Cottrell v Alcon Labs
Will they or will they not allow the case to be heard. The Supremes will vote to either hear this case over the size of eye drops or they won't. The lower courts are split on the issue of whether or not patients can sue the makers of eye drops as to the size of their drops. The class action suit wants smaller drops so they can get more medicine out of vial. Seems stupid but a glaucoma patient can save up to $1100 per year in wasted drops.
Nebraska v Mary Lanning Healthcare
The hospital will pay $688,000 to the state and feds for filing false claims for services provided by a physician who billed for medically unnecessary services.
US v McKesson
The feds and 30 states have filed against the pharm company for extracting excess oncology drugs from single use vials and repacking them for resale. This is a qui tam filed by Omni Healthcare.
US v Davis
John Davis and Brenda Montgomery of Camden, Tennessee, were indicted for kickback Medicare fraud. They were the CEO of Comprehensive Pain Specialists and the CEO of CCC Medical, a DNE company respectfully. It is alleged that Montgomery paid Davis a kickback of the Medicare proceeds for referring patients to the DME company.
US v Khan
Dr. Azad Khan of Villanova, Pennsylvania, was sentenced to 24 months for distributing controlled substances from a clinic owned by Dr. Alan Summers. Dr. Summers and Drs. Keyhosrow Parsia and Clarence Verdell have already pleaded guilty and are awaiting sentencing.
US v Gowder
The past CEO of Union General Hospital in Blairsville, Georgia, John Gowder, and two physicians have been charged with illegal prescribing of pain meds. The feds allege physicians Dr. David Gowder and Dr. James Heaton forged prescriptions and gave them to the CEO who directed employees of the hospital to fill them at various pharmacies and bring the meds to him for resale.
US v Panos
Dr. Spyros Panos, an Orthopod in Duchess County, New York, surrendered his license to practice in 2013 and at the same time pled guilty to health care fraud. He was sentenced to prison and then released in 2016. In December 2013, a company was formed by a Panos family member who is not a physician. The company took in several hundred thousand dollars in fees for doing IME evaluations for Worker Compensation record review. After Panos got out of prison a second company came into being by the same family member and collected over a half million dollars for the reviews. Money was transferred from that account to a family account. The physician whose identity was used to do the reviews says he never did them and never have any information to Panos or the company. Panos is now charged with wire fraud and health care fraud as well as aggravated identity theft.
US v Banner Health
It could not happen to a better system. Banner Health will pay $18 million to settle allegations that it falsified Medicare claims. Banner Health charge Medicare for short stay inpatient services instead of outpatient services. The number of hours outpatient received services was also inflated according to the complaint. Banner got a corporate compliance agreement for five years. This was a whistleblower suit and the blower got $3.3 Million.
US v Ahmed
Dr. Asm Ahmed of Hamtramck, Michigan, Pharmacists Samir Berri, Anthony Cole, Shamimur Rahman and Ghassan Hamka were all charged with health care fraud. It is alleged that they billed for both controlled and other high price meds but not dispensed them. Some of the patients had actually died prior to the delivery of the prescriptions and the charges. Also the physician prescribed opiods and other meds without exams where the prescriptions were taken to the Conet Pharmacy for filling.
US v Canada Drugs
Canada Drugs, an online Canadian pharmacy, has been fined $34 million for importing counterfeit cancer drugs and other unapproved meds to the United States. This includes $29 million forfeited, $5 million in fines and a five year probation. The owner, Kristian Thorkelson, will get six months house arrest, five years probation and a $250,000 fine. They will stop selling unapproved, misbranded and counterfeit drugs and will surrender all domain names.
US v Pelicci
Dr. Leroy Pelicci of Scranton died but his estate must pay $625,000 to settle allegations that he billed for trigger finger injections upcoded.
US v Lindblad
Drs. Carl Linblad and Susan Vergot of Choice MD in Cleveland, Tennessee, pled guilty to prescribing expensive and unnecessary meds. They were part of a scheme with fake medical studies involving Marines in san Diego and interviewing them via tele. The prescriptions were then sent to a pharmacy in Bountiful, Utah, for the huge billing for compounded meds. Top
Doe v US
The Obama appointed federal judge on the DC District Court ordered the feds to stop interfering with teen illegal immigrants getting abortions. The pregnant teens may now get unfettered access to abortion procedures but the feds will not pay the bill.
