March 15, 2014 Recent Legal News

Malpractice

Fraud

Healthcare

Peer Review and Employment

HIPAA

Malpractice

McCall v US
Florida Supreme Court

In a major blow to the physicians in Florida, the state's high court ruled that the woman's family who sued for her death while under the care of the US Air Force was not bound by the med mal law that limited non-economic damages.  The woman died after a C Section.  Her family sued and the son was awarded $2 million in non-economic damages reduced to $1 million under the Florida law.  The federal court stated the Florida Court should consider state constitutional issues.  This ruling invalidates the 2003 law passed by the legislature and signed by then Governor Bush.  This 5-2 decision means that all suits now have no caps on non-economic damages at least on wrongful death actions.

Dieffenbach v NIH
Settlement

The feds agreed to pay $307,000 to a deceased boy's parents the implantation of a pacemaker into the boy and not telling the parents of the experimental nature of the procedure.

Patients v King's Daughter Medical Center
Filed

Several patients have filed suit against the hospital for allowing physicians to perform medically unnecessary cardiac procedures on 500 patients.  The suit states that the feds are investigating the hospital for the same reason.  It should be noted that the same attorney is targeting this hospital and another that paid $16 million to settle allegations of false billing related to cardiac procedures. 

Patients v South Nassau Community Hospital
To Be Filed

The hospital has sent letters to 4200 patients that they may have been subjected to HIV and/or Hepatitis due to their using an insulin pen reservoir on multiple patients.  The CDC states it should only be used on one patient.  It is offering free blood testing.        Top

Fraud

US v Halifax Health
Settlement

Halifax Health has agreed to finally pay money to the feds for illegal kickbacks to physicians.  They were originally going to court to fight the billion dollar fine but now are settling half of the allegations for about $85 million.  They will not admit wrongdoing and will pay over time.  This is a whistleblower case and there will be a separate trial in Jul between the whistleblower and the hospital over the allegation that the hospital billed Medicare for inpatient care where the medical need was not documented.  The hospital will also be on compliance oversight.

FTC v St. Luke's
Stay Filed

St. Luke's and Saltzer Medical Group have jointly filed a stay request.  They want to remain as an entity while the appeal is going forward.  They state that if the two are not allowed to remain as one the medical group would be substantially injured as they would lose physicians and would not be able to compete.

US v Panos
Sentenced

It bothers me to put this in the area of fraud because it deserves its own area of sleeze.  Dr. Spyros Panos of Poughkeepsie, New York, was sentenced to only four and one half years in prison and payment of $250,000 as well as restitution of $5 million.  He also was required to turn in all his medical licenses.  What did the scum do?  He did hundreds of fake and poor surgeries for the money.  There are about 260 civil law suits against him. 

US v Raia
Settlement

Dr. Joseph Raia has agreed to settle the claim against him for filing claims for supervising physical therapy when he was not even in the state.  He has agreed to pay $1.5 million and be barred from all federal programs for 15 years.

US v Kiely
Settlement

Dr. John Kiely of Lutherville, Maryland has denied all allegations against him but has agreed to pay the feds $1.4 million and be barred from the federal programs for 20 years.  He was accused of doing unneeded laser procedures for glaucoma and causing Bon Secours Hospital to submit wrongful claims for the unneeded procedures.        Top

Healthcare

Keffeler v Partnership Healthplan of California

The California Court of Appeal denied a suit by the owner of a pharmacy against a Medicaid health plan that wanted to reduce the amount they paid for prescriptions by 10%.  The argument was hat this would reduce the quality of the healthcare in the state.  The ruling means the plans do not have to take into consideration how much pharmacies pay for meds when they set their rates.  It also means that many will not get their meds.  The ruling will be appealed to the Supreme Court.

Centinela Freeman Emergency Med. Assoc. v Health Net of Cal.
Cal Ct App

Groups of radiologists and ED physicians sued the HMO after they had not been paid for years by an IPA who has since gone out of business.  Past decisions have gone against physicians in this scenario but this one went for the physicians on the issue of negligent delegation.  The HMO has a duty not to delegate to an IPA the obligation to reimburse physicians when it knows the IPA is unable to do so.

Gaines v Covered California
Filed

Gaines is a State Senator who is suing the California Obamacare organization for not allowing people to keep their health insurance.  This was when Obama said if you like your health insurance you can keep your health insurance even if it does not reach my lofty expectations and has been cancelled.  The Republican wants Covered California to reinstate about 900,000 policies but to do this state law must be changed either by the legislature of the courts.  Oh, I should mention, Gaines is running for state insurance commissioner.        Top

        Peer Review and Employment

Auluck v Alameda County
ND CA

Dr. Auluck, a 69 year old psychiatrist, did some whistle blowing at the county facility and was suspended once, had the suspension lifted after jumping through multiple hospital required hoops.  He was then suspended a second time and submitted his resignation.  A report was filed with the state who investigated the physician.  The state said there was nothing wrong and then the physician sued the hospital and the person who came after him for his whistle blowing.  The court said the hospital was OK to file the 805 report with the state but the separately submitted report was filed with malice.  Also, after he left, the hospital hired a much younger psychiatrist at about one half the salary.

Satgunam v Michigan State University
6th Circuit

The board certified surgeon had two deaths during laproscopic procedures and refused to see a referred patient while on call.  The surgeon was peer reviewed and in typical haughty academic fashion was denied legal counsel, a record kept of the proceedings and was found to be "guilty".  He was terminated from the staff.  He sued and won a re-hearing where it was recorded.  He lost again.  He sued again.  He lost all matters in the second suit because he had administrative things he could have done prior to suing and his attorney did not bring up things to be tried.        Top

HIPAA

People v Sutherland Healthcare Solutions
To Be Filed

The company, a business associate of LA County, had a break in and lost several unencrypted computers containing about 169,000 names and SSNs.  Shame on them.  They deserve a nice fine by the feds.  So far about 30 million people have had their health information compromised.  Ain't technology wonderful.  Think of all the help the EMR has given the physician and the patient.  Yes, I am sarcastic.        Top

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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.