10 recent lawsuits involving payers

Here are 10 lawsuits involving commercial and government payers posted by Becker's Hospital Review in the past month.

1. Ex-CEO sentenced to prison in billing fraud case involving California clinics
The former CEO of Merced, Calif.-based Horisons Unlimited, a nonprofit chain of health clinics, was sentenced Nov. 4 to five years in prison for her role in a billing fraud scheme, according to the Department of Justice.

2. 5 Montana hospitals settle lawsuit alleging they swapped $26M from insurer for inflated employee premiums
Five Montana hospitals have agreed to pay $6.9 million to employees to settle allegations that they made a deal with Blue Cross Blue Shield that boosted employee health plan prices in exchange for $26 million.

3. UnitedHealth hit with another lawsuit over mental health coverage
UnitedHealthcare is facing another lawsuit that alleges the health insurer discriminated against members who received mental health services.

4. U of Mississippi Medical physician sues insurers for denying cancer treatment
A physician practicing at the University of Mississippi Medical Center filed a lawsuit against his insurers for denying coverage of proton therapy to treat his brain cancer.

5. Judge: Feds owe $1.6B to 100+ insurers
More than 100 health insurers represented in a class-action lawsuit against the federal government should get $1.6 billion in ACA payments.

6. UnitedHealth drops appeal of Supreme Court decision on alleged overpayments
UnitedHealth Group dropped an appeal asking the Supreme Court to uphold a controversial billing tactic.

7. Humana sues 37 generic drugmakers: 3 things to know
Humana filed a lawsuit Oct. 18 accusing 37 pharmaceutical companies of partaking in a conspiracy to increase generic drug prices.

8. Arizona health centers sue Medicaid for unpaid services
Arizona health centers are accusing the state's Medicaid program of not reimbursing them for their full costs of all provided services.

9. Oscar appeals decision in Florida Blue lawsuit
Insurer Oscar filed a notice of appeal Oct. 16 after a judge dismissed the startup's lawsuit against Florida Blue.

10. Oregon insurer sues, says 3 health systems have locked it out of Portland market
Trillium Community Health Plan has filed a federal antitrust suit against three of the largest hospital systems in Portland, Ore., claiming they colluded to block the insurer from operating in the area.

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