Kansas Attorney General Kris Kobach filed a lawsuit in state court June 24 against Aetna, alleging the insurer misused tens of millions of dollars while administering the state employee health plan. Aetna has served as a third-party administrator since at…
Legal
A California judge entered a final judgment that called on Kaiser Foundation Health Plan, part of Oakland, Calif.-based Kaiser Permanente, to pay more than $82 million to the state’s Pomona Valley Hospital Medical Center over concerns of insufficient emergency care…
Elevance Health paid CMS $342 million following a Medicare Advantage sanction notice alleging the insurer did not properly address overpayments for years. June 22 filings in a New York federal court included an email from an Elevance vice president to…
A Minnesota federal judge is allowing key claims in a proposed class action lawsuit against UnitedHealth Group to progress, deciding current and former participants in the company’s 401(k) savings plan plausibly alleged economic injury. The court issued the opinion June…
CareFirst BlueCross BlueShield has filed a federal racketeering lawsuit against a Maryland insurance broker and his brother, alleging the pair fraudulently enrolled overseas clients in health plans meant for Maryland residents as part of a yearslong scheme that cost the…
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A Pennsylvania bill would create a category of aggravated assault in the state’s criminal code to hold health insurer CEOs liable if a covered person gets an “adverse benefit determination” of a medically necessary benefit that leads to serious bodily…
A federal judge has denied an emergency request by Montgomery, Ala.-based Jackson Hospital, which filed for bankruptcy in February, to force Blue Cross Blue Shield of Alabama to raise its reimbursement rates to match area hospital Baptist Medical Center South. …
The Pharmaceutical Care Management Association, a trade group for pharmacy benefit managers, filed lawsuits in June challenging Illinois and Tennessee pharmacy laws. PCMA raised Employee Retirement Income Security Act-based preemption counts targeting Illinois’ Prescription Drug Affordability Act. The law, signed…
The Justice Department filed a lawsuit against New York officials and the company Public Partnerships LLC June 16 over alleged fraud involving Medicaid funds for a $10 billion home care program. PPL is responsible for managing caregivers in the Consumer…
Luigi Mangione plans to mount a psychiatric defense at his New York state murder trial in the death of UnitedHealthcare CEO Brian Thompson, the judge presiding over the case said during a June 17 hearing, according to NBC News. Manhattan…