US v Vitas Health Corporation
The corporation paid the feds $200,000 to settle allegations that they paid Dr. Faid Fata, the Detroit chemotherapist who is now sitting in prison for making up cancer diagnosis, money to refer patients to their facility.
US v Harlan
Cynthia Teresa Harlan of Charlotte was sentenced to 16 years in prison for her role in the a Medicaid fraud along with the payment of $3 million. She orchestrated a scam of billing for services never performed.
Patients v Yakima Regional Medial
and Cardiac Center
The Washington hospital agreed to make major changes in its indigent care policies as they did not tell indigent patients that they were eligible for charity care. The hospital has agreed to pay a total of $4.5 million due o their carelessness. The attorneys will get $1.5 million of that total amount. If any money is left over after all the plaintiffs get triple damages the remainder will go to charities. Thee hospital had ordered its employees not to mention charity care when they were talking about money owed.
US v Forest Park Medical Center
The feds indicted multiple people involved with the physician owned hospital in Dallas. They were charged with either paying or receiving about $40 million worth of services. Those indicted were the owners as well as the executives.
US v Rideout Health
The northern California hospital system agreed to pay $2.4 million to settle claims it mishandled drug records in their hospitals. They let their DEA license lapse and the techs were transporting drugs between hospitals with little or no security. Terrible.
US v Ononuju
Dr. Chidozie Ononuju of Saganaw, Michigan, has been sentenced to five years probation for Medicaid fraud. He also has to repay $407,340 and his passport has been revoked. He has no more DEA license. He now practices in Georgia.
US v GNC
The giant company has agreed to pay $2.5 million for misbrandng supplements. A subsidy said it used natural ingredients when in fact they used manufactured ones.
US v South Miami Hospital
The hospital agreed to pay a fine of $12 million to settle allegations they billed illegally for electrophysiology studies and other procedures performed by one physician. This was a whistle blower suit by two physicians who will split the bounty of $2,748,000.
US v Southwest Orthopedic
The Jacksonville, Florida, medical group agreed to pay a fine of $4,488,000 to settle claims they met meaningful use when they did not, billing for incident to when no physician was present, billing for two procedures when should have only billed for one, scheduling follow-up visits so they fell outside the 12 week DRG, used ultrasound guided injections when there was no need and billed physical therapy without medical necessity.
US v Koroma
Dr. Banio Koroma of Tinley Park, Illinois, has been sentenced to 40 months in prison and ordered to pay restitution of $1,5 million. He had been convicted of health care fraud for stating patients were home bound when they were not. Top
Bastidas v Good Samaritan Hospital
Dr. Bastidas is a surgeon at he hospital who had a patient die after a Whipple's surgery. He was peer reviewed for this and lost his privileges and the board decided to put him on proctoring. He was also reported to the NPDB as incompetent. While on proctoring and with the medical staff never acting on various requests he was elected by the surgical department as chief of surgery. The MEC would not seat him and also took him off another committee as he was not in good standing due to his proctoring. He sued the hospital for racial discrimination and won in the summary judgment phase with the hospital being denied summary judgment. The court said that his suit was a protected activity and soon after filing his proctoring was delayed even more. The court also said the hospital's delay in updating his NPDB report also may have affected his employment privileges. The court said it was possible that the refusal to seat him as Chair of Surgery and his removal from the Cancer Care Committee my be reprisals.
Brandner v Providence Heath
A physician went before the state Medical Board for a psychiatric issue. He underwent a psychiatric evaluation and was cleared for practice. One year later the physician said things that made the hospital have concerns and they ordered a psychiatric exam. He then told them about the earlier exam and his passing it. The hospital then found out about the Medical Board and automatically terminated him for failing to tell the about a condition of his practice. The medical staff took away his privileges and the board confirmed prior to any hearing. He was given a post termination hearing and lost and sued. The court correctly ruled that he was entitled to a pre-termination hearing. They also ruled they were not protected under HCQIA so are liable. The case goes to Superior Court. Top
Andrews v DePuy Orthopedics
A jury awarded six plaintiffs a total of $1 Billion for injuries from the DePuy hip prosthesis. They ruled that the devices were defective and the company failed to warn physicians that there was a risk that they would fail. The verdict was for $30 million in damages and over $1 Billion in punis. This was J&J's second loss over this device. There are still over 9000 suits pending. These are being appealed. The two losses are in plaintiff friendly Dallas. The six plaintiffs in this case were all from California which has no limit on puni damages.
