Aetna Inc. has agreed to pay $117.7 million to settle claims that the company violated the False Claims Act by submitting, and failing to correct, false diagnosis codes for its Medicare Advantage plan customers in order to boost cash flow from the federal insurance program, the U.S. attorney's office in Philadelphia said Wednesday.
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TOP NEWS

Aetna Will Pay $117.7M To Resolve False Billing Suit

By P.J. D'Annunzio

Aetna Inc. has agreed to pay $117.7 million to settle claims that the company violated the False Claims Act by submitting, and failing to correct, false diagnosis codes for its Medicare Advantage plan customers in order to boost cash flow from the federal insurance program, the U.S. attorney's office in Philadelphia said Wednesday.

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Insurer Can Limit Coverage For Gym's Sex Misconduct Suits

By Mark Payne

A commercial general liability insurer can only owe a maximum of $100,000 in total for abuse alleged in four lawsuits against a gym for a personal trainer's sexual misconduct, a Tennessee federal court ruled, saying that the claims fell under an abuse endorsement.

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Ohio Hospital Defeats DaVita's Dialysis Discrimination Suit

By Hope Patti

An Ohio hospital and its health benefit plan did not discriminate against patients with end-stage renal disease by eliminating in-network coverage for dialysis, a federal court ruled, finding that dialysis provider DaVita Inc. failed to show the plan intended to harm participants.

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Hospital Revenue Co. Not Covered In $8M Loss Suit, AIG Says

By Hope Patti

An AIG unit said it has no duty to defend or indemnify a management company accused of causing $8 million in losses to a South Carolina nonprofit hospital system, telling a Texas federal court that the company knew about the losses before its policy's inception.

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POLICY & REGULATION

DOL Won't Oppose Vacating ERISA Fiduciary Rule In Texas

By Kellie Mejdrich

An insurance trade group challenging the U.S. Department of Labor's regulations expanding the definition of an investment advice fiduciary under the Employee Retirement Income Security Act asked a Texas judge Wednesday to vacate the policies and said the DOL didn't oppose the request.

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LITIGATION

Anthem Beats Lab's $1.9M ERISA Payment Demand

By Brian Steele

Anthem Blue Cross Blue Shield of Connecticut has prevailed in a medical laboratory's $1.9 million contract and ERISA lawsuit over allegations the insurer refused to pay for out-of-network tests.

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Allstate Says Chiropractors Ran 'Personal Injury Mill'

By Gianna Ferrarin

Allstate told a Texas federal court in a lawsuit seeking at least $25.8 million that two chiropractors and their associated healthcare entities operated a racketeering enterprise to make money from automobile accident personal injury settlements.

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Insurer Demands $3.6M Repayment From Conn. City Over Fire

By Aaron Keller

Pennsylvania Manufacturers Association Insurance Co. is asking the city of New Haven, Connecticut, to repay nearly $3.6 million for settling two lawsuits surrounding the deaths of two rooming house residents in a fire, arguing the city breached an agreement to notify the insurer of any litigation.

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BANKRUPTCY

Brief

El Paso Diocese Files Ch. 11 Amid Abuse Litigation

By Ben Zigterman

The Catholic Diocese of El Paso filed for Chapter 11 relief in Texas as it faces 12 pending sexual abuse lawsuits from 18 plaintiffs involving allegations from 1956 to 1982.

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LEGAL INDUSTRY

Sidley Adds Cooley Corporate And Securities Pro In San Diego

By James Mills

Sidley Austin LLP continues expanding its California team, bringing in another Cooley LLP lawyer — this one a corporate and securities expert — as a partner in its San Diego office.

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Holyoak's US Attorney Nomination Advances

By Courtney Bublé

The nomination of Melissa Holyoak, former commissioner of the Federal Trade Commission, to be U.S. attorney for the District of Utah was sent to the full Senate on Thursday.

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Bar Exam Pass Rates Increased In 2025, ABA Says

By Tracey Read

The pass rate for first-time takers who sat for the bar exam rose by more than a percentage point last year over 2024, according to statistics released by the American Bar Association.