Aileen Rizo v Fresno County Office
The frequently overturned 9th Circuit unanimously agreed that past income can not be used to justify wage differences in a new job. The case will be appealed to the US Supreme Court. Top
New Jersey v Virtua Medical Group
The firm has agreed to pay $417,000 to settle a complaint that it exposed medical records via poor web site management. The firm has dozens of medical and surgical practices.
US v Hodge
Krystal Hodge of Parkland Memorial Hospital in Dallas will plead guilty to stealing personal information to get illegal tax refunds. The patients were prisoners in the Dallas County jails.
Patient v Outcome Health
This should be a warning to all, not just in the medical field, regarding the Telephone Consumer Protection Act. Outcome Health has agreed to pay $2.9 million for violating the Act in a class action suit. The plaintiff opted in to receive automated texts containing nutrition tips. She then opted out but the texts kept on coming.
Patients v A. J. Boggs &
A suit has been filed by Lambda Legal against the private company that contracted with California regarding the inadvertent access to the HIV status of 93 people. The people were beneficiaries of the state AIDS Drug Assistance Program and Boggs was contracted to handle enrollment but the contract was terminated in 2017. Information was left on line for all to see. Top
Leonard v Washington Hospital
Leonard filed suit against the hospital for withholding information about a 11 month spill of sewage in the OR which has now been corrected. However, the patient developed an infection post thyroid surgery and eventually died. The patient's attorney says the withholding of this information deprived the patient of the choice of whether to go ahead with her surgery at this hospital. The attorney also states the physician should have prescribed antibiotics pre operative since the patient was obese and diabetic. The attorney does not know if Leonard was operated in one of the infected ORs. Top
University of Pittsburgh Medical
Center v Cheek
Dr. Edwin Cheek, an OB at a clinic was charged with theft for seeing patients off book and giving them cosmetic treatments for profit. He used hospital supplies totaling about $18,000.
Al-Shaikh v State Dept. of Health
Dr. Raad Al-Shaikh sued the Department for denying him to continue as a Medicaid provider in a new office location due to his billing procedures. The physician showed the Department that his fee arrangement did not violate federal law and the restriction was lifted. He then wanted attorney fees for his pro-per work. this was denied by the Department and won in the Court of Appeals. The Court said the Department had a responsibility to know the laws and acted without justification. Since it took Dr. Al-Shaikh three years to get the permission he was entitled to the full $7500 in feeds authorized.
CCS Oncology in upper New York is doomed. In 2016 they were dropped from a Independent Health dropped then as a provider of health care. This led to a mass exodus of physicians and other workers along with their patients. Last week the FBI raided the offices looking for evidence of health care fraud. Two weeks ago a judge said that CCS and failed to comply with the terms of its loan and allowed the bank to seize CCS' assets. The bankruptcy stays the seizure and allows CCS to continue for a short time.
Atrium Health v Mednax
The hospital owner filed a frivolous lawsuit claim against its anesthesia group Mednax who originally filed a claim against Atrium for breach of contract and trade secrets violations. Top
Delashaw v Seattle Times
Dr. Johnny Delashaw was a member of Swedish Health in Seattle who resigned after being featured in a series of articles in the Seattle Times regarding his practices. He has now sued the Times for defamation. He wants money and the removal of the articles from the website as well as a gag order on another physician. Dr. Delashaw had his license suspended and this is currently under appeal. This seems like it will be a very difficult case to win.
Chomer v Logansport Memorial
Dr. Chomer lost his position in the ED at the hospital after he continually asked patients who had minor complaints not to use the ED. The hospital saw this as losing money and eventually removed him from the ED rotation and then terminated him from the staff for what they stated were unlawful actions as against EMTALA. The court ruled that the case can go forward since he never refused to treat patients and therefore did not break any law. The court did say that Dr. Chomer's actions qualified as an action in furtherance of an legitimate retaliation suit and the hospital could be on notice of a qui tam FCA suit. Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.