From the Department of Justice intervening in false claims lawsuits against Kaiser Permanente to Prime Healthcare Services agreeing to settle kickback allegations, here are the latest hospital lawsuits and settlements making headlines.
1. DOJ joins false claims lawsuits against Kaiser
The U.S. Department of Justice announced July 30 that it intervened in six False Claims Act complaints alleging Kaiser Foundation Health Plan and other affiliates of Oakland, Calif.-based Kaiser Permanente submitted inaccurate diagnosis codes for its Medicare Advantage members to receive higher reimbursements.
2. Illinois hospitals sued over plan to create 4-hospital system
An outpatient surgery center in Illinois is suing to block Carbondale, Ill.-based Southern Illinois Hospital Services from acquiring Harrisburg (Ill.) Medical Center.
3. Northwell loses COVID-19 coverage lawsuit
New Hyde Park, N.Y.-based Northwell Health is unable to collect insurance coverage for lost revenue and higher costs stemming from the COVID-19 pandemic, a New York federal judge ruled July 26.
4. Prime, 2 physicians reach $38M settlement over patient referrals, billing
Ontario, Calif.-based Prime Healthcare Services and two physicians agreed to pay $37.5 million to resolve allegations that they violated the False Claims Act.
5. Virginia Mason Franciscan Health to pay $5.5M settlement in nurse class-action suit
Virginia Mason Franciscan Health — the byproduct of a merger between Tacoma, Wash.-based CHI Franciscan and Seattle-based Virginia Mason — will pay $5.5 million to settle a class-action lawsuit in which thousands of nurses claim they weren't properly paid for lunch and other breaks.
6. New Mexico hospital settles billing fraud allegations
Christus St. Vincent Hospital in Santa Fe, N.M., agreed to pay $563,809 to resolve allegations that a physician employed by the facility fraudulently billed insurers.
7. 14 hospitals, systems sue HHS over graduate medical education payments
A group of 14 hospitals and health systems, including Michigan Medicine in Ann Arbor and Hospital for Special Surgery in New York City, is suing HHS over a calculation used to determine payments for physician training programs.
8. Cedars-Sinai, Huntington settle affiliation lawsuit with California
California reached a settlement with Los Angeles-based Cedars-Sinai Health System and Pasadena, Calif.-based Huntington Hospital after the hospitals challenged affiliation conditions proposed by the state.
9. Maryland health system settles false claims allegations for $9.5M
University of Maryland Shore Regional Health in Easton will pay $9.5 million to settle False Claims Act allegations, the whistleblower's counsel said July 19.
10. Surgical Care Affiliates, USPI sued again, accused of collusion to limit employee wages, mobility
A former employee of DaVita sued the company, UnitedHealth Group subsidiary Surgical Care Affiliates and Dallas-based Tenet Healthcare subsidiary United Surgical Partners International, alleging they colluded to suppress wages and inhibit mobility of senior-level directors.