Carriers Report Higher Claims Severity as Medical Inflation, Litigation Trends and AI Fraud Increase Complexity
A new industry report indicates that insurance carriers across North America are facing higher claims complexity and rising costs. Medical inflation,...
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United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing
The U.S. Attorney’s Office for the District of Maryland (USAO-MD) announced that it obtained a judgment of $1,407,493.23 against Dr. Richard Akoto,...
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California Behavioral Medicine Provider Agrees To Pay $2.75 Million To Resolve Alleged False Claims For Psychotherapy Services
American Psychiatric Centers, Inc., doing business under the name Comprehensive Psychiatric Services (CPS), has agreed to pay $2.75 million to resolve...
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America’s biggest pharmacy chain slapped with massive penalty over fraud
A federal judge has ordered CVS Health’s pharmacy benefit manager, Caremark, to pay nearly $290 million after a whistleblower accused the...
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AG Yost sues two home remodeling contractors
Lawsuits have been filed against two contractors who tried to fleece consumers, Ohio Attorney General Dave Yost announced today. The lawsuits...
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Gilead Sciences, Inc. to Pay $202 Million to Resolve Kickback Allegations on HIV/AIDs Drugs
The State of Alaska has joined with other states and the federal government to reach an agreement with Gilead Sciences, Inc....
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GEICO pursues $2.2 million fraud claims in New York lawsuit
A leading auto insurer is suing to recover nearly $800,000, alleging a sweeping fraud scheme involving no-fault insurance claims and medical...
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Tri-Cities Urgent Care Clinic Agrees to Pay $2.8 Million to Resolve Claims of Overbilling for Diagnostic Tests
United States Attorney Pete Serrano announced that Health First Urgent Care, an urgent care clinic with locations in Richland and Pasco,...
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Fifth Circuit Decision in Health Care Fraud Case Highlights Importance of Careful Drafting in Civil RICO Complaints
What You Need to KnowKey takeaway #1 Insurers and other health care payors often use RICO to pursue claims against providers...
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Former NASCAR champion Kyle Busch settles $8.5M lawsuit against life insurance company
Two-time NASCAR champion Kyle Busch and a life insurance company have settled an $8.5 million lawsuit in which the driver said...
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