Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., have introduced legislation that would prohibit companies from simultaneously owning a health insurer or pharmacy benefit manager and a medical provider or management services organization, and would require companies in violation to…
Legal & Regulatory Issues
The House Judiciary Committee issued subpoenas Feb. 9 to eight health insurers, seeking documents about fraud issues and ACA marketplace subsidies. The subpoenas target Blue Shield of California, Centene, CVS Health, Elevance Health, GuideWell, Health Care Service Corp., Kaiser Permanente…
Tacoma, Wash.-based MultiCare Health System is suing Optum and Change Healthcare, alleging that Change owes the system at least $1.2 million in outstanding claims. The lawsuit, filed Jan. 27 in Washington federal court, alleges that Change “consistently failed to provide…
A former transplant program director at Memorial Hermann has been charged with five counts of falsifying medical records that potentially made some patients ineligible for organ donations, according to a Feb. 5 Justice Department news release. John “Steve” Bynon Jr.,…
Tacoma, Wash.-based MultiCare Health System has agreed to pay more than $3.7 million to resolve allegations that it fraudulently billed government and commercial insurers for spine surgeries performed by former neurosurgeon Jason Dreyer, DO. Eight things to know: 1. The…
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A jury in New York has returned a verdict against two healthcare workers who provided gender-affirming care to a minor, The New York Times reported Feb. 3. The New York case Filed in September 2023 in Westchester Supreme Court in…
Bausch Health and Lannett have settled a decadelong lawsuit regarding claims the drugmakers colluded to inflate generic drug prices, according to court documents filed in the U.S. District Court for the District of Connecticut. In agreeing to pay nearly $18…
A California appeals court has ordered that James Heaps, MD, be retried due to a juror who lacked sufficient knowledge in speaking English to carry out their duties, NPR reported Feb. 3. In October 2022, Dr. Heaps, a former OB-GYN…
Elevance Health is suing four former executives of its Puerto Rico subsidiary, alleging they violated noncompete agreements by leaving for rival insurer Triple-S Salud. The complaint, filed Jan. 29 in an Indiana federal court, claims the former executives broke the…
California Attorney General Rob Bonta has filed a lawsuit against Rady Children’s Health, alleging the San Diego-based system violated legally binding conditions tied to the merger of Rady Children’s Hospital-San Diego with Children’s Hospital of Orange County by ending gender-affirming…