Corporate investigations archive

Insurance Executives Refused to Pay for the Cancer Treatment That Could Have Saved Him. This Is How They Did It.

This story was originally published by ProPublica. Forrest VanPatten was 50 and strong after years as a molten-iron pourer when he learned in July 2019 that a hyperaggressive form of lymphoma had invaded his body. Chemotherapy failed. Because he was not in remission, a stem cell...

Nov 15, 2023 Read Now >

AirSculpt: Patient Died From Complications During Liposuction Procedure, Company Concealed Patient Death; Public Awareness Could Negatively Affect Company

A 37-year-old mother of two walked into a San Diego AirSculpt (AIRS) office last October for abdominoplasty and gluteoplasty with liposuction. The woman had been sold on the promise of AirSculpt—advertised as a noninvasive alternative to traditional liposuction that claims to deliver...

Nov 10, 2023 Read Now >

Labcorp: The Invisible Workers Keeping Our Healthcare System Alive Are Reaching a Breaking Point

This piece is published in collaboration with 404 Media. Somewhere in the bowels of a Labcorp drug testing facility in Madison, Wisconsin, which one worker described to me as “the bunker,” is a severed human finger encased in wax. The finger, which workers presume was once attached to...

Nov 09, 2023 Read Now >

ODDITY: Beauty Tech Company’s Product Marketing Based on Artificial Intelligence Claims Called into Question

Beauty and wellness product company ODDITY (ODD), which markets itself as a consumer technology firm that uses artificial intelligence to match shoppers with personalized skin, hair and anti-aging products, may be overstating the capabilities of that technology, a Capitol Forum...

Oct 27, 2023 Read Now >

InnovAge: After CMS Lifted Sanctions, Company Cut Large Portions of Compliance and Quality Departments; Former Employees Say Cuts Will Only Exacerbate Ongoing Patient Harm; Company Already Out of Compliance with Multiple Regulations, Increasing Likelihood of Additional Sanctions

A few months after CMS and state regulators lifted sanctions against InnovAge (INNV), the country’s largest operator of PACE healthcare programs for low-income seniors, the company fired large portions of staff in its compliance, quality, and nursing departments. The company also began...

Oct 26, 2023 Read Now >

Medtronic: Recalled Defibrillators Continue to Generate Adverse Event Reports; MAUDE Data Indicates Device Problems Persist Despite Recall

More than a year after medical device maker Medtronic (MDT) notified customers of life-threatening defects in its implantable cardiac defibrillators—a warning that was later classified by the Food and Drug Administration as its most serious type of recall—hundreds of reports of...

Oct 13, 2023 Read Now >

InMode: Pricing Flexibility of Products Raises Questions Regarding Statements to Investors and Margin Consistency

InMode (INMD), a manufacturer of aesthetic medical devices, has consistently posted gross margins of roughly 85% over the last several years, a figure that CEO Moshe Mizrahy has said is an absolute necessity for the company. In 2021, Mizrahy told investors that 85% gross margins are “a...

Oct 12, 2023 Read Now >

Corcept Therapeutics: VA Prescriptions Fall Off for ‘Lack of Therapeutic Response;’ VA OIG Conducted Independent Assessment of Prescriptions at Orlando VA System

Prescriptions for Korlym, the only drug sold by Corcept Therapeutics (CORT), at VA hospitals has fallen by roughly 90% since 2018, according to a Freedom of Information Act request by The Capitol Forum. That steep drop-off comes after a previously-undisclosed VA Office of Inspector...

Sep 28, 2023 Read Now >

ZoomInfo: Repeated Processing of Personal Information Raises Questions About Company’s GDPR Compliance

ZoomInfo (ZI), a creator and aggregator of profiles for business professionals, has been repeatedly processing and selling the personal information of at least one individual covered by the United Kingdom’s General Data Protection Regulations (UK GDPR), in violation of the...

Sep 27, 2023 Read Now >

Evolv Technology: Claims Made in Connection With Sales of Weapons Detection Systems Appear to Overstate Capabilities, Potentially Exposing Company to FTC Action

Security screening company Evolv Technology (EVLV) may be overstating the capabilities of its walk-through metal detectors, which the company markets as faster and smarter than competitors—claims that have been called into question by customers and an industry research group, raising...

