AdventHealth Lawsuit: Verdicts, Settlements, and Antitrust Cases

AdventHealth lawsuits over the past decade span both sides of the courtroom: a $5.7 million wrongful death verdict against one of its Kansas hospitals in 2025, a $115 million federal False Claims Act settlement in 2015, an antitrust suit the health system filed against claims repricer MultiPlan, and an active billing dispute accusing Blue Cross and Blue Shield of Kansas City of using artificial intelligence to wrongly deny inpatient claims. Smaller matters include an $807,000 settlement with federal regulators, a data breach class action, and employment discrimination cases in Kansas.

$5.7 Million Wrongful Death Verdict in Kansas

In June 2025, a Johnson County, Kansas jury awarded Christopher Yates $5.7 million after finding two medical professionals at AdventHealth Shawnee Mission at fault for the death of his wife, Kim Yates. The Greater Kansas City Jury Verdict Service reported it as the largest wrongful death or medical negligence verdict in Johnson County history.¹

Kim Yates was brought to the emergency department on April 11, 2021, after an attempted suicide. A licensed professional counselor and a nurse practitioner evaluated her, deemed her high-risk for suicide, and discharged her with a safety plan rather than admitting her for inpatient behavioral health treatment. She died by suicide three days later using the same method her husband had previously observed.²

The trial turned in part on how long the clinical evaluation actually took. The counselor testified it lasted two to three hours. Plaintiff’s attorneys countered with badge access logs and video footage indicating 29 minutes or fewer. The defense argued the providers met the standard of care and that Kim Yates had not been truthful about her suicidal thoughts.²

Of the $5.7 million, $1 million was designated for noneconomic damages. Kansas caps noneconomic damages in wrongful death cases at $250,000, so $750,000 of that portion will be reduced unless the cap is successfully challenged. The plaintiff’s attorneys said they intend to challenge the cap’s constitutionality if AdventHealth appeals. As of mid-2026, no appeal had been publicly reported.²

Antitrust Suit Against MultiPlan

In August 2023, AdventHealth sued MultiPlan in the U.S. District Court for the Southern District of New York, alleging violations of Section 1 of the Sherman Act. MultiPlan reprices out-of-network medical claims on behalf of insurers, and AdventHealth’s complaint described a “multi-year, ongoing conspiracy” it labeled the “MultiPlan Cartel.”³

The complaint named seven insurers as participants: Aetna, Elevance Health, Centene Corporation, Cigna Group, Health Care Service Corporation, UnitedHealth Group, and Humana. AdventHealth alleged MultiPlan used confidential claims data from these competing insurers to generate artificially low reimbursement offers, leaving providers little practical choice but to accept them. The filing cited an analyst’s characterization of MultiPlan as acting “like a mafia enforcer for insurers.”⁴

AdventHealth framed the case as a “hub-and-spoke” conspiracy, with MultiPlan as the hub, insurer contracts as the spokes, and uniform repricing methodology as the rim. By 2020, the complaint said, MultiPlan was repricing roughly 370,000 out-of-network claims per day for more than 700 insurers, producing about $19 billion in annual underpayments to providers. AdventHealth sought hundreds of millions in damages and a permanent injunction against MultiPlan’s contracting model. MultiPlan called the suit “meritless” and “baseless.”³

In 2024, the U.S. Judicial Panel on Multidistrict Litigation consolidated the growing set of provider suits into In re MultiPlan Health Insurance Provider Litigation (MDL No. 3121), assigned to Judge Matthew F. Kennelly in the Northern District of Illinois.⁵ The MDL eventually grew to include more than 100 provider lawsuits from chiropractic groups, state medical associations, and major health systems.⁶ The American Hospital Association and the Federation of American Hospitals filed an amicus brief supporting the providers, pointing to hospital Medicare margins of negative 12.6% in 2024.⁷

On June 3, 2025, Judge Kennelly largely denied the defendants’ motions to dismiss, upholding nearly all the federal and state antitrust and consumer protection claims. Only the state law unjust enrichment claims were dismissed. The court rejected arguments that the providers lacked antitrust standing and found the plaintiffs had plausibly alleged a relevant product market and a hub-and-spoke conspiracy. The case then moved into fact discovery.⁸

Suit Against Blue Cross Blue Shield of Kansas City Over AI Claim Denials

In May 2025, AdventHealth Shawnee Mission sued Blue Cross and Blue Shield of Kansas City in Missouri state court, alleging the insurer improperly withheld more than $2 million by denying hundreds of inpatient claims through what the hospital called flawed “clinical validation” audits. The case was removed to the U.S. District Court for the Western District of Missouri in early July 2025.⁹

The complaint focuses on Blue KC’s use of two third-party vendors, Cotiviti and Apixio, to retrospectively review inpatient diagnoses for conditions such as malnutrition, respiratory failure, and sepsis. AdventHealth alleged that Apixio, hired in early 2024, uses artificial intelligence in its reviews and deemed 60% of inpatient diagnoses “clinically invalid,” a figure the hospital called “staggering and deeply flawed.” The suit pointed to more than 350 instances where Blue KC rejected diagnoses as unsupported, targeting claims with comorbidities tied to higher reimbursement.¹⁰⁹

AdventHealth alleged the vendors bypass standard medical review safeguards, fail to consult physicians, and disclose little about reviewer qualifications or how AI is applied. The hospital sought a court order stopping the audits, payment of the denied claims, and damages, arguing the denials violate the parties’ provider agreement and state and federal law. A protective order was granted in November 2025, and a jury trial was scheduled to begin November 2, 2026.¹¹

