Director of Communications at @UnitedHealthGrp covering health care news. Formerly @FierceHealth. Opinions all mine. DMs open.
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Articles by Evan Sweeney
Delaware Court Greenlights Earnout Manipulation Claims
In a decision with implications for M&A deal structuring, the Delaware Superior Court’s Complex Commercial Litigation Division, in Prosser, et al. v. Pharmalogic Holdings Corp., allowed sellers to proceed with a breach of contract claim alleging that a buyer deliberately manipulated operations to avoid triggering a $6.6 million earnout payment. The decision underscores that courts may look beyond the face of routine business decisions when the timing and circumstances suggest possible bad faith.
Evan Sweeney Launches The Access Archive Video Series
Author: Evan Sweeney Published: 18 Jul 2026 Publication Type: Announcement Synopsis: This article reports on the launch of The Access Archive, a ten-part digital video series created by writer, consultant, and advocate Evan Sweeney to document adaptive living, barrier-free design, and everyday disabled joy on the community's own terms.
Delaware Supreme Court Holds ERISA Does Not Bar Advancement of Defense Costs for State-Law Claims
On April 13, 2026, the Delaware Supreme Court, sitting en banc, reversed the Court of Chancery and held that Section 1110 of the Employee Retirement Income Security Act of 1974 ("ERISA") does not bar the advancement of litigation expenses from fund assets when such advancement is sought for the defense of state-law claims and is conditioned on a written undertaking to repay. The decision in Invictus Global Management, LLC et al. v.
Delaware Court of Chancery Rejects Corporate Takeover Attempt Based on Fabricated Documents
Delaware Court of Chancery Rejects Corporate Takeover Attempt Based on Fabricated Documents Overview On March 27, 2026, Vice Chancellor Will of the Delaware Court of Chancery issued a post-trial memorandum opinion in Berg v. Bar-Lavi, rejecting the plaintiff's attempt to seize control of Tracki, Inc. through a Section 225 action after finding that the corporate documents underlying his ownership claim were fabricated.
Delaware Supreme Court Affirms Use of Post-Demand Evidence in Section 220 Actions to Inspect Corporate Books and Records
In a closely watched en banc decision, Paramount Global v.
Delaware Court of Chancery Interprets Senate Bill 21’s Amended Books and Records Provisions in First Post-Enactment Decision
On December 22, 2025, the Delaware Court of Chancery issued its decision in Moran v. Unation, Inc., providing the first judicial interpretation of the sweeping amendments to Section 220 of the Delaware General Corporation Law enacted through Senate Bill 21 (“SB 21”).
Sixth Circuit protects privileged materials and work product from internal investigations via mandamus and relevance to Delaware law
Earlier this month, the U.S. Court of Appeals for the Sixth Circuit granted FirstEnergy Corporation’s petition for a writ of mandamus and vacated a district court order compelling production of materials generated during two internal investigations conducted by outside counsel in the wake of a high-profile bribery scandal.
As self-insurance market grows, health insurers adapt
As more employers turn to self-funded health insurance plans for flexibility and cost control, health insurance companies are tweaking their business models to adjust, according to Managed Care Magazine. Self-funded plans are particularly popular among larger employers. Statistics show the percentage of employers with 5,000 or more employees that are self-insured has grown to 94 percent in 2015.
Healthcare’s vertical mergers kick-started a massive industry shift in 2018. Will it pay off?
Two massive megamergers in CVS-Aetna and Cigna-Express Scripts dominated the conversation around M&A in healthcare. Regardless of whether you think the mergers will help or hurt consumers, both have sparked a distinct shift across the industry as their competitors searched for ways to keep pace. It also frames 2019 as the year in which five big vertically integrated insurers in CVS, UnitedHealth, Cigna, Anthem and Humana begin to take shape. Combined, the mergers totaled nearly $140 billion.
