Compliance & Legal
Anthem and Aetna plan to pursue in court the Department of Justice's injunction to block their respective mergers with Cigna and Humana, according to statements from both insurers.
While sources have said they expect a decision in August, Bloomberg said the DOJ could file the lawsuits this week or next.
Red Oak claims self-insured or fully insured companies and their coverage plans administered by UnitedHealthcare have conspired to embezzle funds through a process called recoupment.
Humana stock fell by 9 percent last week and a recent report gives the merger a 50/50 chance of happening.
The Centers for Medicare and Medicaid Services announced Thursday that it has barred Theranos founder and CEO Elizabeth Holmes from the blood-testing business for two years, according to a statement on the company's website.
Proposal would eliminate any potential financial pressure clinicians may feel to over-prescribe pain medications, especially opioids.
Many clinicians report feeling pressure to overprescribe opioids because scores on the pain management questions are tied to Medicare payments.
Anthem and its pharmacy manager Express Scripts overcharged patients with job-based insurance for prescription drugs, alleges a lawsuit that seeks class action status for what could be tens of thousands of Americans.
Blue Cross and Blue Shield of Georgia faces separate lawsuits accusing it of sending reimbursement money for emergency room care directly to patients -- and not to the hospital because it isn't part of the insurer's network. That's costing the hospitals money since patients don't always turn over the funds, according to the lawsuits, filed by Polk Medical Center in northwest Georgia and Martin Luther King, Jr. Community Hospital in Los Angeles
The United States House of Representatives' Committee on Energy and Commerce is demanding to know what Theranos, the embattled blood-testing startup based in California, is doing to address its testing inaccuracies and questionable adherence to federal guidelines.