A federal magistrate judge in Minnesota has ordered UnitedHealth Group to produce a wide range of documents in an ongoing lawsuit accusing the insurer of using an AI algorithm to wrongfully deny Medicare Advantage members post-acute care. The March 9…
Legal & Regulatory Issues
As lawmakers intensify scrutiny of the insurance industry, healthcare providers are watching closely. During a recent Becker’s Healthcare podcast sponsored by HaloMD, Patrick Velliky, chief external affairs officer at HaloMD and a longtime healthcare policy advocate, unpacked the implications of…
Aetna has agreed to pay $117.7 million to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate diagnosis codes for its Medicare Advantage enrollees in order to increase payments from CMS. The settlement…
Chattanooga, Tenn.-based Erlanger Health System must defend against a pair of False Claims Act lawsuits after a federal judge denied the system’s dismissal bids. Former CFO J. Britton Tabor and former Chief Compliance Officer Alana Sullivan filed a whistleblower complaint…
Two leaders at NewYork-Presbyterian and Columbia University are stepping down amid systemwide changes following a gynecologist’s sexual abuse of patients, according to a letter from Columbia’s office of the president. Mary D’Alton, MD, is stepping down as chair of the…
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Port Townsend, Wash.-based Jefferson Healthcare has settled a lawsuit that claimed the hospital and its leadership violated the state’s open public meetings law, the hospital’s CEO said in a March 10 statement shared with Becker’s. Here are five things to…
Idaho Republican state lawmakers have introduced a bill to repeal Medicaid expansion, the Idaho Capital Sun reported March 9. Four things to know: 1. The proposed legislation would repeal Medicaid expansion on Jan. 1, 2028, removing about 90,000 Idaho residents…
A federal judge ruled March 6 that The Leapfrog Group’s Hospital Safety Grades for five Florida hospitals constitutes “an unfair and deceptive business practice,” finding Leapfrog deliberately punished the hospitals for not participating in its voluntary survey by assigning them…
The Republican-controlled House Committee on Energy and Commerce sent letters March 3 to 10 states — California, Colorado, Massachusetts, Maine, Nebraska, New York, Oregon, Pennsylvania, Vermont and Washington — requesting information on fraud, waste and abuse, as well as integrity efforts, in…
Maine is considering a bill that would set a maximum price for hospital procedures in order to cut healthcare costs, but Portland-based MaineHealth warned the cap would drive layoffs and service closures, NBC affiliate News Center Maine reported March 4.…