Hospitals in Minnesota are calling on the state to look into a new policy enacted by its largest nonprofit health insurer that ends reimbursement for routine colonoscopies and other services under certain circumstances, according to the Star Tribune.
Legal & Regulatory Issues
Democratic California Gov. Gavin Newsom signed a bill into law July 11 that protects healthcare whistleblowers who report patient safety issues, The Sacramento Bee reports.
Surescripts, a health information network focused on e-prescriptions, filed a motion July 12 to dismiss the FTC's charge from April that the company used illegal tactics to develop monopolies over two e-prescribing markets.
Tennessee officials are looking into allegations that 16 Georgia residents fraudulently received coverage under Tennessee's Medicaid program, The Atlanta Journal-Constitution reported.
Reno, Nev.-based Renown Health and Anthem have yet to reach an in-network agreement, according to ABC affiliate KOLO TV.
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UnitedHealth Group should create new guidelines for covering behavioral health treatment and reevaluate denied claims based on those guidelines, plaintiffs in a class-action lawsuit against the insurer said in a rebuttal, according to MPR News.
Elite Medical Center, a Las Vegas-based acute care hospital that some experts say is operating similarly to a 24/7 freestanding emergency room, has to contract with Medicare and Medicaid beginning in 2021, according to the Las Vegas Sun.
Residents in Massachusetts have been scammed by a fake health insurer allegedly behind a $100 million scheme, The Boston Globe.
An indictment unsealed July 10 charges Vasso Godiali, MD, with orchestrating a $60 million healthcare fraud scheme and laundering proceeds from the scheme, according to the Department of Justice.
From a judge blocking an HHS rule that would have required pharmaceutical companies to include list prices in TV ads to physicians accusing a South Dakota health system of defrauding Medicare, here are the latest healthcare industry lawsuits and settlements…