Jeffrey Robinson first visited the emergency department at Central Maine Medical Center, Lewiston, in March 2023 complaining of back and stomach pain. 

Ahead of June 1 to 5—Medicare Fraud Prevention Week—here’s a timeline of fraud-related news, views and developments as captured in concise statements uttered or written in May. 

The same day that Tennessee Gov. Bill Lee signed a bill that would force pharmacy benefit managers to divest from retail pharmacies, CVS Health filed a lawsuit to block its implementation.

Last week hospitals owned by three big health systems filed suit against CVS Health. The trio filed separately, but all accuse the corporation of robbing them of funds they’re owed through the federal 340B drug pricing program. 

The U.S. Department of Justice says its investigation into the scheme to defraud Amtrak’s employee health plan resulted in 19 prosecutions, all resulting in guilty pleas. For her role in over $2.2M of fraudulent billing, physical therapist Taejin Kim will serve a year in prison.

Jeffrey and Kim Sayward, of Florida, charge that radiologist Eric J. Sax, MD, working for MaineHealth Hospital in Biddeford at the time, failed to identify a dangerous blood clot three years ago. 

Washington-based Providence Health and Services denies the allegations. The lawsuit, filed by the state attorney general, details incidents of noncompliance and retaliation dating back to 2021. 

The new caps on how much borrowers pursuing professional degrees may take out have been set at $200,000. However, the plaintiffs—led by Maryland and New York—take issue with how the Trump administration defines a “professional degree,” as it includes many common healthcare fields.