Healthcare Fraud

Disputes over whether automated claim rejections constitute fraudulent misrepresentation of coverage.

State of Alabama et al v. Oxford Emergency Medical Services Inc et al
  1. State of Alabama et al v. Oxford Emergency Medical Services Inc et al
  2. Jurisdiction: United States (October 19, 2018)
  3. DefendantsOxford Emergency Medical Services IncPlaintiffsState of AlabamaProsecutorsSteve MarshallInstitutionsAlabama Attorney General's Office
  4. Case Tags: False Claims Act;Medicaid Fraud;Healthcare Fraud;Government Settlement
Loftus v. Optum Services, Inc.
  1. Loftus v. Optum Services, Inc.
  2. Jurisdiction: United States (March 27, 2026)
  3. VictimsSarah LoftusDefendantsOptum Services, Inc.PlaintiffsSarah LoftusInvestigatorsFederal Trade Commission Bureau of Consumer ProtectionDefense AttorneysMichael D. HatcherPlaintiff AttorneysJonathan C. SingerJudgesJudge Ana C. ReyesInstitutionsUnited States District Court for the District of MinnesotaOptum Services, Inc.UnitedHealth Group
  4. Case Tags: Algorithmic Denial of Care;ERISA Breach of Fiduciary Duty;Healthcare Fraud;Medical Necessity Litigation