Sep 22, 2023 Read Now >

InMode: Sales Meeting Recording Details Importance of Morpheus8V Sales to OBGYNS Even Though Company Does Not Have FDA Approval for Treatment of Stress Urinary Incontinence

In audio recordings from a February sales conference, Dr. Spero Theodorou, Chief Medical Officer of InMode (INMD), told sales representatives to sell a device that he acknowledged did not have FDA approval to treat stress urinary incontinence (SUI) to OBGYNs because it was a “Trojan...

Sep 18, 2023 Read Now >

Medtronic: Class Action Filed Over Recalled Defibrillators; Devices Continue to Produce Adverse Event Reports, Including Deaths and Injuries, in FDA Data

Implantable cardiac defibrillators sold by medical device maker Medtronic (MDT), some of which have been recalled since August of 2022, continue to generate a high volume of reports of adverse events to the Food and Drug Administration, a Capitol Forum review of report data has found. The...

Sep 14, 2023 Read Now >

LifeStance: Company Imposed Restriction on New TRICARE and Anthem Patients in Some California Locations, but Misled Payer Representatives and Patients into Believing Appointments Could be Scheduled

Payers that contract with LifeStance Health (LFST) frequently send questionnaires to LifeStance to inquire about provider and appointment availability for a specific insured member who needs mental health care. But in the case of TRICARE and Anthem Blue Cross Blue Shield in certain...

Aug 24, 2023 Read Now >

AAON: Sales Concentration with Texas AirSystems and Meriton Raises Red Flags, Potentially Requiring Additional Disclosures

AAON Inc. (AAON), a large manufacturer of ventilation and air conditioning equipment for both commercial and residential use, discloses in its SEC filings that its customer Texas AirSystems LLC accounted for “more than 10% or more of its sales during 2022, 2021 and 2020” and accounted...

Aug 24, 2023 Read Now >

Khan Outlines FTC Support for Employees to Report Harassment Following Allegations Against Wright

This article has been updated slightly for clarity. FTC Chair Lina Khan, in the wake of allegations made against former Commissioner Joshua Wright, outlined steps this week that agency employees can take to report sexual harassment. In a memo yesterday to agency staff and her fellow...

Aug 16, 2023 Read Now >

Fiserv: California State Legislator’s Office Investigating Award of Two Additional Contracts to Money Network After Problems With Middle Class Refund Program

Money Network Financial—a subsidiary of global fintech and payments company Fiserv (FI)—last year was awarded a contract by California’s Franchise Tax Board to administer the state’s middle class tax refund, consisting of over $9 billion to be disbursed to over 32 million eligible...

Aug 14, 2023 Read Now >

Medtronic: Device Incident Data Differs from Company’s Figures in Recall of Implantable Cardiac Defibrillators, Raising Questions About Company’s Calculations

After a series of recalls of implantable cardiac devices sold by medical device maker Medtronic (MDT), a Capitol Forum review of device incident data suggests that there may be more adverse events associated with the defibrillators than the company has identified in its recalls due to the...

Aug 08, 2023 Read Now >

Citigroup: DOJ Investigating Possible Race Discrimination in Mortgage Lending

The Department of Justice is looking at whether Citigroup (C) discriminated against Black and Hispanic homebuyers in recent years, at a time when the nation’s third-largest bank was struggling to satisfy federal banking rules, according to sources familiar with the matter. A national...

Jul 21, 2023 Read Now >

Encompass Health: Former Employees Raise Concerns Regarding Enrollment Practices and Compliance with Medicare Requirements

For Medicare to pay for inpatient rehabilitation, patients must be diagnosed with at least one of 13 possible conditions and must be able to show a need and capability to undergo intensive rehabilitation for at least 15 hours per week. Medicare also requires that the assessment, known as...

Jul 20, 2023 Read Now >

How Often Do Health Insurers Say No to Patients? No One Knows.

