5 recent payer lawsuits, settlements

From Humana suing HHS over a new Medicare Advantage clawback rule, to Prisma Health accusing UnitedHealthcare of breaching a confidentiality agreement, here are five lawsuits and settlements involving payers Becker’s has reported since Aug. 16.  

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1. UCare and the University of Minnesota settled a lawsuit brought by the Minneapolis-based university in November that sought to stop UCare from expanding its board of directors. 

2. Humana is challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans. 

3. Greenville, S.C.-based Prisma Health alleged UnitedHealthcare breached its confidentiality agreement with the system in the midst of contract negotiations. UnitedHealth hit back, alleging the health system “coordinated a media effort to put pressure” on the insurance giant. 

4. Cincinnati-based Bon Secours Mercy Health is suing Anthem Blue Cross Blue Shield of Virginia for $93 million, alleging the payer owes the health system millions in unpaid claims.

5. An Amedisys stockholder filed a lawsuit against the home health provider and its directors, alleging they misrepresented key information in a proxy statement related to UnitedHealth’s proposed acquisition of the company.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Register to Attend Webinar

Read. Deleted. Ignored. What It Takes to Drive Behavior Change and Lower the Cost of Care

Tuesday, August 4
11:00 AM - 12:00 PM CDT

Presenters: Koleen Cavanaugh, Independence Blue CrossBukata Hayes, HMO Minnesota (Blue Plus)Nathan Foco, Select HealthTrish Cox, SCAN Health PlanJonas Puente, ZS Associates

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