Legal & Regulatory Issues

A district court denied Indianapolis-based Community Health Network's motion to dismiss a false claims lawsuit brought by the Justice Department alleging that it engaged in a fraud scheme to keep referrals in its network. 

A recent audit of Tennessee Medicare found that of the $2 billion in certified public expenditures it claimed during the audit period of 2009 to 2014, $909.4 million was allowable while $1.1 billion was not.

Colonial Family Practice, a physician-owned primary and urgent care practice with multiple locations in South Carolina, will pay $1.25 million to settle allegations that it billed government insurers for medically unnecessary services, the Justice Department said Oct. 20. 

U.S. Supreme Court Justice Stephen Breyer has rejected a request from healthcare workers to immediately block enforcement of Maine's COVID-19 vaccination mandate based on their religious objections, according to The Washington Post and The New York Times.

A September HHS Office of Inspector General report found 20 insurers received about half of a $9.2 billion pool of suspicious Medicare payments over a year, but a new statement from the office ties the largest portion of those funds…

HCA Healthcare is seeking to dismiss a lawsuit filed by a group of Western North Carolina residents alleging the Nashville, Tenn.-based hospital operator engaged in anticompetitive tactics that resulted in higher prices.

Springfield Clinic (Ill.) alerted patients of an upcoming contract deadline with Blue Cross and Blue Shield of Illinois, calling the thought of the insurer terminating the contract as "unimaginable."

A Michigan man was sentenced to seven years in prison for his role in the hacking and theft of data belonging to more than 65,000 UPMC employees, the Justice Department said Oct. 18. 

Premera Blue Cross is joining Blue Cross and Blue Shield of Kansas City in suing GS Labs over allegedly inflating the prices of COVID-19 tests. 

A Pennsylvania appellate panel sided with Colmar, Pa.-based HealthSpark Foundation Oct. 13 in an 18-year battle that determined the health system did not owe a group of former nurses compensation and leave benefits.