Hatzell v Health and Hospital
Corporation of Marion County
Another EMTALA case bites the dust. An adult handicapped patient went to the ED for lethargy and inability to urinate. The patient was examined and an abdominal -ray was done for constipation. An uninanaysis was ordered but never done since the patient did not urinate. The next day the patient came back to the same ED because he fell down stairs and was unresponsive. She was assessed and had CT scans etc. She was found to have a broken nose but nothing else. The physician was told the patient still had not yet urinated and the abdomen was swollen. The physician sent the patient home without even reviewing her past history. Five days later the patient still had not urinated and was nonresponsive. She went to a different ED. She was found to have acute renal failure and suffered permanent physical and mental disabilities from the failure. The attorney filed an EMTALA claim for an unknown reason. This of course was dismissed on summary judgment since it only requires screening and not a correct diagnosis. The court said this is a malpractice and not an EMTALA case.
Patients v VA
An unnamed dentist has resigned from the staff of Tomah VA in Wisconsin. He was accused of using his own instruments against the hospital rules. He did not follow proper sterilization procedures and the patients are being notified they may have Hepatitis or HIV.
Cantrell v Mountain States Health
The Cantrells sued after they were denied adequate communication help from the hospital. The feds took up the case and now the Alliance must make changed in their policies and procedures to accommodate deaf people under the ADA. They will also pay a fine of $50,000.
Mendez v Children's Dental Group
The 8 year old went to the clinic and was told she needed a pulpotomy. She developed a severe infection from the procedure and has lost part of her mandible. This is the clinic that had multiple infections from a problems with their water system. the suit also alleges she never needed the procedure in the first place. Watch, this will never go to trial.
Stafford v Burns
In a strange ruling the court ruled that EMTALA applied even though it was never plead. The patient ingested an unknown quantity of methodone. He came to the hospital ED and was examined by a physician and then another one and after 12 hours discharged. He was found dead the next day. The parents filed a malpractice suit but the lower court said they needed a higher standard of proof due to EMTALA. The parents said they never plead EMTALA and the son never had an emergency medical condition. The court said the law applied if a patient came to an ED with what may be an emergency condition. The court went on to say if malpractice it was when providing an EMTALA service. This goes against all other rulings. Top
Akhtar-Zaidi v DEA
Dr. Syed Jawed Akhtar-Zaidi was involved in an undercover sting operation against him. After a hearing he had his DEA license immediately suspended. He appealed but of course lost since the judge found that he falsified each officer's medical record at nearly every visit. They had plenty of reason to immediately suspend his DEA license. Top
Patients v Glendale Adventist
A per-diem nurse at the hospital illegally accessed 528 medical records while working at the hospital. This was found in June but no action was taken until now due to an investigation. Top
Ohio v Allen
Arthur Allen, a 38 year old male was arrested at the Ohio State Hospitals for posing as a physician and criminal trespass.
Pennsylvania v Bado
Former physician Jefferey Bado was found guilty of 308 counts of drug distribution and causing the death of a patient. He may be in prison for the rest of his life. He had "medical offices" in Roxborough. He charged new patients $800 and returning patients $400. Much better than Medicaid rates. Top
Congress v Obama
The court has delayed the start of the trial to determine whether or not the subsidies of Ocare are legal. The reason is the new administration may decide to not defend the action.
AHA v HHS
A judge has ordered HHS to get rid of the entire backlog of appeals by hospitals against the RAC denials of payments. The backlog is about 800,000 cases awaiting disposition. By the end of next year there must be 30% less. The hospitals usually get about 60% of the claims of the RACs overturned.
Sutter Health v Eden Township
Sutter sued its hospital for leaving the system and won $17 million plus interest. This would bankrupt the District hospital so they have asked the court to lower the interest rate. the Appellate Court ruled that the interest should be reduced and the money may be paid over 10 years but the lower interest rate does not go back to the beginning. The original lump sum judgment accrual of interest stands until now.
Stramshan-Ford v South Africa
The patient had sued in 2015 to be allowed to do assisted suicide. the lower court agreed but the patient died before the ruling. The Court of appeal overturned the ruling because the patient died prior to the ruling. Therefore assisted suicide is still illegal in the country.
Parkview Adventist Medical Center
The hospital has claimed bankruptcy. CMS has revoked the hospital's ability to be paid by fed med. The hospital sued to stay the CMS order. The court said bankruptcy does nothing about CMS taking away the payments. The hospital has no property right to bill CMS and CMS was exercising its police powers. 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.