June 15, 2020 Recent Legal News






Peer Review and Employment


US v Terry

Magnum, Oklahoma, pharmacist Jeffery Terry was sentenced to 37 months in prison for health care fraud.  He submitted false clams for meds not prescribed or dispensed.  He was also ordered to pay restitution of $1 million.

US v Coluccio

Branden Coluccio was a co-founder of Liberation Way, a drug rehab facility in Pennsylvania.  He was convicted of health care fraud for doing unnecessary urine drug tests and getting a kick back.  H also fraudulently purchased health polkicies which allowed the billing and receiving more money for the unnecessary treatments.  He was sentenced to 37 month and ordered to pay restitution of $3 million.  

US v Jackson

Paulette Jackson, of Williamston, Virginia, was sentenced to four years in prison for healthcare fraud.  She was the owner of a DME company inflated the costs of oxygen to receive an illegal money from the state.  

US v Kennerson

Sherman Kennerson and Jeffey Madison of Texas pleaded guilty to healthcare fraud.  They owned with others Spectrum Labs and Metric Labs in Texas and Mississippi.  They paid bribes to other labs to induce referrals for DNA testing.  

US v McLean

Kyle McLean of Arlington Heights, Illinois, pleaded guilty of fraud.  He ran, along with others, Privy Health, a company that collected DNA samples.  They then had illegal genetic testing done with falsified medical authorization.  

US v Alaska Neurology Center

The medical group and its owner Cr. Franklin Ellenson agreed to pay $2 million to settle allegations that they submitted false claims with false dates of service, submitted claims for infusion services provided by an unqualified person, submitted claims for massage services, submitted unbunduled claims, submitted claims with false names and re-submitted claims with false diagnosis.

US v Braylovsky

Dr. Anatoly Braylovsky and Jennifer Bousquet, both of Wallingford, Connecticut, were arrested and charged with health care fraud and selling opioid prescriptions for cash.  

US v Hassan

Mohamed Hassan and his home health company Noble Home Health of Portland, Maine have agreed to pay $111,200 to settle allegations that they submitted false claims for providing mental health services to children.  

Patients v Allergen
Court Order

In a decision that shocks the conscience the attorneys that sued Allergen for delaying the launch of an Alzheimer drug.  the total award was $750 million for the class.  The gonif attorneys wanted $157 million and were awarded the ungodly amount of $60 million or almost 10% of the judgment by the judge.  

US v Pharmacists

Nine pharmacists were indicted for their role in billing insurers for prescriptions never received nor dispensed.  Those indicted are from mostly Northern Ohio and Michigan.  They are Auday Maki, Hassan Abdullah, Raef Hamaed, Tarek Fakhuri, Kindy Ghussin, Balhar Singh, Ali Abdeirazzaq, Hassan Kheizat and Nofal  Cholag.

US v Sheridan

Jennifer Sheridan of Austentown, Ohio, was sentenced to 27 months in prison and restitution of almost $16 million.  She is the last of the six people to be sentenced for billing for drug service not medically necessary, not received  or not provided.  

US v Hallam

Daneil Hallam of Palm Beach Gardens, Florida, was indicted for conspiring to pay kickbacks for leads as to who may need DME.  

US v 19

Nineteen people including four physicians, two NPs, three Pharmacists and a clinic owner were indicted for opium distribution.  These are all from the Detroit, Michigan, area.  They include DRs. Beth Carter, Robet Kenewell, Jason Brunt and John Swan.  The physicians and NPs allegedly wrote prescriptions for fake patients.

US v Richardson

Russell Richardson, the former Georgia DeKalb Medical Center chief of security, plead guilty to using hospital funds to acquire multiple firearms that he sold for personal benefit.

US v Regeneron

The feds are suing Regeneron for alleged illegal funneling of payments to a shell charity to pay out of pocket costs to patients who buy their expensive products.  This will probably cost the company over $100 million as the others who have been sued for the same thing all have paid over that amount.

US v Augusta University Medical Center

The Georgia hospital has agreed to pay the feds $2.6 million to settle allegations that they submitted false claims for a procedure known as "Belsey Collis".  Not a covered procedure and not one I am familiar with.

US v Novartis Hellas

The Greek subsidy agreed to pay over $233 million to settle allegations that they violated the Foreign corrupt Practices Act.  They bribed employees of state owned and operated hospitals and falsely recorded the improper payments.  They did this in Greece and Alcon did it in Vietnam.

US v Tompkins 

Pharmacist George Tompkins of Houston and his wife Marene were sentenced to prison.  He got 10 years and she got 30 days of home confinement and three years of supervised release.  They were convicted by a jury of paying and receiving kickbacks as well as fraud.  They billed for unnecessary compounded prescriptions.

