November 2025

Westside Behavioral Care Inc., a Colorado mental health clinic, recently sued Kaiser Foundation Health Plan of Colorado for prematurely terminating its participation agreement. Kaiser terminated the agreement in an effort to increase the provision of services through a less costly telehealth model.

The clinic is alleging that the early termination disrupted care for more than…

The 2025 National Health Care Fraud Takedown, announced in June, was the largest in history, with 325 defendants charged (including 96 providers) in 50 federal districts. In all, the charged schemes involved more than $14 billion in intended loss, and more than $245 million in cash, luxury vehicles, cryptocurrency and other assets were seized. These…

Ransomware cyber attacks have been a prominent threat to the healthcare industry. In this case, First Choice Dental, a large dental practice with multiple locations across Wisconsin, was targeted by hackers in October 2023. The hackers gained access to sensitive information including patient names, dates of birth, Social Security numbers, passport numbers, driver’s license numbers…

In October, two medical transportation companies were charged with or indicted for fraud in New York.   

The owner of Pearl Transit Corp. (“Pearl”), Jael Watts, was accused of running a sham transportation service that supposedly provided rides for persons with disabilities and seniors in Westchester, Putnam, Rockland, and Suffolk counties. In 2024, the…

The New York Attorney General’s Office imposition of a $250,000 penalty on MVP Health Care for maintaining an inaccurate mental health provider directory riddled with “ghost” providers was recently discussed here. The problem, however, extends beyond New York. The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a…