This article is being published in partnership with ProPublica. This joint investigation won Silver in the Barlett & Steele Awards, which recognize excellence in investigative business journalism. It’s one of the most crucial questions people have when deciding which health plan to...

Jun 28, 2023 Read Now >

LifeStance: Company Creates Barriers to Mental Health Treatment, Cancels Appointments When Patients Refuse to Pay Amounts They Don’t Owe

LifeStance Health (LFST), a nationwide roll up of outpatient mental health clinics, has, in at least some clinics, installed gatekeepers who demand patients pay whatever the company’s error-ridden billing system shows as outstanding—even if it’s wrong—as a precondition to seeing...

Jun 27, 2023 Read Now >

iRhythm: FDA Publishes Warning Letter to Company Citing Several Problems with Labelling and Data Storage, Potentially Paving Path for Recall

Earlier this morning, the FDA published a lengthy warning letter the agency had sent to heart monitoring company iRhythm (IRTC) regarding the marketing of its Zio AT System as providing “near real-time monitoring” for immediate monitoring of “high-risk patients.” However, as the...

Jun 06, 2023 Read Now >

Natera: Response to Public Records Request Suggests Kentucky Attorney General’s Investigation into Natera Has Progressed

The response to a recent records request by The Capitol Forum to the Kentucky Attorney General suggests that the agency’s investigation into genetic testing company Natera (NTRA) has progressed over the last three months, with the agency gathering evidence and potentially preparing for...

Jun 05, 2023 Read Now >

InMode: Former Sales Employees Detail Relationship with Financial Partners Group

Former sales employees of InMode (INMD), a manufacturer of medical aesthetic devices, tell The Capitol Forum that the company had a “hand in glove” relationship with Financial Partners Group (FPG), a broker that arranged financing for purchases of InMode devices by clinics and med...

May 26, 2023 Read Now >

Zynex: Company’s Accounting Practices Raise Red Flags, According to Accounting Experts

The accounting practices of Zynex (ZYXI), a manufacturer of electrotherapy devices for pain management, are raising red flags with finance experts who questioned how the company is accounting for adjustments, allowances, and nonpayment of the claims it submits to insurers. According to...

May 24, 2023 Read Now >

LifeStance Health: Vulnerable Mental Health Patients Burdened with Unwarranted Medical Debt from Company’s Billing Practices, Errors, and High Fees

In October, the Better Business Bureau submitted a written request to LifeStance Health Group, Inc. (LFST), a publicly traded, private equity-backed company that owns or manages hundreds of outpatient mental health facilities across 33 states, encouraging LifeStance to address a pattern...

May 19, 2023 Read Now >

Congressional Committee, Regulators Question Cigna System that Lets Its Doctors Deny Claims without Reading Patient Files

This article is published in partnership with ProPublica. This joint investigation won Silver in the Barlett & Steele Awards, which recognize excellence in investigative business journalism. A key congressional committee asked insurance giant Cigna on Tuesday to provide corporate...

May 16, 2023 Read Now >

Zynex: Company Overbilling Federal TRICARE Program for Electrodes; Practice Mirrors 2018 DOJ False Claims Act Settlement

Zynex Medical (ZYXI), a manufacturer of electrotherapy devices for pain management, is overbilling TRICARE, the military health program for active-duty soldiers and their family members, for millions of dollars in unnecessary supplies for its devices, according to a Capitol Forum...

May 11, 2023 Read Now >

TD Bank/First Horizon: CEO Met With Top Bank Examiner Days After Deal Delay Announced, Document Shows

Days after the head of Toronto-Dominion Bank (TD) declared he was “fully committed” to his company’s proposed acquisition of First Horizon Bank (FHN), he met with senior officials of one U.S. regulator that will decide whether the $13.4 billion deal goes ahead, according to an...

May 04, 2023 Read Now >

CFPB March Complaint Data: Total Monthly Complaints Hit 12 Month High as Bureau’s Policy Statement on Abusive Acts or Practices Appears to Signal Paradigm Shift, Prioritizing Fair Dealing Over Consumer Sovereignty

Total monthly complaints submitted by consumers to the CFPB rose to 112,600 in March 2023, reflecting an approximately 30% increase from February and the highest total number of complaints over the past twelve-month period, as measured by The Capitol Forum. The categories with the largest...

