From Houston-based Memorial Hermann Health System agreeing to pay $1.9 million to settle improper billing allegations to a Texas physician charged for his role in a healthcare fraud scheme that involved falsely diagnosing patients with various degenerative diseases, here are the latest healthcare industry lawsuits and settlements making headlines.
1. Blue Cross denied appeal in suit alleging it sank $40M hospital deal
In April, a federal judge denied Blue Cross & Blue Shield of Rhode Island's motion for summary judgment in an antitrust suit filed by Boston-based Steward Health Care. Last week, the judge denied the insurer's request to immediately appeal the April ruling, meaning BCBS of Rhode Island will have to face the antitrust suit.
2. DOJ: Texas physician misdiagnosed patients to fund 'opulent lifestyle'
A Texas physician was charged in a recently unsealed indictment for his role in a $240 million healthcare fraud scheme that involved falsely diagnosing patients with various degenerative diseases and then administering chemotherapy and other toxic drugs to patients based on the false diagnoses.
3. Memorial Hermann will pay $1.9M to settle improper billing allegations
Houston-based Memorial Hermann Health System agreed to pay the federal government $1.9 million to resolve allegations three of its hospitals improperly billed Medicare for inpatient services provided to beneficiaries that should have been billed as less costly outpatient care.
4. Nicklaus Children's Hospital sues Florida to stop opening of competing trauma center
Miami-based Nicklaus Children's Hospital, which operates the only pediatric trauma center in Miami-Dade County, is suing the Florida Health Department over a state law that would enable a competing level 1 trauma center operated by Nashville, Tenn.-based HCA Healthcare to open in the region without full review.
5. Chicago area hospital sued, accused of failing to recognize patient's painkiller addiction
A patient's family is suing Geneva, Ill.-based Delnor Hospital and the patient's physician for allegedly failing to follow protocols that aim to recognize patients at risk of becoming addicted to pain medications.
6. Kansas hospital's interim CEO was allegedly part of 20-hospital kickback scheme
Karsten Randolph, CFO and interim CEO of Shawnee (Kan.) Mission Health, part of Altamonte Springs, Fla.-based Adventist Health, feared he would go to jail over a kickback scheme at his former job.
7. UnitedHealth, AARP face lawsuit for $400M illegal rebate scheme
UnitedHealth and AARP face a class-action lawsuit for allegedly diverting $400 million a year through a Medigap premium rebate scheme that violates Connecticut law, breaches the terms of contract with enrollees and misleads consumers about the insurance offering.
8. Texas man convicted in multimillion-dollar Cerner fraud scheme
A federal jury convicted a Texas man for his role in a multimillion-dollar scheme to defraud Cerner, the EHR vendor, by conspiring to impersonate the company in business and legal activities.
9. 3 former execs at medical billing company face criminal charges in $300M investment fraud scheme
Three former executives of Constellation Healthcare Technologies, a now-bankrupt medical billing company, were charged May 16 with orchestrating an elaborate scheme to defraud investors out of more than $300 million.
10. Sutter Health motions to dismiss California AG's antitrust lawsuit: 5 things to know
Sacramento, Calif.-based Sutter Health filed a motion with the San Francisco Superior Court May 14 asking the court to dismiss state Attorney General Xavier Becerra's antitrust lawsuit against the health system, claiming the lawsuit would upend its business practices.
11. California state judge overturns physician-assisted suicide law: 4 notes
A state judge tossed out California's physician-assisted suicide law May 15, claiming the legislation was unconstitutional because it was introduced in the wrong forum.
12. Attorneys general can intervene in ACA lawsuit, court rules
A coalition of attorneys general will be allowed to intervene in a lawsuit seeking to dismantle the ACA.
More articles on legal and regulatory issues:
23-hospital system enters $14M settlement with feds over improper physician payments
Nurse collects $6M in whistle-blower lawsuits against Banner, Christus and Renown Health
CEO, CFO of Missouri hospital allegedly received $100k in inappropriate reimbursement