Arizona Attorney General Kris Mayes accused healthcare data company MultiPlan, rebranded as Claritev, and eight health insurers of a price-fixing scheme. The complaint, filed in state court, alleged MultiPlan — along with Aetna, Cigna, UnitedHealth Group, Humana, Elevance Health, Health…
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Massachusetts has filed a lawsuit against UnitedHealthcare, accusing the insurer of retaining more than $100 million in fraudulent Medicaid payments. The May 29 complaint, filed in a state court, focuses on UnitedHealthcare’s role as a contractor for “Senior Care Options,”…
A federal judge in Georgia has ruled in favor of Clover Health in its lawsuit challenging its 2026 Medicare Advantage star ratings. In a May 27 opinion, U.S. District Judge Lisa Godbey Wood partially granted the insurer’s motion for summary…
AmeriHealth Caritas and its pharmacy benefits manager subsidiary, PerformRx, is facing a lawsuit from two Philadelphia pharmacies alleging the companies illegally concealed transmission fees. The complaint from Friendly Pharmacy and Samuel J. Robinson Pharmacy alleges PerformRx charged pharmacies transmission fees…
A Texas federal court has dismissed a Blue Cross and Blue Shield of Texas lawsuit against independent dispute resolution company HaloMD. The lawsuit, filed in 2025, alleged HaloMD, which focuses on the provider side of IDR disputes, formed a scheme…
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The Justice Department charged 15 people in Minnesota in connection with alleged fraud schemes involving more than $90 million. According to a May 21 news release from the department, the action included two of the largest Medicaid fraud cases charged…
Three health systems have filed federal lawsuits against CVS Health, alleging the company and several affiliates improperly diverted about $250 million in savings generated through the 340B drug pricing program. The health systems include New York City-based Mount Sinai Health…
A federal judge has denied The Cigna Group’s motion to dismiss a lawsuit alleging mismanagement of employee retirement benefits, according to a May 19 ruling. One year ago, former Cigna employees filed a proposed class action against the company’s 401(k)…
Payments from the $2.67 billion Blue Cross Blue Shield antitrust settlement began rolling out May 11, more than a decade after the original lawsuit was filed. Six things to know: 1. The lawsuits alleged BCBS plans conspired to divide up…
A federal jury has found a 55-year-old Michigan nurse and home health agency owner guilty of committing Medicare fraud using patient records stolen from a Detroit hospital. Ruby Scott, of Farmington, Mich., was convicted May 14 of five counts of…