Apr 20, 2023 Read Now >

The Beauty Health Company: Syndeo Defects, Company Policies Frustrate Machine Users

The Beauty Health Company (SKIN), maker of the HydraFacial skincare device and products, has clamped down on chatter among frustrated estheticians who recently took to a Facebook group page to voice concerns about defective HydraFacial machines and to discuss potential competitor...

Apr 13, 2023 Read Now >

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

This article was published in partnership with ProPublica. This joint investigation won Silver in the Barlett & Steele Awards, which recognize excellence in investigative business journalism. When a stubborn pain in Nick van Terheyden’s bones would not subside, his doctor had a...

Mar 25, 2023 Read Now >

InMode: Company Only Recently Began Submitting Required Malfunction and Injury Reports to FDA

Prior to last month, InMode (INMD), a manufacturer and vendor of aesthetic medical devices, had not been submitting mandatory reports to the Food and Drug Administration regarding injuries and malfunctions stemming from the use of its devices, according to a Capitol Forum analysis of an...

Mar 10, 2023 Read Now >

Xponential: Sales Pitch to Some Former Franchisees May Have Violated Franchise Disclosure Rules

Fitness franchisor Xponential (XPOF) in some cases appears to provide financial projections as part of its sales pitch to prospective franchisees beyond those contained in its franchise disclosure documents—a potential violation of federal franchise rules—according to interviews and...

Mar 10, 2023 Read Now >

CMS Policy: Advance Notice Appears to Target Lucrative Diagnosis Codes Previously Used by Companies Like Signify and Oak Street Health

The Centers for Medicare and Medicaid has proposed changes to the risk adjustment model that will reduce or eliminate some of the extra money the agency pays to Medicare Advantage plans to manage and treat certain chronic conditions. In focus are certain inappropriate coding...

Mar 03, 2023 Read Now >

Federal Reserve Taps Amazon for New Payments Project; Lawmakers Calls for Scrutiny

The Federal Reserve has tapped Amazon (AMZN) to provide data storage for an ambitious new payment system, according to sources familiar with the matter. The move could increase political pressure to put the tech giant under the watch of U.S. financial system regulators. The new...

Feb 24, 2023 Read Now >

FleetCor: Company and FTC Unable to Come to Agreement on Injunctive Relief Order; Judge Asks Parties to Answer Questions Ahead of Potentially Issuing Order

After initially trying to get the Federal Trade Commission and FleetCor (FLT) to reach an amicable decision on the scope of an order for permanent injunction and other relief, federal district court judge Amy Totenberg may be forced to issue an order, as the parties appear to remain far...

Feb 22, 2023 Read Now >

The Beauty Health Company: Syndeo Problems Persist After Rushed Rollout of Machine

Almost one year since The Beauty Health Company (SKIN) rolled out its new RFID-enabled facial machine, Syndeo, problems with the device that were previously reported by The Capitol Forum persist and appear to be getting worse. The Capitol Forum has learned that facialists who bought the...

Feb 17, 2023 Read Now >

Xponential: Some Franchisees Say They Struggle to Make Business Model Work at Franchised Locations; Company Potentially Obfuscates Franchise Failure Rate in Disclosure Documents

Fitness franchisor Xponential (XPOF), whose brands include Club Pilates, Pure Barre and Cycle Bar, touts that it has never had a studio go out of business, even in the midst of pandemic restrictions that temporarily shut down exercise facilities and scared customers away from gyms. The...

Feb 15, 2023 Read Now >

Pediatrix: Halt of Arbitration Payment Determinations Could Delay Company’s Collection of Disputed Payments

In response to a Texas Federal District Court decision vacating certain No Surprises Act implementation rules, the Centers for Medicare and Medicaid Services last week paused the issuance of all new No Surprises Act arbitration payment determinations and recalled all determinations issued...

