Compliance & Legal
In 2022, the AG launched an investigation into Mayo Clinic, which is ongoing.
The ruling, which includes banning telemedicine prescriptions, will not take effect until and if the Supreme Court reviews it.
The notices are part of the settlement of a lawsuit regarding charity care in Santa Clara County.
Subsidiary UMR denied screenings when it should have determined whether the claims were medically necessary, the suit states.
The lawsuit claims the Cigna PXDX algorithm enables automatic denials for treatments that do not match preset criteria.
The scheme involved genetic testing and durable medical equipment that patients did not need, which the defendants procured with kickbacks.
The deal would give IQVIA a market-leading position in programmatic advertising for healthcare products, the FTC said.
The U.S. contends that NextGen falsely obtained certification for its software and that its EHR lacked required functionality.
The allegations involved HCA billing Medicaid improperly for three separate behavioral health services available to children who qualify.
The lawsuit argues that Medicare is required to institute the payment model changes in a budget neutral manner.