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News You Need to Know Today
Weekly Update: 200K ransom | Allstate lawsuit | ACA subsidies | UHC hits RPM | Patient dies due to blade | Shutdown update
Sunday, November 16, 2025
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This Week’s News

Cybersecurity researcher provides more details on $200K ransom pinned on Doctor Alliance

The outlet DataBreaches.net was able to gather more details on the alleged hack of the healthcare billing automation platform, said to be perpetrated by a notorious cybercriminal.

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cybersecurity hacker ransomware cyber data breach
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Cybersecurity researcher provides more details on $200K ransom pinned on Doctor Alliance

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cybersecurity hacker ransomware cyber data breach
The outlet DataBreaches.net was able to gather more details on the alleged hack of the healthcare billing automation platform, said to be perpetrated by a notorious cybercriminal.
READ MORE >

Allstate accuses Texas provider network of operating $1.7M auto injury fraud scheme

The insurer claims personal injury attorneys referred patients to the network, where they allegedly received dubious treatments and undergo excessive testing to inflate medical claims. Allstate is seeking up to $5.2 million in restitution.

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Car accident head injury
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Allstate accuses Texas provider network of operating $1.7M auto injury fraud scheme

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Car accident head injury
The insurer claims personal injury attorneys referred patients to the network, where they allegedly received dubious treatments and undergo excessive testing to inflate medical claims. Allstate is seeking up to $5.2 million in restitution.
READ MORE >

Toddler dies after allegedly being given 10 times too much potassium due to decimal error

A lawsuit contends that De’Markus Page, 2 years old, died because no one at University of Florida Health’s Shands Teaching Hospital spotted the errors, which should have been labeled as a “red flag” by EHR systems.

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Banner ASC in Sun City, Arizona.
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Toddler dies after allegedly being given 10 times too much potassium due to decimal error

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Banner ASC in Sun City, Arizona.
A lawsuit contends that De’Markus Page, 2 years old, died because no one at University of Florida Health’s Shands Teaching Hospital spotted the errors, which should have been labeled as a “red flag” by EHR systems.
READ MORE >

House Democrats push for last-ditch amendment to protect ACA subsidies for 3 years

With the U.S. Senate passing a funding agreement to reopen the federal government, the House of Representatives will now have a chance to make changes—though there’s little chance this particular amendment will succeed.

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bipartisan house task force on artificial intelligence
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House Democrats push for last-ditch amendment to protect ACA subsidies for 3 years

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bipartisan house task force on artificial intelligence
With the U.S. Senate passing a funding agreement to reopen the federal government, the House of Representatives will now have a chance to make changes—though there’s little chance this particular amendment will succeed.
READ MORE >

UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

Starting in 2026, patients covered by UnitedHealthcare's Medicare Advantage and commercial plans will not have care reimbursed for instances of remote patient monitoring unless they have diagnosed heart failure or are pregnant and experiencing hypertension. The shift stands at odds with traditional Medicare, which added new claims codes for providers to use next year.

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UnitedHealthcare UHC UnitedHealth
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UnitedHealthcare bucks Medicare, ends reimbursement for most RPM services

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UnitedHealthcare UHC UnitedHealth
Starting in 2026, patients covered by UnitedHealthcare's Medicare Advantage and commercial plans will not have care reimbursed for instances of remote patient monitoring unless they have diagnosed heart failure or are pregnant and experiencing hypertension. The shift stands at odds with traditional Medicare, which added new claims codes for providers to use next year.
READ MORE >

Doctor sues Waymo after AI flags him as a terrorist

Nasser Mohamed, MD, a neurologist who operates a clinical practice in San Francisco, said an artificial intelligence system used by the autonomous taxi company led to him being denied multiple rides. He is seeking injunctive relief.

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Waymo Creative Commons Image
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Doctor sues Waymo after AI flags him as a terrorist

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Waymo Creative Commons Image
Nasser Mohamed, MD, a neurologist who operates a clinical practice in San Francisco, said an artificial intelligence system used by the autonomous taxi company led to him being denied multiple rides. He is seeking injunctive relief.
READ MORE >

CMS’ AI program to add prior authorizations to traditional Medicare; new bill aims to stop it

President Donald Trump’s administration argues that their “WISeR” model will eliminate unnecessary testing and save Medicare money. But eight Democrats opposing it think it will only bring Medicare Advantage chaos to Part A and Part B.

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Medicare money payment
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CMS’ AI program to add prior authorizations to traditional Medicare; new bill aims to stop it

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Medicare money payment
President Donald Trump’s administration argues that their “WISeR” model will eliminate unnecessary testing and save Medicare money. But eight Democrats opposing it think it will only bring Medicare Advantage chaos to Part A and Part B.
READ MORE >

Patient dies when surgical 'blade' is left inside him, spurring $1M malpractice lawsuit

The family of Jeffrey Alan Fulcher, 58, sued the Medical University of South Carolina after the father of three died six days after undergoing a minimally invasive procedure to remove part of his esophagus. The state, on behalf of the hospital, settled the case out of court. 

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surgery
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Patient dies when surgical 'blade' is left inside him, spurring $1M malpractice lawsuit

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surgery
The family of Jeffrey Alan Fulcher, 58, sued the Medical University of South Carolina after the father of three died six days after undergoing a minimally invasive procedure to remove part of his esophagus. The state, on behalf of the hospital, settled the case out of court. 
READ MORE >

Republicans win shutdown showdown—Senate agrees to funding deal without ACA subsidy extension

With eight Democrats agreeing to the Republican-backed deal that reverses the firings of federal workers, the Senate now has the 60 votes needed for the bill to advance. The rehirings will include the 1,200 workers fired at the Department of Health and Human Services. 

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Congress Senate Washington D.C. DC
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Republicans win shutdown showdown—Senate agrees to funding deal without ACA subsidy extension

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Congress Senate Washington D.C. DC
With eight Democrats agreeing to the Republican-backed deal that reverses the firings of federal workers, the Senate now has the 60 votes needed for the bill to advance. The rehirings will include the 1,200 workers fired at the Department of Health and Human Services. 
READ MORE >

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