Legal & Regulatory Issues

A California judge on Nov. 1 ruled that four drugmakers cannot be held liable for the state's opioid crisis, according to NPR.

Danville, Pa.-based Geisinger Community Health Services will pay $18.5 million to resolve allegations that it improperly billed Medicare for hospice and home health services, the Justice Department said Nov. 1.

An appeals court in Shreveport, La., has temporarily blocked New Orleans-based Ochsner Health from suspending some workers because of their COVID-19 vaccination status, according to NOLA.com.

A judge on Oct. 20 ordered Cano Health New Mexico to destroy Optum patient records allegedly stolen by an employee who formerly worked for OptumCare. 

A lawsuit from GS Labs is accusing Minnesota-based Medica of violating the federal COVID-19 relief act by withholding over $10 million in payments for COVID-19 tests. 

Nashville, Tenn.-based HCA Healthcare has defeated a former payment coordinator's retaliation lawsuit.

Phoenix Children's Hospital was hit with a class-action lawsuit after the hospital listed the names of 368 employees exempt from its COVID-19 vaccination mandate in an Oct. 15 email to staff. 

The Texas Medical Association has sued the Biden administration over what it says is an unfair process to resolve billing disputes between health insurers and providers. 

The Justice Department will be making several policy changes when it comes to the federal response to white-collar crime, focusing on corporate misconduct, Politico reported Oct. 28.

The operational and financial complexity of healthcare delivery can create tension between payers and providers. This tension can be heightened due to regulations and the implementation of sub-performing technologies.