The U.S. Department of Labor has reached a settlement with Oakland, Calif.-based Kaiser Foundation Health Plan to resolve its investigations into the company’s alleged failure to provide timely and appropriate access to mental health and substance use disorder services. The…
Legal
Montgomery, Ala.-based Jackson Hospital and BCBS Alabama tensions are not just playing out in court filings — they have hit the press, as well, with each side stating their case in dueling op-eds. Amid its Chapter 11 proceedings in the…
The House Judiciary Committee issued subpoenas Feb. 9 to eight health insurers, seeking documents about potential fraud issues related to ACA marketplace subsidies. The subpoenas target Blue Shield of California, Centene, CVS Health, Elevance Health, GuideWell, Health Care Service Corp.,…
Tacoma, Wash.-based MultiCare Health System is suing Optum and Change Healthcare, alleging that Change owes the system at least $1.2 million in outstanding claims. The lawsuit, filed Jan. 27 in Washington federal court, alleges that Change “consistently failed to provide…
Cost Plus Drugs co-founder Mark Cuban is not convinced the Federal Trade Commission’s settlement with Cigna’s Express Scripts is going to amount to much. “My initial response to the FTC [and pharmacy benefit manager] settlements … meh. [G]reat intent. [W]ill…
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The California Department of Managed Health Care fined Centene’s Health Net $1.3 million for “mishandling [of] provider payment disputes,” according to a Feb. 4 agency news release. California levied an $850,000 fine on Health Net Community Solutions, which provides Medi-Cal…
The Federal Trade Commission reached a settlement with Cigna’s Express Scripts in a case over alleged inflation of insulin prices, according to a Feb. 4 agency news release. With the move, the FTC expects to lower out-of-pocket costs for drugs…
Elevance Health is suing four former executives of its Puerto Rico subsidiary, alleging they violated noncompete agreements by leaving for rival insurer Triple-S Salud. The complaint, filed Jan. 29 in an Indiana federal court, claims the former executives broke the…
California’s Department of Managed Health Care issued Anthem Blue Cross a $15 million fine due to “longstanding and widespread failures” with handling member complaints, according to a Jan. 30 news release from the department. The enforcement action also stipulates that…
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…