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Calif. Bar Says Internal Docs Bolster Claims Against Exam Co.

By Emily Sawicki

The State Bar of California has bulked up its breach of contract and fraud suit against the administrator of its "disastrous" February 2025 bar exam, filing an amended complaint in light of information it says it learned from internal communications unearthed amid discovery.

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Sheppard Welcomes Back Business Litigator In LA

By Christine DeRosa

Sheppard Mullin Richter & Hampton LLP has rehired one of its former business litigators in Los Angeles following his stint as the legal leader of boutique family office Point Break Capital LLC.

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Democrats Seek Review Of Bondi's Role In Brother's Cases

By Alison Knezevich

Two Democratic lawmakers have asked the U.S. Department of Justice's inspector general to review whether Attorney General Pam Bondi "adequately recused herself" from cases involving clients represented by her brother Brad Bondi, who is a partner at Paul Hastings LLP.

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Colo. Lawyer Disbarred For Misusing Client Funds

By Emily Sawicki

A Colorado solo practitioner found to have mismanaged client funds, operated under unclear fee agreements and "ignored" reasonable inquiries from clients has been disbarred and ordered to pay back nearly $12,000 in restitution.

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4th Circ. Scolds Atty Suspected Of Using AI In Race Bias Suit

By Patrick Hoff

The Fourth Circuit has reprimanded an attorney suspected of using generative artificial intelligence to draft briefs in a race discrimination lawsuit against Baltimore Gas and Electric Co., warning that courts need to grapple with the technology as it "may soon become the norm."

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Colo. Law Firm Alleges Personal Injury Firm Owes It $120K

By Rachel Konieczny

A Fort Collins, Colorado, trial law firm alleged in state court that a Denver personal injury firm has not paid it $120,000 in fees the trial firm says it is owed for legal work it performed for the PI firm.

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LAW FIRMS IN TODAY'S NEWS

Bochner PLLC

Cooley LLP

Davis Kessler & Davis

Esbrook PC

FBT Gibbons

Figari & Davenport

Gibson Dunn

Holland & Knight

Hueston Hennigan

Killmer Lane

King & Spalding

Knox Ricksen

Leach & Walker

Loughlin Fitzgerald

Luper Neidenthal

Morrison & Foerster

Nicolaides Fink

O'Melveny & Myers

Parsons McEntire

Paul Hastings

Potomac Law Group

Rocky McElhaney Law Firm

Sheppard Mullin

Sidley Austin

Squire Patton

Stewart Smith

Troutman

Vorys

WilmerHale

COMPANIES IN TODAY'S NEWS

Aetna Inc.

Alabama Policy Institute

American Bar Association

American Council of Life Insurers

American International Group Inc.

Baltimore Gas & Electric Co.

Blue Cross Blue Shield Association

CVS Health Corp.

Cisneros

Cornell University

DaVita Inc.

Genesis Diagnostics

GetixHealth Inc.

Great American Insurance Co.

Hamilton Lincoln

LinkedIn Corp.

Nikola Corp.

State Bar of California

The Cigna Group

Tidelands Health

University of Southern California

GOVERNMENT AGENCIES IN TODAY'S NEWS

Centers for Medicare & Medicaid Services

Equal Employment Opportunity Commission

Federal Trade Commission

U.S. Attorney's Office for the Eastern District of Pennsylvania

U.S. Court of Appeals for the Fourth Circuit

U.S. Department of Justice

U.S. Department of Labor

U.S. District & Bankruptcy Courts of Southern District of Texas

U.S. District Court for the District of Columbia

U.S. District Court for the District of Connecticut

U.S. District Court for the Eastern District of Pennsylvania

U.S. District Court for the Eastern District of Texas

U.S. District Court for the Middle District of Tennessee

U.S. District Court for the Northern District of California

U.S. District Court for the Northern District of Texas

U.S. District Court for the Western District of Texas

U.S. Navy

U.S. Securities and Exchange Commission

U.S. Supreme Court

United States Bankruptcy Court for the Western District of Texas

United States District Court for the District of Colorado

United States District Court for the Southern District of Ohio