Feb 15, 2023 Read Now >

Natera: Kentucky AG Investigation Ongoing; Public Records Request Indicates AG Formulating Policies, Official Actions

A response to a public records request from the Kentucky Attorney General indicates that the office may be formulating policy recommendations in regard to its active criminal investigation of the genetic testing company Natera (NTRA). The Capitol Forum has previously reported that Natera...

Feb 06, 2023 Read Now >

“We’re Still Gonna Say No”: Inside UnitedHealthcare’s Effort to Deny Coverage to Chronically Ill Patient

This article is being published in partnership with ProPublica, with ProPublica’s David Armstrong and Maya Miller and The Capitol Forum’s Patrick Rucker contributing. This joint investigation won Silver in the Barlett & Steele Awards, which recognize excellence in...

Feb 02, 2023 Read Now >

Corcept: Use of Charitable Foundations Could Draw DOJ Scrutiny

Corcept Therapeutics Incorporated (CORT) appears to have provided patients with free Korlym or financial assistance through charitable foundations to give them access to the company’s expensive flagship drug. After those people got access to the drug, the company aggressively pushed...

Jan 24, 2023 Read Now >

Zynex: Company Improperly Billing Worker’s Compensation Funds for TENS Devices; Practices Strikingly Similar to Competitor Being Sued by 28 Liberty Mutual Insurers

A Capitol Forum investigation has uncovered extensive issues regarding the billing practices of the medical device company Zynex (ZYXI), with these issues ranging from the use of improper billing codes to shipping large quantities of unnecessary supplies to patients. These issues bear...

Dec 21, 2022 Read Now >

Procept Biorobotics: UnitedHealthcare Commercial Policy Effective December 1, 2022, Reiterates Aquablation as Unproven and Not Medically Necessary Due to Insufficient Evidence of Safety and/or Efficacy

UnitedHealthcare (UNH), the largest insurer in the country, recently released its prostate surgeries and interventions commercial medical policy effective December 1, 2022. The policy reiterates the insurer’s prior view that aquablation, which uses a high pressure saline solution to...

Dec 13, 2022 Read Now >

InMode: Company Misrepresents Licensing Requirements and Earnings Potential when Selling Devices to Doctors, According to Former Sales Representatives

InMode (INMD), a manufacturer of aesthetic medical devices, often does not tell doctors interested in purchasing their products about the additional licensing requirements needed to operate the devices, according to former company sales representatives. The omission, the former employees...

Dec 09, 2022 Read Now >

Corcept: DOJ Investigation may Involve Off-Label Marketing of Flagship Drug; Source says Potential Promotion for Off Label use Continues

Drug manufacturer Corcept (CORT) disclosed that late last year it received a records subpoena from the U.S. Attorney’s Office for the District of New Jersey, stating that the office was “seeking information relating to the sale and promotion of Korlym, Corcept’s relationships with...

Dec 09, 2022 Read Now >

Natera: Company’s Ties with China’s BGI Genomics Exposes it to Political and Regulatory Risk

Natera’s (NTRA) joint venture with a Chinese genetic testing company that has ties to the People’s Liberation Army could spell issues for the company and raise potential national security and human rights concerns, according to national security experts interviewed by The Capitol...

Dec 07, 2022 Read Now >

The Beauty Health Company: Customers, Former Employees Challenge Company’s Explanation for Slow Growth in Consumables Sales

The Beauty Health Company (SKIN) recently told investors that slow growth in sales of the solutions and serums used in its trademark HydraFacial treatments was due to company giveaways of product with sales of its new Syndeo devices, saying device purchasers are given enough product to...

Nov 23, 2022 Read Now >

Healthcare Policy: DOJ Sues Cigna Over Medicare Advantage Risk Score Adjustments; Alleged Practices Similar to Those Uncovered in Reporting About Oak Street Health and Signify Health

Yesterday, the Department of Justice announced that it had filed a civil lawsuit against Cigna (CI) alleging that the insurer defrauded the Medicare Advantage program out of tens of millions of dollars. The allegations raised by the government are similar to those uncovered by The Capitol...

Oct 18, 2022 Read Now >

EDITOR'S PICKS

Read a selection of our subscriber-only news articles

Corporate investigations | RECENT ARTICLES | EDITOR'S PICKS

FILTER BY