February 15, 2018 Recent Legal News

Criminal

Fraud

Healthcare

HIPAA

Malpractice

Peer Review and Employment

Criminal

US v Chin
Sentenced

Glenn Chin, the former supervising pharmacist at the now defunct New England Compounding Center in Massachusetts was sentenced to eight years in prison for his role in the contamination of medication with fungus that killed 76 people.  He was convicted of abetting the fraud but found not guilty in the second-degree murder charge.  The owner had previously been sentenced to nine years.  Several other pharmacists will also be tried.        Top

Fraud

Seaman v Duke
USDC

The court ruled that Dr. Danielle Seaman's antitrust case against Duke and the University of North Carolina may be considered as a class action.  This means that if she wins all the medical school professors may receive compensation for damages.  She is suing because she applied to UNC for a position but was told she could not be hired as it was forbidden to hire between the two institutions.  No lateral moves.  Seaman got an out of court settlement from UNC which bars it from colluding with anyone to suppress competition for labor.  

US v Moret
Sentenced

  Dr. Rodney Moret of Madison Heights, Michigan, was sentenced to 75 months in prison for illegally prescribing opiates and fraud.  He had pleaded guilty of the charges that he ran a pill mill for getting drugs on to the street.  He has had his license in the state revoked.

Petrowski v Epic
Case Dismissed

Geraldine Petrowski was the supervisor of physician coding for WekeMed Health.  She claimed Epic software caused fraudulent payments for anesthesia services.  The judge said the charges are not founded in fact and tossed the case.

US v Gott
Guilty

Charles Gott of Warren County, Kentucky, pleaded guilty of illegally distributing controlled substances.  He has agreed to serve 96 months in prison and pay restitution.  He is a former licensed physician.

US v Horizons Hospice
Settlement

Horizons has agreed to pay $1.24 million to settle a whistleblower suit for admitting patients who were not terminal.  This settlement comes as two execs were sentenced to prison for fraud.  

US v Ahmed
Sentenced

Dr. Syed Ahmed, a surgeon in New York, was sentenced to 13 years in prison for fraud. He also is to repay $7,266,008, forfeit an equal amount and pay a fine of $20,000.  He billed for procedures never performed.  

US v Norman
MD Fla

A whistleblower action against Dermatology Healthcare and its owners alleging false billing due to radiation services not provided and provided by a radiation tech without supervision.  The relator did not provide specific actions by each defendant.  The truth or falsity of the accusations were not decided.

US v Memphis Operator
Settlement

The feds alleged that services provided by Spring Gate Rehabilitation and Healthcare Center were so substandard that they were worthless and should not have been billed.

US v Arshad
Filed

Dr. Muhammad Arshad of New Orleans and Dr. Padmini Nagaraj of Kenner have been charged with getting kickbacks from a New Orleans home health company for referring patients unnecessarily.  They are both psychiatrists.

US v Henry Ford Allegiance Health
Settlement

This case now into its third year of litigation has finally been settled.  The feds alleged that the hospital did anticompetitive marketing with three other hospitals.  They are alleged to have agreed not to market in each others market.  Henry Ford was the only one not to settle up to now.  They have agreed to reimburse litigation costs and submit to compliance inspections.        Top

Healthcare

Weems v Montana
Filed

Two NPs have filed suit to be able to perform abortions in the state.  Montana has a law that only physicians and physician-assistants are allowed to perform the procedure.  The ACLU, who filed the suit, wants to overturn the law and prevent its enforcement while the suit is in progress.  

 Physicians v US
USDC Tennessee

The physicians filed suit against the feds after they were told they had to repay money that was paid to them under a pay bump for seeing Medicaid patients under the ACA.  The kicker is that the physicians had to be boarded in family practice, peds or geriatrics or if not certified they had at least 66% of the claims for EM services.  This was claims not money.  The 21 physicians who sued did in house labs or imaging and sued because they did in house testing and were discriminated for this.  The federal judge agreed with the physicians and the fed has 30 days to appeal. 

US v UnitedHealth
USDC

A federal judge in LA has ruled that the feds can proceed on their case against the insurer that they claim has retained over $1 billion wrongly.  The judge ruled that the feds had sufficiently plead their case that the insurer submitted invalid data regarding the MA patients.  He did dismiss the feds case that the insurer falsely attested to the validity of the claims.  

