From the Justice Department accusing a Tennessee health system of fraud to a Washington health system agreeing to pay $22.7 million to resolve false claims allegations, here are the latest healthcare industry lawsuits and settlements making headlines.
1. Justice Department backs $800M fraud claim against Tennessee health system
The Justice Department on April 11 filed a complaint in intervention alleging Memphis-based Methodist Le Bonheur Healthcare violated the False Claims Act and the Anti-Kickback Statute.
2. Tech attacked, burned by travel nurse sues Hackensack
A hospital technician who was attacked and critically burned by a traveling nurse in February at Hackensack (N.J.) University Medical Center has sued the organization.
3. Justice Department adds CEO to $120M Medicare fraud case
The Justice Department intervened in a whistleblower lawsuit accusing former executives of San Antonio-based Merida Health Care Group of violating the False Claims Act.
4. Physician Partners of America paying $24.5M to settle fraud, kickback charges
Tampa, Fla.-based Physician Partners of America will pay $24.5 million to settle several allegations, including that it violated the False Claims Act and made a false statement to obtain a loan through the Small Business Administration’s Paycheck Protection Program.
5. Providence to pay $22.7M to settle unnecessary spine surgery allegations
Renton-based Providence Health & Services Washington agreed to pay $22.7 million to resolve allegations that it defrauded federal healthcare programs with medically unnecessary neurosurgery procedures.
6. U of Central Florida graduate sues medical center for residency match mix-up
An Orlando-based University of Central Florida medical school graduate is suing Orlando Regional Medical Center for "false and defamatory statements" that hurt her chances of obtaining an emergency medicine residency.
7. Judge extends Northside-Anthem contract 'until further order'
The 400,000 patients at Atlanta-based Northside Hospital System with Anthem insurance will remain in network "until further order," a judge ruled April 13.
8. Judge dims hope for proposed class action against UnitedHealth subsidiary over alleged 'profit-driven' coverage guidelines
A federal judge in California reduced the chances of a proposed class action moving forward from drug abuse and mental health treatment providers against United Behavioral Health for allegedly denying coverage for medically necessary treatments.
9. Judge tosses Cigna lawsuit from shareholders over loss of $1.85B termination fee in failed Anthem merger
A Delaware judge dismissed a lawsuit from Cigna shareholders April 7 that claimed executives with the company fumbled a $1.85 billion termination fee following the failed $54 billion merger with Anthem in 2017.
10. 34 urban hospitals win challenge to Medicare rate formula change
A Medicare payment formula change enacted in fiscal year 2020 unlawfully lowered reimbursements for 34 urban hospitals, a federal district court ruled April 8.
11. Florida health system will pay $20M to resolve false claims case
Clearwater, Fla.-based BayCare Health System agreed to pay the U.S. $20 million to resolve allegations that it violated the False Claims Act.