Legal News

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.

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UnitedHealthcare launches rural Medicare Advantage pilot to cut reimbursement delays 50%

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.

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Kaiser Permanente hit with record-setting $556M Medicare Advantage fraud settlement

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.

An Illinois appellate judge upheld a pervious trial victory that cleared and central Illinois cardiologist Amit Dande, MD, and Prairie Cardiovascular Consults LLP of alleged misdiagnosis of the severity of a patient's heart condition that led to his death prior to a schedule percutaneous coronary intervention (PCI).

Radiologist accused of writing 'confusing' report lawyers say led to child's severe birth defects

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. 

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AI roundup: Of workslop and rework | Patent that tech, industry player | Artificial Intellectualism, anyone?

Across industries, more than a third of the time saved by AI gets eaten by overstretched humans who have to clean up the technology’s sloppy work. 

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Rape charges against Texas cardiologist dropped as part of plea agreement

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." 

Epic, provider groups sue companies over alleged scheme to sell patient data

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.

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Senate Report: UnitedHealth was aggressive in seeking higher Medicare Advantage payments

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. 

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Lawsuit alleges crew failed to act after man suffered stroke on flight

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.