CareFirst BlueCross BlueShield is suing CMS over its 2026 Medicare Advantage star ratings, alleging improper calculations cost the insurer an estimated $32 million in quality bonus payments. The lawsuit, filed Jan. 20 in the U.S. District Court for the District…
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Jury selection in the federal murder trial of Luigi Mangione is scheduled to begin Sept. 8, U.S. District Judge Margaret Garnett said Jan. 23. The 27-year-old is accused of fatally shooting UnitedHealthcare CEO Brian Thompson outside the New York Hilton…
Minneapolis-based Hennepin Healthcare filed a notice of intervention Jan. 22 to interject itself into insurer UCare’s rehabilitation. UCare planned to hand over its Medicaid and ACA businesses to fellow insurer Medica in 2026 as its Medicare Advantage line discontinues. In…
The Montana Office of the Commissioner of Securities and Insurance hosted an administrative hearing Jan. 22 to address a data breach that affected BCBS Montana, owned by Health Care Service Corp. The hearing comes in the wake of a cybersecurity…
False Claims Act settlements and judgments totaled more than $6.8 billion in fiscal year 2025, the highest annual amount on record, according to a Jan. 16 report from the Justice Department. Six things to know: 1. The $6.8 billion total…
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Grocery chain Albertsons is suing the Cigna-owned pharmacy benefit manager Express Scripts for at least $10.9 million for alleged prescription underpayments, according to a Jan. 7 complaint shared by the National Community Pharmacists Association. The lawsuit filed in Delaware’s Superior…
A federal judge ruled that Florida failed to provide adequate notice to Medicaid recipients before terminating their coverage during the post-pandemic unwinding process. The class-action lawsuit was filed in August 2023, alleging that beneficiaries received confusing notices from the state’s…
Anthem Blue Cross is suing 11 Prime Healthcare hospitals in California, accusing them of defrauding the insurer by “knowingly flooding” the No Surprises Act’s independent dispute resolution process with thousands of claims they knew were ineligible for arbitration. The complaint,…
San Antonio, Texas-based Baptist Health System has filed a lawsuit against UnitedHealthcare over alleged underpayments for emergency room services provided to patients with ACA coverage, the San Antonio Express-News reported Jan. 2. The health system’s hospitals are not in network…
Health Care Service Corp.’s Blue Cross and Blue Shield of Texas filed a lawsuit against medical billing company Zotec Partners Dec. 18, alleging “abuse” of the No Surprises Act’s independent dispute resolution process, according to filings from the Eastern District…