US v Smith
Dr. Barbara Smith, Dr. Roy Berkowitz and RN Beverley Breaux all of the New Orleans area were sentenced to prison for home health care fraud for over ten years. They were also ordered to pay sums ranging from $9.5 million to $2 million in restitution.
US v Gross
Dr. Robert Gross of San Angelo, Texas, was convicted of healthcare fraud. He submitted claims for services rendered to dead people. He was a psychiatrist. He has been sentenced to 71 months in prison and ordered to repay $1,832,867 in restitution.
US v 21st Century Oncology
The group has agreed to pay $19.75 million to settle claims that they ordered bladder cancer tests that were not medically necessary and these were performed by the company pathologists. Incest.
US v Hospitals
Another 32 hospitals have settled with the feds over admitting patients for surgery that could have been done as an outpatient. this centers on kyphoplasty procedures. This brings the total hospitals to about 130 and the total money collected on this boondoggle up to $105 million.
US v Dynasplint Systems
The company agreed to pay $10 million to settle claims that it violated the False Claims Act. They were accused of mischarging for splints for patient in nursing hoes. They should not have been separately charged and should have been included in a bundle of services.
US v HCA
The feds got another $2 million after HCA agreed to settle over the allegations that their Fairview Park Hospital and two cardiologists performed unnecessary cardiac procedures. This was a whistleblower case.
US v Persaud
Dr. Harry Persaud of Westlake, Ohio, was sentenced to 20 years in prison for fraud. He was guilty of ordering unneeded heart tests for unneeded cardiac surgery. He still faces restitution and malpractice suits. He is planning to appeal the verdict and admits only to billing errors. The doctor came out swinging. He claims the feds targeted him under Obamacare to force physicians to cut down on procedures. He says that if unsure he was not going to play with patient lives and he should do the tests to determine how serious a problem is.
US v Advocate
The merger between Advocate Health Care in Chicago and the suburban NorthShore University health System has been put on hold due to the feds wanting a temporary restraining order against the merger. There will be a trail on the matter in May.
US v Memorial Health
The chain agreed to pay almost $10 million to settle claims that it over billed Medicare for items coming from illegal financial relationships with physicians. This was a whistleblower suit by a former CEO. Top
SEIU v California
Several groups filed a complaint against the state for their low Medicaid rates. This was filed not in court where they would certainly lose but with the HHS OCR. They are complaining that the low rates discriminate against latinos and other low income residents. They say this is intentional. They are right. The low rates were to save the state money and it was intentional. The Supreme Court has already ruled this is legal. They want rates raised high enough to ensure the availability of services comparable to Medicare and employer based coverage. Taint going to happen.
Chamorro v Dignity Helath
The woman and her physician are suing after she was denied an elective tubal ligation post partum by the Catholic hospital. The physician agreed to the procedure but was denied the ability to do it by the hospital. Top
Morman v Campbell County Memorial
A female ortho attempted to sue the hospital for discrimination and of course lost. She was not in the same situation as her male counterparts. She was hired for skill and experience and they were hired as part of a sale of their entire practice. Also the hospital and the other defendants were entitled to qualified immunity. Her attorney should have know this.
ECMC v Cleland
The Erie County Medical Center has settled with its former CEO Richard Cleland. They will pay him $1.2 million after removing him for cause. His contract specified that is what he would be owed if he was fired for anything other than cause. The board caved. He maintains he was not fired for cause but resigned for cause. Top
Powell v City of Ocean City
A patient was arrested for DUI. She could not produce a reading on a breathalyzer nor could she produce enough urine for a test. she was taken to the hospital where the personnel in the presence of an officer was catheterized without proper sterilization or dress and she contracted MRSA. The court refused to dismiss the case since it was a fact question whether or not the catheterization was necessary or if it was done in a medically acceptable manner.
Dawson v Liberty Calhoun Hospital
She was taken to the hospital ER with breathing problems. She was treated and deemed stable and released. However, she did not feel she was able to be released and refused to go. The police were called by the hospital where they arrested her for trespassing. She collapsed while walking to the police car and efforts to revive her were unsuccessful.
Crawford v Oregon State Hospital
The estate of Christopher Crawford filed suit against the hospital for causing the death of the patient. They say he died of medications and not the official cause of hypertension. They claim that he had been heavily sedated for three months leading up to the death due to telling police and reporters about a nurse who had sex with another patient. He had been a confined patient for 20 years after committing a home burglary. Top
Patients v Community Mercy Health
The medical records of patients from the organization in Springfield, Ohio, were found in a local recycling enter. The records were supposed to be shredded but of course were not. The amount of patients affected are not known. Top
The past CFO of Curry Health Network has been arrested on vandalism charges. He was apparently seen on tape spray painting the house of the CEO Ginny Razo. Ms. Razo has found out recently that the system is in deep doo doo financially. She has let go 20 employees and Landau was placed on administrative leave. 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.