Aetna sued several radiology companies and clinicians Nov. 17, alleging they provided unlicensed services, billed for services they didn't perform and upcoded billing to inflate charges linked to COVID-19 testing.
Legal & Regulatory Issues
A petition with over 1,500 physician signatures is calling on HHS to end the CMS Medicare direct contracting program.
Dignity Health, now part of Chicago-based CommonSpirit Health, will pay $19 million to Sequoia Healthcare District to settle a dispute over the ownership transfer of Redwood City, Calif.-based Sequoia Hospital, The Daily Journal reported Nov. 19.
A physician who owned and operated a heart institute in Florida was sentenced to seven years in prison for performing unnecessary surgical procedures and defrauding health insurance providers, the Justice Department said Nov. 18.
In tandem with the Maryland Department of Health, Optum announced a recoupment schedule on Nov. 17 for behavioral health providers to refund overpayments to state Medicaid and health programs.
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From litigation over federal vaccination mandates to air ambulance companies filing a lawsuit to halt a surprise-billing rule provision, here are the latest healthcare industry lawsuits making headlines.
A trade association representing air ambulance companies sued several government entities, including HHS, in an effort to halt a provision in the surprise-billing rule.
The University of Miami, which operates a variety of medical facilities and medical education institutions, must face a retaliation lawsuit filed by a former operations and compliance officer who claimed the organization violated the False Claims Act by firing him…
Here are five updates on legal actions involving payers:
The Biden administration issued an interim final rule Nov. 17 that requires health plans to report prescription drug and health coverage costs.