CMS is appealing its court loss that led to boosts in Clover Health’s 2026 Medicare Advantage star ratings. The case will now move to the U.S. Court of Appeals for the Eleventh Circuit, according to a July 21 court filing. …
Legal
Chapel Hill, N.C.-based UNC Health hospitals have voluntarily dismissed two lawsuits against Humana over alleged 340B drug underpayments, according to July court filings. UNC Health Care System and affiliated hospitals dismissed their case against Humana and ChoiceCare Network July 17…
A Delaware judge has dismissed UnitedHealth Group’s defamation lawsuit against The Guardian following the outlet’s reporting last year that said the insurer secretly paid nursing homes to reduce hospital transfers for its Medicare Advantage members. “We are delighted that Judge…
A federal judge has dismissed a proposed class action lawsuit that accused Centene of mismanaging its employees’ 401(k) retirement plan, ruling the former employee who brought the case did not adequately show she was harmed. In its July 16 decision,…
The Federal Trade Commission reached a settlement with CVS Caremark that requires the pharmacy benefit manager to change its business practices as part of the agency’s antitrust case alleging the PBM inflated insulin list prices through rebate practices. The FTC…
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A federal judge has dismissed with prejudice a lawsuit from Blue Cross Blue Shield of Georgia that accused medical billing company HaloMD and two physician groups of conspiring to defraud the insurer through the No Surprises Act’s arbitration process. The…
A former senior executive with Alignment Healthcare is suing the Medicare Advantage insurer, alleging he was pushed out of the company after reporting that it misclassified millions of dollars to inflate profits and trigger bonuses for its executives. According to…
Nearly 5,000 independent pharmacies have filed a federal lawsuit against Prime Therapeutics, alleging the pharmacy benefit manager conspired with Cigna’s Express Scripts to suppress pharmacy reimbursement rates and increase fees in violation of federal antitrust law. The complaint was filed…
Blue Cross and Blue Shield of Louisiana has lost its most recent bid challenging how CMS calculated its 2025 Medicare Advantage star rating. On June 26, the U.S. Court of Appeals for the D.C. Circuit upheld a July 2025 district…
Elevance Health is suing CMS over its 2026 Medicare Advantage star ratings, arguing the agency gave competitor Clover Health a favorable recalculation after losing a court case to the insurer in May. In its July 1 complaint filed in the…