US v Dube

Michael Dube of Abington, Virginia, plead guilty of health care fraud.  His wife also plead guilty.  He omitted intentionally information required in Controlled Substance reporting forms in 2011.  He was excluded from the fed programs but he formed a new company and started again.  They owe the feds and others just over $9 million.  

US v Goyal

Dr. Ameet Goyal of Rye, New York, was indicted for fraud in 2019.  He was on pretrial release when he fraudulently applied and received money from the PPP program.  He applied for two loans, a real no no even if eligible.   Bad Boy.

US v Hughes

William Hughes the owner of Universal Oral fluid Labs in Greensburg, Pennsylvania, pleaded guilty of defrauding the feds.  he entered into kickback arrangements.      

US v Piedmont Healthcare

The Atlanta system agreed to pay $16 million to settle allegations that they billed for in house care when it should have been outpatient and they overpaid for the purchase of the Atlanta Cardiology Group.  The hospital manager overturned the judgment of the physicians in order to bill for inpatient rather than outpatient treatments.  This means the whistleblower will get $3 million.    

US v Heaton

Dr. James Heaton was a GP in Blairsville, Georgia, Dr. David Gowder was the ED Director of a hospital were both sentenced to prison for illegally prescribing opiates.  Healton got 6 years and Gowder one year and a day.          Top


Bostock v Clayton County, Georgia
US Supreme Court

The high court consolidated three cases to rule in a 6-3 opinion that discrimination on the basis of sexual orientation or gender identity is fundamentally no different than discrimination based on ses.  this decision came one day after the administration took away transgender discrimination form health care.  

Gay Groups v HHS

An amalgamation of gay groups sued the administration on their ruling exempting transgenders from protection in healthcare.  They know this is now illegal after the Supreme Court ruling so they are dong this for money for the attorneys or publicity.

Chicago v Department of Health

The new mayor of Chicago, a Democrat, wasted no time to get on the sue the administration bandwagon.  She ordered a suit filed because the HHS did not open a special enrollment window for Ocare due to the Covid.  Good luck with this one done only for the politics.

Merck v HHS
DC Ct App

The court ruled as did the lower court that the administration does not have the power to make the companies put the list price of their drugs on their TV ads.  


A district court judge ruled that the hospitals and and insurers must disclose tha actual price of common tests and procedures.  

Maine Community Health Options v US

The feds agreed to pay $54 Million to resolve the insurers lawsuit for risk corridor payments.  This after the US Supreme Court ruled several months ago that the obligations of the feds was intact.  

Riley v Houston Northwest Medical Center
SD Texas

The court ruled that the patient's outstanding balance on her bill constituted a sufficient injury for Article III.  She had ED treatment and signed a Patient Contract which failed to mention a fee to patients that was dependent of the level of service performed.  She was billed $963.47 plus her treatment charges which she filed to pay an dwas sent to a debt collector.  A class action was filed for an unconscionable fee without prior notice.  She does not have standing for future injunctive relief but the attorney is happy they passed muster on the class action.    

Abortion Clinics v Louisiana
US Supreme Court

The Court blocked the law requiring abortion physicians have hospital privileges as this would unduly burden women.  The 5-4 decision was interesting as Justice Roberts sided with the liberals even though he voted a dissent four years prior when a similar law was also turned away.  The reason for his change was very telling.  He felt he had to follow precedent.  This means that if Roe V Wade ever again returns to this court he would probably vote to uphold the law on precedent.  Top


Patients v Aveanna Helathcare

Email accounts of its employees were hacked and the information on 166,000 individual were potentially compromised.  An additional problem is these were pediatric records.  This is a class action suit stating the pediatric home health provider stored the information negligently allowing the hack.  

Patients v Kaiser
To Be Filed

Kaiser Mid Atlantic stated that one employee illegally accessed 2700 patients medical records between 2012 and 2020.  She was fired.  They did not pick up on this for eight years.  Terrible.

Keach III v BST & Co.

The attorney patient filed a puative class action suit against the accounting firm who represented Community Care.  They had been hacked and had exposure of some data.  The suit says the firm was negligent and the people have a heightened risk of fraud.  

Paramedics v NYFD

Three paramedics all belonging to one Local were pu on restricted status which does not allow them to collect overtime pay.  they have filed suit and have not been told the reasons why.  It is potentially for violations of the social medial policy.

Patients v University of Caliornia SF
Probably Never Filed

UCSF allowed an outside hacker to penetrate their IT program and they paid $1.14 million to get their data back.  They did find and take care of the problem promptly but it should never happened at all.

