US v GlaxoSmithKline
The Pharma giant has agreed to the largest fraud settlement in history. The company will pay $3 Billion to settle charges of unlawfully pushing certain dugs such as Paxil and Wellbutin. They also failed to submit safety information on Avandia. Two Billion will be paid under the civil false claims act and the remainder under criminal charges.
US v NextCare
Clinic owner NextCare agreed to pay $10 million for billing for unneeded allergy and flu testing as well as over billing for visits. This is another whistleblower case and the person will get $1.6 million of the total paid.
US v Maury Regional Hospital
Maury Hospital in Tennessee has agreed to pay $3.59 million to settle charges of False Claims. They self reported their error in ambulance charges.
US v Lagrada
Dr. William Lagrada of Edison, New Jersey, pled guilty of taking kickbacks from an MRI facility for referring patients to the Orange MRI facility. Twelve other physicians and nurses have been arrested on the same charge. Orange MRI executives have also been arrested. Dr. Lagrada will forfeit $69,880 that he had received.
California v Alta Bates/Summit
Although this is a state fine and not a fraud case I decided to put it here. Californian fined the Berkley/ Oakland hospital $84,5000 for failure to report a meningitis case to the state. The hospital also put at risk for the disease others by not informing them of the danger so they could take prophylactic antibiotics. Two have permanent disabilities due to lack of reporting. Top
DeMuth v Walter William Strong
The Court overruled the tort reform law in Maryland where an expert witness in a med mal case must be in the same specialty as the defendant physician. In the case at hand a vascular surgeon was allowed to be an expert witness against an orthopedic surgeon. The trial had found Dr. DeMuth guilty of med mal and awarded Strong $1.7 million for the loss of a leg due to vascular compromise.
Patients v Exeter Hospital
The hospital is in a huge amount of trouble. They have a bundle of cardiology catheterization patients with Hepatitis C. This is due to a technician with the disease working on patients in the lab. The person stole drugs for self use and refills the vial using the same syringe they use on themselves. To date there have been 27 patients have turned up positive for the disease. There have been three class action suits filed by scumbag attorneys looking for a quick buck. Hopefully, all three will be denied and the individuals affected will settle with the hospital. There are also several governmental investigations going on simultaneously and the hospital has destroyed it's reputation.
Lowy v Peacehealth
Lowy sued the hospital for corporate negligence and wanted the information from the hospital on other injuries like her own. The hospital attempted to say they could not due to it being unduly burdensome. That was shot down by the courts had a list of related cases that it had developed as part of its quality review process. The court ruled they could easily get the information and redact to keep privacy so they must give up the information to the plaintiff. Top
CMA v Aetna
Aetna has sued a group of physicians for overcharging the insurer and now the California Medical Association has sued Aetna for not paying for and discouraging out of network referrals. The suit contends that Aetna illegally threatens doctors and patients who want to sue out of network providers and then cancels the contracts of physicians who make the referrals. Look to see many more of these in the future when Obamacare sets in. Top
The feds have indicted Dr. Vaziri of Napa, California, wit income tax evasion and healthcare fraud. The government state that he took unjustified deductions on his corporate tax return as well as upcoding. He has pled not guilty to all charges.
US v Ryser
Dr. Carol Ann Ryser of Missouri has been charged with income tax evasion and healthcare fraud. She and her husband, who ran her office, are accused of understating income. They are also charged with billing for physician services when the physician was not in town. The physician has also been under investigation for the erroneous diagnosis and treatment of Lyme Disease. Top
Nath v Texas Children's Hospital
Dr. Nath, a plastic surgeon, was ordered to pay the attorney fees of the hospital and medical school due to his alleged disruptive conduct during the litigation. If not for his conduct, the court ruled, the attorney fees of the hospital and medical school would not have been so high. He was ordered to pay $650,000 to the entities.
Salamon v Our Lady of Victory
Dr. Salamon did it. She beat back the hospital on all sexual harassment charges and her termination. The court denied the hospital's summary judgment motions saying that all her problems with peer review happened after she rebuffed the Department head's sexual advances. I don't know who the attorney is but he/she argued stupidly that HCQIA prevented them from being sued. It doesn't hold sway in civil rights litigation. The case goes to trial or settlement. 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.