FierceHealthcare’s 10 most read stories of 2018: Amazon, mergers and more Amazon
It was a wild year for healthcare. Amazon made waves early on with a big, but vague partnership with JPMorgan Chase and Berkshire Hathaway to take on healthcare costs. EHR vendor Allscripts was hit with a ransomware attack that brought down physician practices, and UnitedHealth announced the launch of a new personal health record. Here’s a look at the stories FierceHealthcare readers were drawn to the most this year.
CMS finalizes ACO overhaul, shortening pathway for financial risk | FierceHealthcare
The Centers for Medicare & Medicaid Services (CMS) finalized substantial changes to the Medicare Shared Savings Program (MSSP), an overhaul that will truncate the time that Accountable Care Organizations can remain in one-sided risk models. CMS said the highly-anticipated 957-page final rule (PDF) issued Friday morning "dramatically redesigns" the program to ensure more ACOs in the program take on real risk.
CVS rebuffs oversight monitor as D.C. court reviews Aetna deal | FierceHealthcare
CVS told a D.C. district court on Thursday that a court-appointed monitor is unnecessary to ensure the company keeps Aetna's operations separate as the court reviews the $69 billion transaction. The company argued that voluntary conditions to keep aspects of Aetna's business separate is sufficient during the court's Tunney Act proceeding to evaluate a settlement in which Aetna sold its Part D business to WellCare.
Cigna closes $67B Express Scripts acquisition, promising affordability and choice
Cigna officially absorbed one of the largest pharmacy benefit managers in the country on Thursday, closing its $67 billion purchase of Express Scripts. The acquisition gives Cigna significant leverage in a market in which insurers are increasingly partnering, acquiring or being bought by PBMs. With Express Scripts under its wing, Cigna joins CVS, UnitedHealth and Humana and Anthem as the primary vertically integrated powerhouses in the insurance industry.
Investor suit claims Centene hid $900M tax liability in HealthNet purchase
Insurance giant Centene has been hit with another shareholder lawsuit, alleging company executives concealed financial concerns in its $6.8 billion acquisition of HealthNet. Centene is already the subject of several shareholder lawsuits alleging the company’s top officials knew about HealthNet’s mounting liabilities.
Health IT Roundup—Cerner executive lands at Livongo; Health IT Now blasts info blocking delays | FierceHealthcare
Health IT Now blasts info blocking delays Health IT Now offered up harsh criticism of the Office of the National Coordinator for Health IT's delay on the much-anticipated information blocking rule. Currently, the rule is sitting at the Office of Management and Budget, where it's been for more than 90 days.
Most hospitals still use mail or fax to exchange data
Health systems use numerous methods to exchange patient medical records, but providers continue to rely heavily on the old-fashioned approach of mail or fax, according to new federal data on interoperability. Nearly three-quarters of non-federal acute care hospitals routinely use fax or mail to receive summary of care records from providers outside their system, according to new data released by the Office of the National Coordinator for Health IT.
Cigna-Express Scripts clears final state approval, set to close on Thursday
Cigna and Express Scripts have received approval from the last state necessary to complete their $67 billion merger, setting the stage for the deal to close on Thursday. In a financial filing, Cigna said it received final approval from New Jersey regulators on Tuesday. "All required regulatory approvals now have been received and the parties expect to close the transaction on December 20, 2018, subject to the satisfaction of all other closing conditions," the company stated.
State AGs ask Texas judge to clarify ACA decision as they prepare for appeal
California and 16 other state attorneys general are asking a Texas judge to clarify his ruling on the Affordable Care Act, a procedural move that sets the stage for an appeal. In a filing (PDF), a coalition of Democratic states, led by California Attorney General Xavier Becerra, requested District Judge Reed O’Connor clarify his Dec. 14 ruling that the ACA is unconstitutional due to zeroing out of the individual mandate penalty, which takes effect on Jan. 1.
Providence St. Joseph Health lures another executive from Microsoft
At a time when a number of high-profile healthcare executives are taking jobs at big consumer technology companies, Providence St. Joseph Health has snagged another executive from Microsoft. The Washington-based health system has named B.J. Moore, a 20-year veteran at Microsoft, as its chief information officer effective Jan. 28. At Microsoft, Moore held leadership positions overseeing the company’s cloud and artificial intelligence solutions and Windows platform.
