Blue Cross and Blue Shield of Louisiana has lost its legal challenge against CMS over how its 2025 Medicare Advantage star ratings were calculated. On July 9, the U.S. District Court for the District of Columbia ruled that CMS acted…
Legal
Elevance Health and the Blue Cross Blue Shield Association are suing LifeX Research Corporation, accusing the Georgia-based company of fraudulently using the insurers’ trademarks to sell fake health plans. The lawsuit, filed June 27 in the Northern District of Georgia,…
Justice Department officials have questioned former UnitedHealth Group employees as part of an investigation into the company’s Medicare Advantage billing practices, The Wall Street Journal reported July 9. The Journal first reported in May that the company was under criminal…
A federal court has partially ruled in favor of Alignment Healthcare in a legal challenge against CMS, resulting in the Medicare Advantage company’s Arizona HMO star rating being raised from 3.5 to 4 stars. All of Alignment’s members are now…
A Minnesota judge has ruled against UnitedHealthcare in a lawsuit challenging a Minnesota law barring for-profit insurers from the state’s Medicaid program. In a decision issued June 30, Minnesota District Court Judge Mark Ireland ruled the statute, passed as part…
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A former Medicare Advantage executive has been found not guilty of healthcare fraud. A jury found Kenia Valle Boza, the former director of Medicare risk adjustment analytics for HealthSun Health Plans, not guilty of one count of conspiracy to commit…