Legal & Regulatory Issues

A father and son duo from California was sentenced Feb. 23 for defrauding Affordable Care Act health insurance plans in 12 states, the Department of Justice said.

The owner and CFO of Mansfield, Texas-based Community Care Medical and Medical Case Management & Social Services was sentenced Feb. 23 to more than three years in prison and ordered to pay $3.4 million in restitution for defrauding the IRS,…

Under President Joe Biden, the Department of Justice requested that the Supreme Court cancel arguments in cases concerning Medicaid work requirements, according to Bloomberg Law. 

Grant Memorial Hospital in Petersburg, W.Va., has agreed to pay a $320,175 settlement for submitting false medical claims to insurers, the U.S. Justice Department said Feb. 24. 

An appeals court upheld a verdict against the former chief executive of a blood testing laboratory and two of its marketers that found them liable for violating the False Claims Act.

A Southern California hospice administrator was sentenced to two and a half years in prison for his role in a multimillion-dollar fraud scheme, the Department of Justice said Feb. 19. 

Aetna Better Health of Oklahoma is protesting the selection of four other private insurers to manage Oklahoma's Medicaid program, according to The Frontier.

The Supreme Court declined to review a case alleging healthcare management company RollinsNelson violated the False Claims Act by submitting claims for medically unnecessary hospital admissions, according to Bloomberg Law.

The pandemic has changed the daily usage patterns and motivations for use of many Americans who use opioids, according to recent research released by The Recovery Village and Project Opioid. 

A New York physician has been charged with manslaughter in the second degree and is facing other felonies related to the overdose death of a patient, New York Attorney General Letitia James announced Feb. 19.