Change Healthcare bolsters existing blockchain platform with PokitDok acquisition
McKesson-owned health IT company Change Healthcare is buying a blockchain startup's assets for an undisclosed sum. Change Healthcare announced its purchase of PokitDok on Tuesday following a report by CNBC that the health IT vendor was in discussions to acquire the company that specializes in blockchain for healthcare. As part of the deal, Change Healthcare purchased the company's intellectual property and the PokitDok team.
Molina, Centene face the greatest financial exposure following ACA ruling
Despite huge financial gains under the Affordable Care Act, most insurers remain insulated from Friday's legal ruling that repeals the law in its entirety, even if it withstands a lengthy appeals process. However, Molina Health and Centene represent two notable exceptions given their heavy investment in the ACA marketplace and Medicaid expansion.
Healthcare is closer to democratizing data. Now it needs to figure out what to do with it
As healthcare organizations share more data with one another, the industry is grappling with a slew of new health IT challenges, including how to make use of newfound data sources and engender trust among patients. That’s according to a new “Health Trends Report” released by Stanford Medicine, the organization’s second report in as many years.
Health IT Roundup—Flatiron Health executive heads to FDA; Jonathan Bush speaks out | FierceHealthcare
FDA recruits Flatiron CMO Flatiron Health’s chief medical officer is heading to the Food and Drug Administration, Forbes reports. CMO Amy Abernethy has been named as the agency’s principal deputy commissioner for food and drugs. Abernethy has been credited with helping Flatiron use EHR data for use in FDA drug approval. The company was purchased by Roche for $1.9 billion earlier this year. The appointment is the highest position at the FDA that isn’t politically appointed.
Teladoc Health CFO resigns amid allegations of misconduct
Teladoc Chief Financial Officer Mark Hirschhorn is stepping down from his position amid allegations that he fed stock tips to a company employee he was having an affair with. Hirschhorn, who also served as Teladoc's chief operating officer, will resign effective Jan. 1, the company announced on Monday. "While this was a difficult decision, it’s the right one for my family and the company," he said in a statement.
Centene wants its PBM to move from rebates to net pricing. That could be the new normal
Massive vertical mergers in healthcare could change the pharmacy benefit manager (PBM) payment model going forward, a shift that could focus on net drug pricing instead of rebates. Several PBMs are already making that transition, and another could be following close behind. Analysts say new consolidated negotiating power will drive changes to PBM models without impacting cash flow.
Texas judge strikes down ACA as unconstitutional, but long legal path remains
A federal district judge ruled struck down the Affordable Care Act on Friday evening, ruling the entire law is unconstitutional and setting up a lengthy legal battle that could ultimately bring the law back to the Supreme Court once more.
HHS to appeal New Mexico court's risk adjustment ruling | FierceHealthcare
The legal fight over Affordable Care Act risk adjustment calculations wages on. The Department of Health and Human Services (HHS) filed its notice to appeal a New Mexico district judge's ruling that the agency’s risk adjustment formula was “arbitrary and capricious.” The agency filed a notice with the U.S. District Court of New Mexico on Friday that it will appeal the judge’s ruling to the U.S. Court of Appeals for the Tenth Circuit.
Cigna-Express Scripts nears finish line with approvals from California and New York
Cigna's $67 billion acquisition of Express Scripts cleared regulatory hurdles in two states on Thursday, putting the deal on pace to close by the end of the year. The mega-merger got critical approvals from California and New York and is now waiting for a final approval from New Jersey. The Department of Justice cleared the deal in September.
Appeals court rules BCBS must face antitrust claims
Blue Cross Blue Shield must face antitrust allegations filed against the insurer by a group of employers and providers, an appeals court ruled this week. The 11th Circuit United States Court of Appeals denied an appeal from the insurance giant after a lower court ruled in April that BCBS must defend itself against allegations it engaged in anticompetitive behavior that violates the Sherman Antitrust Act of 1890.
