Allstate has filed a lawsuit against Florida chiropractic clinics Ortiz Health and Rehab Center and Align to Shine Chiropractic, alleging a fraud scheme that cost the insurer hundreds of thousands of dollars. The lawsuit claims that the clinics billed for services that were not performed or were medically unnecessary, concealed true ownership to evade licensing requirements and double billed for services that should not be grouped together.

A federal appeals court has upheld the conviction of Stimwave founder and CEO Laura Perryman for health care fraud and conspiracy, finding that errors during her trial were "harmless" in light of overwhelming evidence of fraudulent intent. Perryman was found guilty of misrepresenting a plastic accessory for the StimQ PNS System as a receiver to enable doctors to bill Medicare and other payers more.

Fawaad Welch and Julia Youngblood, a couple from Florida, have been sentenced to a combined nine-plus years in federal prison for defrauding pandemic relief loan programs of $6.1 million. Authorities say that they used false information to apply for the Economic Injury Disaster Loan and Main Street Loan programs through their business, Slipstream Creative, and diverted funds for personal use, including purchasing a home.

West Tennessee Healthcare is piloting Dragonfly Navigate, an AI-driven technology by Xsolis, to streamline hospital discharge processes and reduce unnecessary patient stays. The system alerts case managers to potential delays, such as pending tests or signatures, allowing for more efficient discharge planning. This initiative aims to cut costs, reduce patient risks and improve bed availability. The technology is part of a broader effort to enhance health care efficiency and patient outcomes.

The American Medical Association has released a new toolkit titled "Governance for Augmented Intelligence" to guide health systems in developing AI policies. Created in collaboration with Manatt Health, the toolkit provides an eight-step framework for implementing and managing AI, emphasizing the need to define AI-related terms, articulate risks, and establish governance and oversight structures. AMA survey data reveals a significant increase in AI usage among physicians, with nearly 70% using AI tools in 2024, up from 38% in 2023. The AMA stresses the importance of aligning AI policies with existing policies on antidiscrimination, data security and patient safety.

The CMS will be sending lists to states each month identifying Medicaid and Children's Health Insurance Program enrollees "whose citizenship or immigration status could not be confirmed through federal databases," according to a CMS news release. The CMS has instructed state program administrators to verify the citizenship or immigration status of people on the list and adjust coverage or disenroll ineligible people.