Columbus-based OhioHealth is seeking the dismissal of the Justice Department’s antitrust lawsuit against the system, arguing the lawsuit is too vague to proceed and misreads how competition in healthcare markets actually works. Four things to know: 1. The Justice Department…
Legal
Cigna will face trial over a provider group’s allegations that the insurer did not pay $6 million in COVID-19 testing costs, according to a May 8 ruling in a Connecticut federal court. Murphy Medical Associates filed its initial complaint against…
A lawsuit filed by Clover Health alleged CMS gave an “unlawful” 2026 Star Rating determination to the insurer. After weighing a potential transfer of the case to a federal court in Washington, D.C., the judge decided to keep the Georgia…
A departing senior Elevance Health executive is pushing back against demands from the Justice Department to depose him in a Medicare Advantage fraud lawsuit against the insurer that stretches back several years. On May 6, Elevance asked a New York…
North Carolina Attorney General Jeff Jackson reached an $11 million settlement with Mylan, now part of pharmaceutical company Viatris, regarding alleged overpayments for EpiPens, according to an April 30 news release. Mylan has handled the marketing and distribution of EpiPen…
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Bellaire, Texas-based Harris Health System filed a lawsuit against Elevance’s Wellpoint Texas, formerly Amerigroup Texas, due to alleged payment failures for Medicare Advantage beneficiaries, according to a March complaint. Harris Health began flagging payment delays in 2020. Following an escalation…
Massachusetts Attorney General Andrea Joy Campbell has settled with Adroit Health Group for $5 million over allegations the Texas-based insurer misled thousands of consumers about the health coverage it sold them beginning in 2016. The attorney general’s office alleged that…
Montana State Auditor and Commissioner of Insurance James Brown said his office is taking action against Strategic Limited Partners, according to a May 4 news release. Some consumers were under the impression that SLP offered ACA-approved plans. On April 1,…
Fort Lauderdale, Fla.-based Broward Health filed a lawsuit against Florida Blue and its HMO due to alleged underpayments for emergency department services, according to an April 7 state court complaint. Broward Health has been out of network for Florida Blue…
The California Hospital Association has filed a lawsuit against Anthem Blue Cross over a policy that would penalize hospitals when patients receive care from out-of-network physicians, even if the hospital is in network. The lawsuit, filed May 4 in Sacramento,…