A federal judge disagreed with AstraZeneca’s claims that the Inflation Reduction Act causes harm by disincentivizing innovation and violates its constitutional rights to due process. Blockbuster AstraZeneca drug Farxiga is one of 10 medications selected for the Medicare drug price negotiation program created by the law.
The former Pfizer statistician worked on the clinical trial for the Covid-19 drug Paxlovid. A jury found the employee guilty of insider trading for transactions made before clinical data for the antiviral were publicly announced.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Fruit Street Health's complaint alleged that Sharecare violated the terms of their shared business agreement by rolling out its own version of Fruit Street’s diabetes prevention program, which had been previously offered to Sharecare members. Sharecare said that the lawsuit is baseless.
In a new lawsuit, Bon Secours Mercy Health Virginia alleges that Anthem Health Plans of Virginia owes the health system more than $93 million in outstanding unpaid and underpaid claims.
Santa Clara Valley Healthcare in California has begun notifying 43,000 patients about their eligibility for billing corrections and refunds. The system’s patient outreach effort is a result of a recently settled lawsuit filed against Santa Clara County. In the complaint, former patients alleged the county did not inform them about its hospitals' charity care and discount payment policies, leading them to have to pay large bills.
CMS recently announced that it will change the administrative fee that providers and insurers must pay when initiating a reimbursement dispute under the No Surprises Act — the agency is lowering the fee from $350 to $50. This move came a week after the Texas Medical Association won a court case challenging HHS over its 600% price hike on the fee.
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
“Botched math” in calculating clinical data for an autoimmune disease drug is one of the allegations Nektar Therapeutics makes in a legal complaint against Eli Lilly. The biotech claims its former partner tried to disadvantage the asset in order to advance development of another drug it acquired in a billion dollar deal.
The Labor Department recently sued UnitedHealth Group subsidiary UMR, alleging that it wrongfully denied claims for emergency room services and urinary drug screenings since 2015. UMR did not determine the medical necessity of the claims, denying them “based solely on diagnosis codes and not applying a prudent layperson standard," according to the complaint.
Digital health startup Dorsata filed a lawsuit against EHR provider athenahealth and women’s health company Unified Women's Healthcare. The startup alleged that athenahealth stole trade secrets, used deceptive business practices and breached its contract — and that Unified aided and abetted these purported practices.
Kraft Heinz recently sued Aetna, claiming that the insurer is not providing all of Kraft Heinz's medical claims data. More lawsuits of this sort are likely to come, experts warned.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Lawsuits filed in opposition to the White House's drug pricing negotiation program are beginning to mount, but legal experts agree that the plaintiffs’ arguments probably won’t hold up during a court battle. However, these lawsuits still could delay when the government's ability to negotiate price goes into effect.
A group of labor unions have filed an antitrust complaint against UPMC. They alleged that the health system has prevented its workers from being able to advocate for themselves and their patients through “a draconian system of mobility restrictions and widespread labor law violations that lock in sub-competitive pay and working conditions.”
The California-based health system and insurer has bilked CMS out of "hundreds of millions of dollars" by submitting claims that were altered to make patients appear sicker than they were, a new complaint filed by the DOJ alleges. Kaiser denied these allegations saying it is confident in its compliance with Medicare Advantage program requirements.
After Capital Rx’s former medical director of pharmacy services got a job offer at CVS, the PBM startup claimed he couldn’t work there because of a noncompete agreement. CVS recently sued the company, saying its non-compete clause was unenforceable.
A previous investigation by MedCity News found that ElectrifAi was touting an improperly-developed algorithm during the earliest phase of the Covid-19 pandemic, with both the company and CEO defendants in an employment discrimination lawsuit. A year later, lawsuits are piling up as more former employees complain that the company and CEO lied about its AI capabilities and business.