoma hospital CEO pleading guilty to $30 million in Medicare fraud, here are 10 healthcare billing fraud cases Becker’s reported since June…
Legal & Regulatory Issues
Elevance Health paid CMS $342 million following a Medicare Advantage sanction notice alleging the insurer did not properly address overpayments for years. June 22 filings in a New York federal court included an email from an Elevance vice president to…
The former CEO of a now-closed Oklahoma hospital pleaded guilty May 26 to conspiracy charges involving five companies he owned, according to court records filed in the U.S. District Court for the Middle District of Florida. Here are five things…
A federal judge ruled June 24 that nursing, physician associate and other clinical groups are likely to succeed in their challenge to a Department of Education rule that excluded their degrees from “professional” status, subjecting students to lower federal loan…
Clinicians and advocacy groups are pressing Congress on two major legislative efforts to better support the nation’s healthcare workforce: a proposed tax credit for healthcare providers practicing in shortage areas and a push to fund the only federal law dedicated…
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St. Louis-based SSM Health Care has agreed to pay $939,290 to resolve allegations that employees at the retail pharmacy at Saint Louis University Hospital routinely waived patient copays, causing Medicare and the Federal Employees Health Benefits Program to overpay for…
In a bid to curtail U.S. emergency department closures, two senators introduced a bill June 24 that seeks to provide rural emergency rooms at least $1 million each year over the next decade. Senators Josh Hawley, R-Mo., and Maggie Hassan,…
The parents of 2-year-old Annelise Camp sued Houston-based Texas Children’s Hospital in late May to block physicians from conducting brain death testing, arguing the procedure violates their religious beliefs and that their daughter needs more time to recover, The Texas…
Florida Attorney General James Uthmeier has issued a Civil Investigative Demand to CVS Health Corp. and its pharmacy benefit manager, Caremark, as part of an investigation into alleged anticompetitive practices affecting patients and independent pharmacies. The probe is examining whether…
Mount Nittany Medical Center has filed a lawsuit challenging the federal government’s decision to cancel its Medicare designation as a sole community hospital, according to court documents reviewed by Becker’s. The lawsuit, filed June 12 in the U.S. District Court…