From a former healthcare executive and three surgeons charged in a $950 million kickback scheme to a nurse sentenced to jail for stealing from Medicaid, here are the latest healthcare industry lawsuits and settlements making headlines.
1. Ex-CFO, 3 surgeons charged in $950M kickback scheme in California
Federal prosecutors unsealed charges against nine new defendants for their alleged roles in a kickback scheme that resulted in the submission of more than $950 million in fraudulent claims, mostly to California's worker compensation system.
2. Hospice operator pays $8.5M to settle False Claims Act lawsuit
Hospice chain Caris Healthcare agreed to pay $8.5 million to settle allegations that it knowingly retained overpayments for patients that were ineligible for the Medicare hospice benefit.
3. Nurse gets jail time for $393K billing fraud scheme
A nurse was sentenced to one year in jail for stealing more than $390,000 from Medicaid over a five-year period, New York Attorney General Barbara D. Underwood announced June 25.
4. Police officer admits assaulting patient at New Jersey hospital
Ruben McAusland, a police officer in Paterson, N.J., admitted beating a hospital patient in two attacks in March.
5. Florida health system accused of illegally poaching physicians from competitor
Physicians Regional Medical Group, Physicians Regional Medical Center-Pine Ridge and Physicians Regional Medical Center-Collier Boulevard, all based in Naples, Fla., sued Naples-based NCH Healthcare System in federal court June 12 for allegedly stealing physicians from its practice.
6. Texas hospital's $58M lawsuit against BCBS gets second life
The Fifth Circuit Appellate Court revived a Texas hospital's $58 million lawsuit against 16 independent insurers and claims administrators doing business under the Blue Cross and/or Blue Shield trademarks across the U.S. over alleged underpayments.
7. Nurse pleads guilty in $60M fraud scheme that allegedly involved accelerating patient deaths
A nursing supervisor for Novus, a shuttered hospice provider in Frisco, Texas, pleaded guilty to conspiracy to commit healthcare fraud for her role in a $60 million scheme that federal prosecutors say involved fatally overdosing patients for profit.
8. Families' lawsuit against UPMC over hepatitis C infections moves forward with Pennsylvania Supreme Court decision
The Pennsylvania Supreme Court will allow a lawsuit against Pittsburgh-based UPMC to move forward. The suit claims dozens of patients were infected with hepatitis C because the health system failed to report a former worker who stole the opioid fentanyl.
9. Colorado health system sues patient over $229K surgery bill, jury awards $766
A jury awarded Centennial, Colo.-based Centura Health $766 in a lawsuit seeking more than $229,000 from a former patient.
10. Judge dismisses anti-kickback suit against UnitedHealth over $25 Walmart gift cards, free in-home visits
A district court dismissed a suit claiming UnitedHealthcare violated the Anti-Kickback Statute by providing $25 Walmart gift cards to Medicare beneficiaries who opted to receive free in-home exams.
11. Tennessee hospital settles false claims allegations for $784K
Livingston (Tenn.) Regional Hospital, a 114-bed hospital owned by Brentwood, Tenn.-based LifePoint Health, will pay $784,000 to resolve allegations it violated the False Claims Act.
12. Prime Healthcare can sue Humana over alleged Medicare Advantage underpayments
A federal judge in California said June 22 Humana cannot dismiss Ontario, Calif.-based Prime Healthcare's breach of contract lawsuit accusing the insurer of underpaying for its Medicare Advantage members.
13. Feds want 12+ years in prison for ex-CEO of senior living network over $20M kickback scheme
Federal prosecutors are recommending a 12-year prison sentence for James Burkhart, the former CEO of Indianapolis-based American Senior Communities, for his role in a $20 million healthcare fraud scheme.
14. Pharmacy group sues Express Scripts: 6 things to know
Pharmacy First, a network of more than 2,300 independent pharmacies in the U.S., is suing pharmacy benefit manager Express Scripts for limiting its market.
15. Federal court reaffirms individual patients cannot file HIPAA lawsuits: 5 things to know
A U.S. district court judge in Washington, D.C., on June 15 dismissed a case by a patient who alleged Laboratory Corporation of America, or LabCorp, violated HIPAA, reaffirming the precedent that individual patients cannot file lawsuits for alleged HIPAA violations.
More articles on legal and regulatory issues:
CMS seeks information to ease Stark Law burden
3 California physicians charged in $580M billing fraud scheme
Healthcare executive gets prison time for role in $100M bribery scheme involving 38 physicians