Legal & Regulatory Issues

From a former Kentucky lawmaker who plead guilty to charges in connection to a $2.7 million fraudulent billing scheme, to a Florida medical biller sentenced to more than five years in prison, here are nine recent healthcare billing fraud cases:  

Critics of a June 6 U.S. Supreme Court ruling involving Medicaid clawbacks from personal injury litigation wins say the decision could result in less money for state Medicaid programs, Bloomberg reported June 10. 

Dallas-based Steward Health Care has agreed to pay $4.7 million to resolve kickback allegations. 

The Federal Trade Commission is considering a new regulation to tighten employers' use of noncompete clauses and plans to target the use of noncompete clauses in individual cases through enforcement, The Wall Street Journal reports. 

An India-based multinational pharmaceutical manufacturer has agreed to pay $12.9 million to settle claims it reported inflated prices to the Texas Medicaid program, the Texas attorney general said June 8. 

U.S. Sen. Kevin Cramer, R-N.D., has introduced the Travel Nursing Agency Transparency Study Act, which would require the Government Accountability Office to study and report to Congress the business practices of healthcare staffing agencies during the pandemic.

Eight lawsuits have been filed challenging the No Surprises Act since December, Health Affairs reported June 6. 

Teladoc is facing a lawsuit alleging the company misled investors regarding its business, operations and future prospects that will result in "significant losses and damages" for stakeholders.  

HCA Healthcare, a for-profit hospital operator based in Nashville, Tenn., is facing another antitrust lawsuit. 

Gregory Ulrich, who shot and killed one person and injured four others at an Allina Health clinic in 2021, was found convicted of all 11 counts against him June 2, according to the Star Tribune.