In a lawsuit, the EHR giant accuses Health Gorilla, et al., of posing as patient care entities to gain access to nearly 300,000 medical records, in violation of HIPAA. Health Gorilla vehemently denies the allegations.

Lawyers representing Luigi Mangione, the man accused of killing UnitedHealthcare CEO Brian Thompson, cite Attorney General Pam Bondi's tenure with Ballard Partners, a lobbying firm whose clients include UnitedHealth, as evidence of her conflict of interest. In response, the prosecution called the claim “misleading.”

The California-based health system faced multiple accusations of upcoding diagnoses to receive additional risk-adjusted payments from the Medicare Advantage program. Its payer plan and providers were implicated in what the DOJ described as systemic fraud. Kaiser Permanente denies any wrongdoing.

Philadelphia-based Jefferson Health has accused the three biggest PBMs—Caremark, Express Scripts and Optum Rx—of a de facto collusion scheme involving the primary makers of insulin, Eli Lilly, Novo Nordisk and Sanofi. The lawsuit alleges rebates offered by the manufacturers unfairly burden self-insured and public health plans, like the one the health system uses for its employees.

An exclusive report from local NBC affiliate KARE 11 tells the story of Noah Leopold, a man who died after receiving two new hearts. The first deteriorated, and the second one killed him. Now, his family is suing, saying the Mayo Clinic failed to inform them of the risks. The nonprofit health system denies the allegations. 

The U.S. Department of Justice has formally accused Done Global of unlawfully distributing ADHD medications without medical need, using a subscription program and targeted advertising to find patients searching for drugs. The company is also accused of filing false medical claims to Medicare, Medicaid and commercial insurance. Done's founder and CEO was convicted last month on related charges and awaits sentencing. 

Cedric Lodge, 58, pleaded guilty in May for his role in procuring human organs and tissue for sale on an interstate black market. His wife, Denise Lodge, was sentenced to one year for collaborating. The couple sold organs out of their home in New Hampshire, prosecutors said. 

Timesha Beauchamp, 20, suffered a seizure in August 2020 that required emergency medical attention. When responders arrived, they declared her dead at the scene. A short time later, she was found to be alive at a funeral parlor. More than five years later, a lawsuit stemming from the incident has been settled out of court. 

HealthExec zooms in on laws passed in Massachusetts, Oregon and California that are set to change how hedge funds interact with patient care organizations.