Express Scripts inks 3-year deal with Walmart
Express Scripts, soon to be under the ownership of Cigna, closed a three-year extension with Walmart on Wednesday to provide members access to the retail giant’s prescription services. The agreement will help both insured and uninsured consumers save on prescription drugs, the companies said in an announcement.
CMS still hasn’t recouped $1.8B in Medicaid overpayments identified in OIG audits
The Centers for Medicare & Medicaid Services (CMS) has failed to recover more than half of the nearly $3 billion Medicaid overpayments identified by auditors over an 11-year period. The main reason for the delay is that the agency’s policy does not include timelines for resolving overpayments when state agencies disagree with auditors’ findings.
Teladoc sued for deceiving investors after report reveals CFO’s misconduct
Teladoc Health has been hit with a class-action lawsuit by shareholders accusing the company and its top executives of violating federal finance laws by hiding company information from investors. The lawsuit, filed on Wednesday, comes on the heels of an investigative report by the Southern Investigative Reporting Foundation (SIRF) that detailed one senior executive’s sexual relationship with a subordinate that included bouts of insider trading.
Athenahealth customers nervous about the future following private equity takeover
The foyer of Athenahealth’s Watertown, Massachusetts, headquarters features an unusually constructed staircase designed with intermittently elongated steps. It’s a purposeful design quirk conjured up by former CEO and founder Jonathan Bush, who wanted it to serve as a reminder to his employees to be attentive to details and think about where you’re walking, according to Aaron Miri, chief information officer of Dell Medical School at The University of Texas at Austin.
ACOs saved Medicare $2.7B to date, outpacing CMS estimates
Accountable care organizations in the Medicare Shared Savings Program (MSSP) have saved Medicare $2.7 billion to date, including $859 million in 2016, according to a new analysis from the National Association of ACOs (NAACOS). The latest financial data outpaces calculations by the Centers for Medicare & Medicaid Services (CMS) which says ACOs saved $1.6 billion between 2013 and 2016.
Azar assures HIV patients ‘protected class’ proposal won’t cut off access to drugs
Department of Health and Human Services Secretary Alex Azar assured the HIV community on Tuesday that new proposals around Medicare Part D would not cut off critical access to lifesaving medications. In a speech at the 2018 National Ryan White Conference on HIV Care and Treatment in Maryland, Azar said the administration’s recent proposal to allow Medicare Part D plans to negotiated better prices for drugs in “protected class,” would not limit access to antiretrovirals used to treat HIV.
DOJ joins lawsuit accusing Sutter Health of Medicare Advantage fraud
Federal prosecutors have intervened in a newly unsealed whistleblower lawsuit accusing Sutter Health of submitting unsupported diagnosis codes to Medicare Advantage plans that generated inflated payments. The lawsuit comes weeks after DaVita's medical group paid $270 million to resolve similar allegations.
ONC focused on privacy and usability in new app-based healthcare ecosystem
The Trump administration’s top health IT official told lawmakers his agency is acutely focused on ensuring that privacy and security remain pillars of future rulemaking as the healthcare industry transitions to an app-based economy.
UnitedHealthcare and Envision extend contract, avoiding coverage lapse for millions
The nation’s largest health insurer and Envision Healthcare have signed an agreement to keep the staffing company in-network, ending a drawn-out dispute between the two companies. The contract renewal with UnitedHealthcare, which was set to expire on Jan. 1, ensures Envision’s 25,000 clinicians across 45 states and the District of Columbia remain in-network.
CMS may narrow its focus on drug costs to Part B | FierceHealthcare
The Trump administration has touted its focus on drug prices, unveiling several policy initiatives over the last year aimed at reducing costs. In 2019, it may begin narrowing its focus to Part B, according to analysts. Recent spending data released by the agency alongside comments suggest that the Centers for Medicare & Medicaid Services (CMS) will target Part B drug spending over Part D, Bernstein analysts wrote in a note to investors on Monday.
