Two senators have introduced a bipartisan bill that would allow patients who receive primary care from advanced practice providers to be included in Medicare’s ACO models. Under current Medicare rules, patients are only assigned to an ACO if they receive…
Legal & Regulatory Issues
From CVS Pharmacy settling allegations that it improperly billed federal health programs to the Justice Department dismissing an indictment against the former owner and CEO of a Texas hospital, here are 10 healthcare billing fraud cases that Becker’s has reported…
Mark Kronfeld, trustee of the SHC Creditor Litigation Trust, filed a 178-page amended complaint Nov. 21 seeking to recover more than $3.4 billion against bankrupt Dallas-based Steward Health Care’s former CEO Ralph de la Torre, MD, and other system “insiders.” …
Independence Health System Westmoreland Hospital in Greensburg, Pa., is facing a negligence lawsuit filed more than a year after photos and videos of patients were shared without their consent, TribLive reported Dec. 1. The lawsuit, filed Nov. 21 in Westmoreland…
Luigi Mangione, the 27-year-old accused of fatally shooting UnitedHealthcare CEO Brian Thompson last December, appeared in New York state court Dec. 1 for pretrial hearings that could shape which evidence jurors see at his upcoming trial. Mangione’s defense attorneys are…
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The American Hospital Association, Maine Hospital Association and four safety-net hospitals have filed a federal lawsuit to halt “unlawful” changes to the 340B drug pricing program, warning the shift could impose major financial harm on rural and underserved communities. Four…
Vohra Wound Physicians Management and its owner, Ameet Vohra, MD, have agreed to pay $45 million to resolve allegations that they knowingly submitted false claims to Medicare.
Mt. San Rafael Hospital and Rural Health Clinic in Trinidad, Colo., and three of its physicians have agreed to pay a combined $650,000 to settle allegations that they improperly prescribed opioids and submitted invalid claims to Medicare and other federal…
Danville, Ky.-based Ephraim McDowell Health will pay $335,000 to resolve a discrimination and retaliation lawsuit filed by the U.S. Equal Employment Opportunity Commission. The lawsuit, filed in the U.S. District Court for the Eastern District of Kentucky in March 2024,…
A physician from Cordele, Ga., pleaded guilty to his role in a $24 million Medicaid fraud scheme. What happened? What next?