From a federal judge tossing a Medicare Advantage audit rule to Florida hospitals challenging a proposed transplant rule, here are 10 lawsuits, settlements and legal developments that Becker’s has reported since Sept. 17:
1. Patients at two Pennsylvania hospitals are asking a federal judge to stop the Justice Department from obtaining years of medical records related to gender-affirming care.
2. A 2023 lawsuit made public in September alleges that a hospital in Maywood, Ill., performed organ transplants on patients ineligible for such procedures to maximize Medicare revenue.
3. A federal judge vacated a CMS rule that would have allowed the agency to claw back billions of dollars in alleged Medicare Advantage overpayments, siding with Humana in a closely watched legal battle.
4. A federal judge granted preliminary approval to Elevance Health’s $12.9 million settlement resolving a class-action lawsuit that accused the insurer of improperly denying coverage for residential treatment of mental health and substance use disorders.
5. Following years of debate, Florida hospitals are challenging a proposed rule for transplant program approvals, arguing it could jeopardize patient safety and quality of care.
6. A federal appeals court refused the Trump administration’s request to resume sweeping layoffs and reorganization at HHS.
7. Employees at Houston-based Memorial Hermann Health System filed a lawsuit after hidden cameras were discovered in hospital restrooms.
8. A woman is suing Elevance Health after being denied coverage for Zepbound — Eli Lilly’s weight-loss drug — to treat her sleep apnea.
9. The Department of Justice filed a False Claims Act lawsuit against Inland Empire Health Plan (IEHP), alleging the Rancho Cucamonga, Calif.-based insurer misused federal Medicaid expansion funds and submitted false statements to the state.
10. A federal judge dismissed former Dallas-based Steward Health Care CEO Ralph de la Torre’s lawsuit against members of the Senate Health, Education, Labor and Pensions committee after ruling that lawmakers have immunity for the legislative actions he challenged under the Constitution’s Speech or Debate Clause.
