Fresno, Calif.-based Community Health System and its affiliate Physician Network Advantage have agreed to pay $31.5 million to settle allegations they provided extravagant benefits to physicians in exchange for patient referrals to the system’s facilities. Five things to know: 1.…
Legal & Regulatory Issues
On May 14, California Gov. Gavin Newsom proposed additional state oversight on pharmacy benefit managers, which negotiate drug prices between payers and drugmakers. In a revised 2025-2026 budget, the governor penned several oversight strategies regarding PBMs, according to a news…
CureIS Healthcare, a software provider focused on managed care, has filed a lawsuit against health IT giant Epic Systems, accusing it of unfair competition and illegal interference. Here are five things to know: “Epic believes in free and fair competition,…
The American Hospital Association and a coalition of healthcare groups, including 340B Health, the Nebraska Hospital Association and the American Society of Health-System Pharmacists, filed a brief in support of Nebraska’s new law reinforcing protections for the federal 340B drug…
Four people have been sentenced for their roles in a kickback conspiracy that resulted in more than $110 million in fraudulent claims being submitted to federal health programs. Three things to know: 1. John Rodriguez, Mohammad Chowdhury, Hector de la…
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Nine employees at One Medical, owned by Amazon, allegedly accessed the medical records of a deceased patient without authorization following the filing of a wrongful death lawsuit by the patient’s family, The Washington Post reported May 10. Here are nine…
A California court judge has rejected Providence St. Joseph Hospital’s attempt to dismiss a lawsuit alleging it unlawfully denied an emergency abortion to a woman with a life-threatening condition. On May 5, Judge Timothy Canning of the Humboldt County Superior…
House Republicans unveiled legislation May 11 that would introduce Medicaid work requirements nationwide and stricter eligibility requirements. The 160-page bill, introduced by the House Energy and Commerce Committee as part of a broader budget reconciliation package, aims to reduce federal…
Four states have joined a federal whistleblower lawsuit against CVS Pharmacy, alleging the company of overbilling state Medicaid programs for prescription drugs. Attorneys general from Connecticut, Massachusetts, Indiana and Oklahoma are participating in the suit, which was originally filed in…
A New York man was sentenced to 14 months in prison for leading a $48 million Medicare fraud scheme. Five things to know: 1. Manishkumar Patel, 44, of Pelham Manor, was sentenced after pleading guilty to conspiring to commit health…