March 1, 2006 Recent Legal News


Peer Review

Medicare Fraud



Physicians v Great Falls Clinic 

Seven physicians have sued the Montana Clinic for forcing the physicians to leave Great Falls if they leave the clinic.  When they leave the clinic they are taken off the managed care plan run by the clinic and the Blues.     

Springer v Henry
3rd Circ

In not only a win for physician whistle blowers but also as a methodology as to how to do it correctly, the 3rd Circuit has approved a decision for the physician against Delaware and the Head of the Psychiatric clinic where Dr. Springer was employed.  Dr. Springer was president of the staff and a practicing psychiatrist.  He complained that there was overcrowding, abuse and personnel shortages.  He sent the concerns to the administration, the hospital board, the secretary of the Health and Human Services and the Governor.  What he got for this was a non-renewal of his appointment by the the Director of Delaware's Department of Mental Health.  He was the only physician to not be re-appointed under a new law.  The trial court and the court of appeals took that into consideration as disparate treatment and awarded him damages.  Although this was a public hospital, it could be seen as a guidance to private hospitals as well.  This would mean the complaint should go to the administration, including the chief of staff, and the hospital board.  If done correctly, the whistleblowing should be protected.  This is especially true in California where there is a whistleblowing protective statute.   

Kentucky v Radiologists

An Ohio group of investors found some Louisville radiologists willing to front for them in Kentucky.  Kentucky had a law that the only radiology units that could be built were to be owned by the physicians.  The physicians in three locations had no ownership in the corporation and only received fees for the reading.  These will now have to close.  Yet, the law has now changed and anybody can now own a radiology suite in Kentucky, not just physicians.  if the Ohio group now applies to the state for a license, they should get it.          Top

Peer Review

King v Teays Valley Health

The hospital terminated the physician's privileges and he sued.  He lost since the hospital was not a state actor as required in this state, the hospital bylaws are not considered a contract in this state and the hospital could not interfere with the contract since it was the other party to the contract.

Neff v Johnson
Conn. App. Ct.

A patient sued the hospital for negligently credentialing a practitioner.  The plaintiff lost since there needs to be an expert to interpret the bylaws.  The bylaws themselves are not enough.  The bylaws are deemed to specialized for the lay person to understand. 

Poirier v Our Lady of Belifonte Hosp.
KY Ct. App.

The hospital denied the physician application for privileges and the physician sued.  The reason for the refusal to grant privileges was he physician's disruptive conduct during his temporary privilege time.  He had multiple episodes and meetings with supervisors regarding his conduct but never changed.  The court agreed with the hospital and stated that all procedures were followed.    

Kreit v St. Paul Fire Ins.
SD Texas

Kreit was sued for medical malpractice and refused to settle.  St. Paul in their contract has a clause that they may settle without the permission of the physician.  St. Paul settled and then as required reported the physician to the National Data Bank.  The physician sued but lost since the report that was filed only gave the facts that the case was settled without the permission of the physician.  

Holley v Norwalk Hosp
Conn. Superior Ct.

The hospital was sued for negligent credentialing of a physician.  The hospital attempted, stupidly, to introduce evidence of the peer review committee's refusal to restrict the anesthesiologist's privileges.  The peer review records can not be introduced for any reason and the hospital's attorney should have known better.  The Count then went on to discuss another aspect of the case regarding the anesthesiologist.  The physician may be asked to discuss his medical history in deposition but the plaintiff can not get the privileged actual information.  The privilege comes from the psychiatrist-patient privilege as well as the peer review privilege.     Top  

Medicare Fraud

US v Abraham Lincoln Hosp.

The hospital has agreed to settle with the government for submitting false claims.  They will pay $1.34 million.  The interesting thing is that this is the fourth hospital to pay back the government based on advise by a Kentucky medical consultant, Dr. Stephen Burkhart.  He denies any wrongdoing but may face criminal charges.  

Shareholders v HealthSouth

HealthSouth has agreed to pay its shareholders stocks of $225 million and an additional $230 million in cash.  The shareholders will also receive 25% of any future money the company recovers from the past CEO Richard Scrushy, Ernst & Young and former bank UBS.        Top


California v Palomar Hgts.

Palomar Heights Care Center, an Escondido, California, nursing home has been fined $100,000 for leaving a patient who was smoking alone while he was receiving oxygen.  The inevitable happened and he died from the burns.  This is the fourth state accusation against the Palomar facility.  

Women v Dr. V. Kashyap
Ohio Filed

 Dr. Vikas Kashyap of Delhi Township, Ohio, was sued by five women for sexual assault and battery.  They claim he did unnecessary breast exams and the attorney wants to make it a class action suit.  This tells you alot about the attorney and his interest in money and not his clients.  The medical board did investigate the physician in 2004 but preferred no charges.  The police have to date stated that this is a civil matter, no matter what the plaintiff attorney states.       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.