$115 Million False Claims Act Settlement

In 2015, Adventist Health System agreed to pay more than $115 million to settle allegations brought by the U.S. Department of Justice under the False Claims Act and the Stark Law. The government alleged that AdventHealth-affiliated hospitals in Florida, North Carolina, Tennessee, and Texas maintained improper compensation arrangements with physicians, paying bonuses tied to the volume of tests and procedures ordered.¹²

Examples cited in the case included a family practitioner earning a $366,000 base salary reportedly double the local rate, a dermatologist making $710,000 annually while working three days per week, and a surgeon whose BMW and Mustang leases were covered by the hospital. The settlement referenced practices at Adventist’s Park Ridge hospital in Hendersonville, North Carolina, among other facilities.¹³

The case began as a whistleblower suit filed by four employees under the False Claims Act’s qui tam provisions: a chief operating officer of physician enterprises, a risk manager, an executive director of physician services, and a compliance officer. The DOJ later joined. Adventist Health System admitted no liability.¹²

Other Legal Matters

$807,000 OIG Settlement

In July 2022, AdventHealth Medical Group (operating as Florida Hospital Medical Group) agreed to pay $807,255.95 to resolve allegations it submitted claims for procedures a physician did not actually perform, including pulmonary surgery, laparoscopic surgery, hiatal hernia repair, rib resection, and thoracoscopy. The matter came to light through a self-disclosure to the HHS Office of Inspector General.¹⁴

Data Breach Class Action

In September 2021, Advent Health Partners detected a breach of its email systems that exposed personal information for 61,072 people, including Social Security numbers, dates of birth, health insurance data, medical records, and financial account information. The class action McHenry v. Advent Health Partners, Inc., filed in the Middle District of Tennessee, settled with a $500,000 fund providing up to $750 for ordinary losses and up to $5,000 for extraordinary losses such as identity theft, plus three years of credit monitoring. Advent Health admitted no wrongdoing, and the settlement received final approval in 2023.¹⁵

Note that Advent Health Partners is a separate entity from AdventHealth’s hospital operations, though the name closely resembles it.

Employment Discrimination Cases

In October 2024, a federal judge in Kansas issued a split ruling in Moussa v. Advent Health South Overland Park, Inc. Natalie Moussa, an emergency room nurse of Egyptian descent, alleged discrimination, hostile work environment, and retaliation under Title VII. The court dismissed the discrimination and retaliation claims, finding the alleged discriminatory comments were too remote or made by non-decisionmakers and that her workplace complaints did not constitute protected activity. The hostile work environment claim was allowed to proceed based on pervasive harassment tied to national origin or color.¹⁶

Sluder v. Advent Health, an ADA employment case filed in December 2025 in the District of Kansas, later substituted Shawnee Mission Medical Center, Inc. as the defendant. As of mid-2026 the case was in discovery with mediation scheduled and a jury trial expected to last four to five days.¹⁷

North Carolina Certificate of Need Dispute

AdventHealth spent years fighting to build a new hospital near Weaverville in Buncombe County, North Carolina. The state awarded a Certificate of Need for 67 beds in 2021, but HCA Healthcare, which operates Mission Health in the region, challenged the approval through multiple appeals. In December 2025, the North Carolina Supreme Court rejected HCA’s appeal, clearing AdventHealth to build. Construction is underway on the 67-bed facility.¹⁸¹⁹ A separate appeal involving 26 additional beds at the same facility remained active as of mid-2026, and AdventHealth is competing against HCA, UNC Health, and Novant Health for 129 additional beds announced in the summer of 2025.

1
Johnson County Post. Johnson County Family Lawsuit With AdventHealth
2
The Kansas City Star. AdventHealth Shawnee Mission Wrongful Death Verdict
3
Fierce Healthcare. MultiPlan’s Contracts Are ‘Mafia Enforcer’ for Insurers, AdventHealth Alleges in Antitrust Lawsuit
4
Healthcare Dive. False Claims Allegations Result in $115M Price Tag
5
U.S. Judicial Panel on Multidistrict Litigation. MDL-3121 Transfer Order
6
Becker’s Payer Issues. What To Know About MultiPlan’s Litigation Saga
7
American Hospital Association. AHA Amicus Brief Challenges MultiPlan Inc. Motion to Dismiss Antitrust Litigation
8
Legalink. Federal Court Permits MultiPlan Antitrust MDL to Proceed
9
The Kansas City Star. AdventHealth Sues Blue Cross Blue Shield Kansas City
10
Becker’s Payer Issues. AdventHealth Hospital Sues BCBS Kansas City Over Clinical Validation Audits
11
Justia Dockets. Shawnee Mission Medical Center Inc. v. Blue Cross and Blue Shield of Kansas City
12
Healthcare Finance News. Adventist Health System to Pay $115 Million to Settle Suit Over False Claims
13
Bricker Graydon. The DOJ Announces Huge False Claims Act Settlement With Adventist Health System
14
HHS Office of Inspector General. AdventHealth Medical Group Agreed to Pay $807,000
15
HIPAA Journal. Advent Health Partners Proposes $500,000 Settlement to Resolve Class Action Data Breach Lawsuit
16
Schragon Law. Court Splits Decision on Nurse’s Discrimination Claims, Moussa v. Advent Health S. Overland Park Inc.
17
PACER Monitor. Sluder v. Advent Health
18
BPR. AdventHealth: High Court Won’t Hear Key Appeal on New Buncombe Hospital
19
AdventHealth. Breaks Ground on New Weaverville Hospital, Expanding Access to Care in Western North Carolina