Bloomberg said the pharmacy benefit manager is being probed as part of a larger look into the “prescription management services” of UnitedHealth. According to sources, this may be related to an ongoing investigation into alleged instances of Medicare Advantage upcoding.

"Today’s sentence sends a deterrent message to doctors and the healthcare industry," according to a DOJ statement. "If you abuse patient trust for profit, you will face justice."

The settlement reached in October 2024 has been finalized. A fund is being set up for the estimated 3 million claimants, as BCBS pledges to reform its BlueCard health plans.

The insurance giant is charging the new board committee with monitoring company policies related to prior authorizations, claims adjudication and AI. The group is scheduled to meet four times a year.

Ladarius Butler took his 3-year-old son to Children’s Hospital Colorado after the boy had trouble breathing. An argument over the care he received led Butler to leave the hospital with the child, prompting staff to call 911. All charges against Butler were dropped, but he has filed a lawsuit against the city of Aurora after he was tased in a Walmart parking lot.

"Jane Doe,” who is under 18, and legal representatives claim Radiology Associates of Richmond failed to safeguard private health information. 

That number includes $285 million in damages. CVS Health’s PBM was found to have committed fraud when it pressured insurers to overbill Medicare Advantage plans for patient care services.

The New York-based safety net hospital has accused former CEO Megan Ryan of impropriety that includes paying out $3.5 million to herself and 12 other executives. She denies the allegations, and claims she is a whistleblower for fraud committed by the state.