Stories about physicians and other healthcare professionals involved in lawsuits—as either a plaintiff or a defendant—or accused of breaking the law. Various legal updates or unusual stories in the news may land here.
The Federal Trade Commission said it's seeking a resolution with Cigna, the parent company of the pharmacy benefit manager. The agency filed an antitrust complaint against Express Scripts, Optum Rx and CVS Caremark in 2024, alleging the "Big Three" PBMs use anticompetitive tactics to control the insulin supply chain within their vertical.
An anesthesiologist in Colorado has been indicted on manslaughter and criminally negligent homicide charges after a patient died during routine cataract surgery. It was discovered that a game of music bingo may have been the distraction that led to Bart Writer, 56, losing his life.
Of the $6.8 billion in judgments and settlements the U.S. Department of Justice reclaimed under the False Claims Act, $5.7 billion came from healthcare cases. The agency said fraud involving Medicare reimbursements, unnecessary patient care and managed care scams remains a key focus.
Danbury, Connecticut-based Advanced Imaging Specialists previously sued Trinity Health in November and is now prepared to vacate their contract amid ongoing challenges.
The Marlborough, Massachusetts-based mammography systems manufacturer revealed details about the litigation in a Jan. 26 filing with the U.S. Securities and Exchange Commission.
The insurer is planning to reduce reimbursement timelines for hospitals in Oklahoma, Idaho, Minnesota and Missouri from 30 days to 15. The details are unclear, but the company said the framework could extend nationwide.
The California-based health system faced multiple accusations of upcoding diagnoses to receive additional risk-adjusted payments from the Medicare Advantage program. Its payer plan and providers were implicated in what the DOJ described as systemic fraud. Kaiser Permanente denies any wrongdoing.
A mother in Georgia alleges the problematic prenatal ultrasound findings forced her care team to make medical decisions resulting in her child being born with lifelong disabilities.
The traveling clinician pleaded guilty to three counts of second-degree assault. All other charges were dropped, and he was released from jail. According to his attorney, the cardiologist agreed to this plea agreement to "get on with his life."
In a lawsuit, the EHR giant accuses Health Gorilla, et al., of posing as patient care entities to gain access to nearly 300,000 medical records, in violation of HIPAA. Health Gorilla vehemently denies the allegations.
The Wall Street Journal obtained a copy of a report from the Senate Judiciary Committee, which reviewed more than 50,000 documents sent by UnitedHealth related to its Medicare Advantage patients. The outlet published the findings of the inquiry.
According to a new wrongful death lawsuit, members of the flight crew failed to pick up on a man's stroke symptoms, resulting in significant care delays. His family is now suing for damages in excess of $50,000.