From a New York health system settling a billing fraud case for $15.6 million to a heart transplant surgeon suing ProPublica and the Houston Chronicle, here are the latest healthcare industry lawsuits and settlements making headlines.
1. Illinois hospital provided $500K in unreimbursed care to inmate, according to lawsuit
Maywood, Ill.-based Loyola University Medical Center filed a lawsuit against Cook County, including the county's hospital system and sheriff's office, accusing the entities of refusing to retrieve an inmate from the medical center's care since April.
2. New York health system pays $15.6M to settle billing fraud case
LaGrangeville, N.Y.-based Health Quest Systems and certain of its subsidiaries agreed to pay more than $14.7 million to the federal government and an additional $895,427 to the state of New York to resolve False Claims Act allegations.
3. CFO: Montana hospital engaged in billing fraud, kickback scheme
Kalispell (Mont.) Regional Healthcare disclosed in June that it is under federal investigation, and a recently unsealed complaint filed by the CFO of the hospital's physician network provides more details about the allegations.
4. Allscripts seeks dismissal, arbitration in class-action lawsuit over January ransomware attack
Allscripts asked an Illinois district judge to dismiss a class-action lawsuit over a January ransomware attack that took down multiple clients' EHRs for about a week, arguing the case should be resolved in arbitration.
5. UnitedHealth, dialysis provider settle fraud lawsuits for $32M
UnitedHealthcare, the health insurance arm of UnitedHealth Group, and American Renal Associates Holdings agreed to settle fraud allegations UnitedHealthcare brought against the dialysis provider in 2016.
6. California hospital settlement reinstalls staff, bylaws, leadership from early 2016
A settlement between Tulare (Calif.) Regional Medical Center and its staff will turn back the clock, restoring the hospital's medical staff, leadership and bylaws from before Jan. 26, 2016.
7. Famed Baylor St. Luke's surgeon sues Houston Chronicle, ProPublica for defamation
Prominent heart transplant surgeon O.H. "Bud" Frazier, MD, of Houston-based Baylor St. Luke's Medical Center, filed a lawsuit against ProPublica and the Houston Chronicle July 9, alleging the publications' reporting amounted to defamation and intentional infliction of emotional distress.
8. Shuttered California hospital sues insurer to cover $42M whistle-blower settlement
Los Angeles-based Pacific Alliance Medical Center, which closed in November 2017, filed a lawsuit against the National Union Fire Insurance Co. of Pittsburgh July 10, claiming the insurer denied coverage to the hospital during an active U.S. Department of Justice investigation into the facility, violating the insurer's own policies.
9. NYC Health + Hospitals accused of age discrimination in lawsuit
Jeffrey Wallach, a 67-year-old former employee of New York City-based NYC Health + Hospitals, filed a class-action lawsuit alleging the public health system targeted employees 40 and older when it cut approximately 400 management positions on June 2, 2017.
10. Florida man impersonates physician, files $1M+ in insurance claims
A 33-year-old Florida man was indicted July 11 on charges of impersonating a physician and billing more than $1 million in fraudulent medical claims through a "phantom medical practice."
11. Premier Health asks court to dismiss lawsuit over $17K, $9K out-of-network bills
Dayton, Ohio-based Premier Health and a contracted surgeon called on a court to dismiss a lawsuit accusing them of failing to notify patients getting treatment in the emergency department that their surgeon was not in-network with their health insurance plan.
12. Children's Mercy facing class-action lawsuit after data breach
Kansas City, Mo.-based Children's Mercy Hospital was served with a class-action lawsuit July 10 after staff members were tricked by an email phishing scam that potentially compromised 63,049 patients' and family members' protected health information.
13. 2 Arkansas hospitals accuse EMS provider of balance billing
Fort Smith, Ark.-based Sparks Regional Medical Center and Mercy Fort Smith (Ark.) filed a lawsuit against Fort Smith Emergency Medical Services that accused the EMS operator of balance billing.
More articles on legal and regulatory issues:
SEC proposes $30M cap on whistle-blower awards
15 False Claims Act settlements over $1.5M
Former West Virginia health system CEO accused of harassing his replacement