Health IT Roundup—Former Constellation Health director arrested; Hospital beds get an upgrade | FierceHealthcare
The former director of a now-defunct revenue cycle management company was arrested by federal authorities in JFK airport over the weekend for his role in a $300 million investment fraud scheme.
EHR integration is the next looming challenge for telehealth vendors
The telehealth industry is riding a wave of satisfaction from healthcare clients that say virtual care vendors are generally worth the money. But a looming challenge around EHR integration could set some companies apart. That’s according to a new analysis released by KLAS Research which evaluates some of the top telehealth companies including MDLive, American Well and Epic. Free Daily Newsletter Like this story?
AMA backs states' suit over association health plans with a warning of fraud
The American Medical Association (AMA) urged a Washington, D.C., district court last week to block a rule finalized by the Trump administration to expand association health plans (AHPs).
Allscripts to net $525M after selling off Netsmart stake
Allscripts said it will make $525 million in post-tax net proceeds after selling off its ownership stake in a behavioral health EHR. The EHR vendor announced on Monday that it signed a definitive agreement to sell its interests in Netsmart Technologies, a company that it invested $52.7 million into in 2016. Allscripts did not disclose the buyer but promised more information in a forthcoming financial filing.
AHIP says public charge rule will have ‘serious negative consequences’
The industry’s foremost health insurance lobby is pushing back against the Trump administration’s proposed “public charge” rule that it says could have huge economic consequences.
Payer Roundup—Former Aetna CEO talks social issues; ACA enrollment lags | FierceHealthcare
Bertolini: "You can't hide" from social issues Former Aetna CEO Mark Bertolini instituted a policy against giving money to politicians with high marks from the National Rifle Association and called up Senate Majority Leader Mitch McConnell, R-Ky., after the shooting in Parkland, Florida to ask him if he had grandchildren. “I said, I’m really concerned we’re not taking enough action on gun control,’" he told an audience of executives at the WSJ CEO Council this week.
Healthcare spending slows for the second consecutive year, remains at 18% of GDP
Healthcare spending in the United States decelerated once again in 2017 to a growth rate of 3.9%, nearly a full percentage point lower than 2016, according to new statistics released by the federal government on Thursday. It’s the second consecutive year that healthcare spending has slowed, stabilizing healthcare’s share of the nation’s gross domestic product at 17.9%. Healthcare spending totaled $3.5 trillion, or $10,739 per person, and grew at a slightly slower rate of the overall GDP.
OIG fraud recoveries dropped $1.2B this year. That might not be a bad thing
The federal government brought in 30% less in fraud recoveries in 2018 than it did the previous year, thanks to far fewer large settlements. But that could be a net benefit, according to the agency. The Office of the Inspector General recovered $2.9 billion from fraud investigations during fiscal year 2018, according to a semiannual report (PDF) to Congress released this week. That’s a $1.2 billion decline from last year, when the agency pulled in $4.13 billion.
Health IT Roundup—Insurers skirt Texas telehealth law; EHR gag clauses limit research | FierceHealthcare
Most insurers aren't complying with a state law in Texas to post telehealth information. Under a 2017 Texas law, plan sponsors in the state are required to post their telehealth payment policies and services as of January 2018. But a new assessment from the Center for Connected Health Policy found that nine of the 18 plans evaluated were not doing so. The remaining insurers fell into varying degrees of compliance, with Molina and UnitedHealth leading the charge.
After White House interoperability meeting, AMIA’s CEO sees research carve-out in upcoming regulations
A White House-hosted meeting of the minds on interoperability on Tuesday afternoon featured a broad range of industry stakeholders including health IT associations, big tech companies, payers, providers and regulators.
CVS Caremark shifts PBM model to 100% pass-through pricing and focus on net cost
With pharmacy benefit managers industry facing greater calls for transparency, one of the industry's largest players has unveiled a new business model that passes 100% of rebates to plan sponsors.
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