Piedmont Hospital v Blue Cross
Filed

The hospital system has filed suit since they do not like the insurers refusal to pay for outpatient expensive imaging.  They will pay for the tests at cheaper free standing facilities.  They think it is a breach of contract.  The insurer will also not pay for Emergency Room treatment when it is not necessary unless the insured had good reason to believe it was an emergency.  Bottom line is the hospital is losing money and they do not like it.        Top

HIPAA

Aetna v Kurtzman Carson Consultants aka KKC
Filed

Aetna has been paying out to the tune of about $20 million to date for the HIV breach on their envelopes sent to members.  Now they are suing KKC for sending the notices.  They want their money back and for KKC to be on the line for all costs.  KKC not to be outdone are suing the attorneys for Aetna for not doing their job.        Top

Malpractice

Neesam v Mt. Sinai West
SD NY

The plaintiff should have used a different attorney.  This one filed both a legitimate state med mal case and a federal EMTALA violation.  To no one's surprise since the patient was hospitalized at multiple hospitals the EMTALA case was dismissed and the state med mal claims survived if filed in time under the statute of limitations.  

Wilcox v US
8th Circuit

The plaintiff sued the physicians Nielsen and Johnson for not diagnosing her cancer and then added Lake Regional Hospital and Richland Medical Center, a federally supported health center for vicarious liability.  Mistake.  The physicians were not employees and the granting of privileges do not make them employees.  Another poorly done job by an attorney.  However, if on contingency they lose their time and money.  Good.

Seitz v US National Whitewater Center
Filed

Teh father of a teen girl who died after being infected with the amoeba Naegleria fowleri, the "brain eating amoeba".  She died days after her raft overturned while at the facility.  The facility was not regulated to protect the public from waterborne diseases, according to the suit.  The facility denies any culpability but a federal epidemiologist found the filtration and disinfections systems were inadequate.        Top

Peer Review and Employment

Day v Spectrum Health Medical Group
Filed

Dr. Susan Day, an orthopedic surgeon, filed suit stating she was constructively fired from the Grand Rapids, Michigan, group after treatment for breast cancer.  She says she was a victim of sham peer review while on leave for the treatment.  She alleges she had a strong practice and her firing enhanced the earning of the chief of orthopedics Dr. Peter Jebsen.  Day alleges she complained about the way billings were done regarding physician assistants and several days later was diagnosed with breast cancer.  While on leave she alleges Jepsen showed a case to another ortho who found nothing wrong but then proceeded to pull other cases.  Jepsen then presented these 16 cases to the executive committee instead of the usual peer review committee.  The MEC requested Day on return have the first 50 cases reviewed prior to surgery by a surgeon of her choosing.  She agreed as this was standard for all returning from an extended leave of absence.  Upon her return the investigation continued and Spectrum returned money to six insurers that they say had surgery that was not necessary.  Day was never consulted regarding this.  She was asked to resign but refused.  Spectrum then filed a report to the NPDB regarding the 50 cases stating truthfully that Day consented but not saying it was routine for all returning.  She is now under investigation from the Michigan medical board.   She has never gone through peer review.

Pinter-Brown v UCLA
Filed

Dr. Lauren Pinter-Brown an expert in T Cell lymphoma had problems with a subordinate physician and felt she was discriminated against because of her sex and age.  She had her research suspended in June 2012 when some became concerned about the test trials.  The research was reinstated in October 2013 but she left for UC Irvine in 2015 and then filed suit.  

Geier v Medical Board of Maryland
Plaintiff Victory

Dr. Mark Geier, believed that vaccines cause autism and the state medical board took his license for those beliefs.  The board posted a cease and desist order on their website alleging Geier had improperly prescribed meds for himself and his family and listed the meds.  Geier was humiliated by other physicians because of the disclosures.  He sued and not only did he win $2.5 millio0n but half of the judgment was ordered to be paid by all including the board attorney out of their own pocket.  The judge excoriated the board for their lax and probably purposeful forgetting of all details and erasing emails.  The board and individuals will appeal.

Hakki v Galencare (Northside Hosital)
DC Fla

Dr. Hadi Hakki sued the hospital for defamation.  The trial court ruled that the physician did not plead with sufficiency but the higher court said he did and allows the case showing extreme bias and malice by the hospital to go forward.

EEOC v Memorial Healthcare
Filed

The EEOC had filed a federal suit against the Owosso, Michigan, provider for discrimination.  The hospital rescinded a job offer to after she refused flu vaccine but volunteered to war a mask as is offered under hospital policy.  She had a religious objection to the influenza shot or spray.  Even more interesting is the job really was for her to work at home.

Kern v UNM Hospital
Filed

Kern is suing for discrimination after she started working as a nurse at the hospital.  She claims that she was treated differently and bullied because she is from Spain and has an accent.  Seems strange in New Mexico where Spanish is prevalent.        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.