Class v UnityPoint Health

The Iowa based system agreed to settle a class suit regarding a phishing in November 2017 and a second breach in March 2018.  The first one compromised over 16,000 patient and the second one over 1 million.  The system was accused of not timely telling the affected people and for saying no SSNnumbers were taken when indeed they were.          Top


Nurses v Detroit Medical Center

  Several nurses are suing Tenet Healthcare the parent of Detroit Medical who ruins the ED Department in Sinai-Grace.  They are suing for millions for wrongful termination and have been accused of violating Tenet's guidelines for social media.  They say they did not violate the policy but another did who has since quit.  They knew a photograph of body bags stacked on a floor and shelving units in a refrigerated truck.  hey also state that patients died due to inadequate staffing and negligence.  The administration has been accused of telling a ED shift to go home because they protested the conditions in the unit forcing the day nurses to work a 24 hour shift.  The administration also is accused of refusing to hire contract nurses to help.  They state that people were on vents in the ED for many days because no beds were available in the ICU.  They had minimal supervision.  In a span of four days 104 people died in the ED.  Oxygen tanks had run dry and there was no monitors.  

Medical Staff v St. Mary Medical Center

The medical staff is challenging the hospital for their removal of the radiologists, anesthesiologists and now the ED physicians without the input of the medical staff and against the wishes of the medical staff.  They contend that Dignity Health is also getting rid of the medical staff's autonomy as required by the Joint and state law.  Even if the hospital wins they lose.

Nurses v Landmark Hospital

Nurses have accused the Athens, Georgia, hospital  of falsifying their Covid-19 results to cover-up an outbreak at the facility.  The hospital said if there was a positive test they would take another one that would come back negative and then state it was a false positive.  The nurses state they were instructed to take samples from the throat not the naso-pharynx where they are supposed to take the swab,  These tests were predisposed to come back negative.  One nurse stated she was terminated after taking a correct test which turned out positive.  The nurses accuse the hospital of lying to the public about the results.              Top

Wicks v Antelope Valley Healthcare
Ca Ct App

Wicks went to the ED for chest and abdominal pain.  He was seen by the hospital nurses and two independent contractor ED physicians.  He was discharged and told to follow-up with a cardiologist the next day but died soon after from a ruptured aortic aneurysm.  The family sued the hospital for its nurses providing negligent care and for negligently credentialing the physicians and that the physicians were the ostensible agents of the hospital.  The hospital moved for summary judgment which was granted and the plaintiffs appealed. The appeals court agreed.  The plaintiffs relied on speculative causation.  the hospital used standard credentialing criteria and the admission forms provide clear notice the physicians are independent practitioners.

Spurgeon v Mercy Health-Anderson Hospital
Ohio Ct App

The plaintiff sued the hospital, nurses and physicians for misdiagnosing their son's meningitis and suffering permanent damage.  The plaintiffs wanted employee files of several nurses.  The lower court allowed the files to be turned over and the hospital appealed.  They lost here as well.  The hospital did not show that any peer review body investigated the case, failed to show they had a peer review body for nurses and found the files in HR not anywhere else.  What a bad hospital attorney.   

Johnson v Lutton  
MD Penn

In what sounds like terrible lawyering the court rejected the Orthopedic Group claim that they should be removed from the suit.  The attorneys did not develop their case and apparently did a poor job of seeing if the law they relied on was still good law.  

Women v J&J
Mo App Ct

The court halved the prior judgment against the company down to $2.1 Billion, still outrageous.  The case is that asbestos in baby powder caused ovarian cancer.  Ridiculous.  

Monsanto v California

The district court again ruled tha AG Bacerra could not put Roundup was cancer causing on the product label.  He did not rule out putting the ingredient glyphosate as a cancer causing agent.        Top

Peer Review and Employment

Lelievre v Life Care Centers

Coleen Lelievrre, RN was fired and Lisa Harmon, RN was barred from the premises after they were quoted in a news piece regarding the atrocious conditions at the Massachusetts institution.  

EEOC v Pediatric Health Care Alliance

The feds have sued the Tampa, Florida, pediatric practice for retaliation against a whistleblower.  The nurse reported a physician and company vice president inappropriately touched her.  She was transferred to a different facility where her job was reduced as was her pay.  Stupid medial practice decision.  This should cost them big time.

Cagle v Tenet

Jason Cagle, the former CFO of United Surgical Partners, sued Tenet after he was fired.  Two weeks prior to his firing he told senior management of problems with their SEC filings.  He apparently had good reviews as well as stock options prior to his firing.          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.