From more than 600 hospitals suing HHS over Medicare payment cuts to a former executive suing Novant Health for “reverse discrimination,” here are the latest healthcare industry lawsuits and settlements making headlines.
1. Florida healthcare mogul must pay $44M in massive Medicare fraud case, court rules
A federal judge ordered Philip Esformes, a Florida healthcare executive sentenced to 20 years in prison in a $1.3 billion Medicare fraud case, to pay $44.2 million in forfeiture and restitution.
2. 15 hospitals sue HHS over Medicare reimbursement
Capital Health Medical Center-Hopewell in Pennington, N.J., and 14 other New York and New Jersey hospitals are suing HHS, alleging the agency is disregarding a previous U.S. Supreme Court ruling that sided with hospitals in a Medicare payment dispute.
3. Former exec sues Novant Health for ‘reverse discrimination’
A former Novant Health executive is suing the health system for wrongful termination and discrimination — he says he was fired to help the Winston-Salem, N.C.-based organization reach diversity goals.
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4. DC hospital allegedly fired director of nursing for reporting unlawful billing
The former director of nursing for emergency and trauma services at Washington, D.C.-based Howard University Hospital filed a lawsuit Nov. 8 alleging she was fired for reporting unlawful billing practices.
5. 622 hospitals sue HHS, accused of illegally allowing reimbursement cut
More than 600 hospitals are suing HHS, challenging the department’s decision to allow a 0.7 percent reduction in Medicare inpatient hospital reimbursement to continue into federal fiscal years 2018 and 2019.
6. Neurosurgeon hit with false claims complaint after Sanford’s $20M settlement
The federal government filed a False Claims Act complaint against Wilson Asfora, MD, and two medical device distributorships owned and operated by Dr. Asfora.
7. Anthem plans sue for $100M in federal payments
Anthem Blue Cross filed a lawsuit against the federal government to recoup $100 million in payments under the ACA.
8. Former CEO will sell California health clinics to settle billing fraud allegations
The founder and former CEO of Merced, Calif.-based Horisons Unlimited, a chain of health clinics, will be excluded from federal healthcare programs and sell 13 properties to resolve false claims allegations.
9. US Supreme Court rejects rural Iowa hospital’s challenge over Medicare payments
The U.S. Supreme Court will not hear a case that challenged the calculation method for Medicare payments to rural hospitals.
Source: Becker’s Hospital Review