8 recent payer lawsuits, settlements

From star rating lawsuits to a record antitrust settlement, here are eight lawsuits, settlements and legal developments involving payers that Becker's has reported since Oct. 3: 

1. Centene is asking a federal judge to require CMS to recalculate its star rating without including a secret shopper phone call Centene says never reached its call center.  

2. UnitedHealth Group reached a settlement with the U.S. Department of Labor over allegations that it improperly denied claims for emergency room visits and urinary drug screenings for thousands of patients.

3. Humana filed a lawsuit asking a federal judge to require CMS to "retract and recalculate" its 2025 star ratings. 

4. Regence BlueShield of Idaho will remain as the state's health plan administrator after a state judge dismissed a lawsuit from Blue Cross of Idaho that looked to invalidate the new contract. 

5. The Blue Cross Blue Shield Association, along with the 33 independent BCBS companies, agreed to pay $2.8 billion to settle antitrust claims from healthcare providers, marking the largest settlement of its kind in the healthcare industry. 

6. L.A. Care will pay a $55 million penalty to resolve allegations the plan improperly denied claims, and had a backlog of unresolved grievances. 

7. A Kansas judge denied Aetna's petition for judicial review of the state's Medicaid contract awards. 

8. UnitedHealthcare is asking a federal court to prevent CMS from downgrading its Medicare Advantage star ratings based on one phone call.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Articles We Think You'll Like