Legal & Regulatory Issues

A former employee at the Veterans Benefits Administration in Huntington, W. Va., pleaded guilty Sept. 3 to computer fraud, according to MetroNews.

CMS didn't grant Idaho's request to expand health insurance subsidies to residents between 100 percent and 133 percent of the federal poverty level regardless of Medicaid status, according to an Aug. 29 letter from CMS.

Horizon Blue Cross Blue Shield of New Jersey sued a physician advocacy group after the group urged patients to fight the insurer's new claim oversight contract, according to the New Jersey Record.

Swedish Health is being probed by the Department of Justice, the Seattle-based system's parent, Renton, Wash.-based Providence St. Joseph Health, disclosed in a quarterly earnings report.

A former Sanford Health executive is suing the Sioux Falls, S.D.-based health system, alleging supervisors retaliated against her for raising concerns about security, according to the Argus Leader.

The former owner of a medical equipment company in Camden, Tenn., was sentenced to 42 months in prison Aug. 28 for her role in a $4.6 million kickback scheme, according to the Department of Justice.

A whistleblower is asking a California federal court not to dismiss a lawsuit she filed accusing Sacramento, Calif.-based Sutter Health of Medicare Advantage fraud, according to Law360.

From a physician suing a health system and malpractice insurer for refusing to cover criminal defense costs to a for-profit hospital operator accused of mismanaging a retirement plan, here are the latest healthcare industry lawsuits and settlements making headlines.

Maine's governor announced plans to change its health insurance exchange to a state-based marketplace.

Here are 10 articles recently published by Becker's Hospital Review on national and state news concerning Medicaid: