US v Gowder
John "Mike" Gowder, the former CEO of Union General Hospital and Dr. James Heaton were convicted of 102 counts of obtaining and selling narcotics illegally. Healton prescribed the narcotics to Growder without medical need. Growder then got the meds from various pharmacies.
California v Koepplin
Kristie Koepplin of Peoria, Arizona, was arrested and charged in the murder of Matthew Sokalski. She ws arrested and extradited to California for trial. It is alleged that she injected im with drugs in a right to die case. This happened prior to California enacting its right to die law.
New York v Blati
Dr. George Blatti was arrested and charged with illegally selling prescriptions for narcotics. This was out of the trunk of his car in a Dunkin Donuts parking lot according to reports.
Florida v Dennis
Dr. Tar Dennis is an OB who is accused of writing prescriptions for Ambien for male patients as well as females. She was arrested several months ago on these charges and now has had her license to prescribe or order meds suspended.
Georgia v Ulbrich
Two physicians and a their secretary were convicted of practicing medicine without a license for running an unlicensed cosmetic surgery clinic. Neither Nathaniel Johnson III nor Peter Ulbrich were licensed as both had had their licenses revoked; one for sexual misconduct annd the other for healthcare fraud. Top
US v Abarientos
Dr. Crispin Abarientos of Middletown, Connecticut, was sentenced to over three years in prison for Medicaid fraud. He was convicted of obtaining Remicade under false pretenses and infuse it into others to collect money. He has repaid the system for his misdeeds.
US v Tenet
Tenet has agreed to pay $66 million to settle allegations that they billed for procedures by physicians that had improper financial or kickback relationships with one hospital.
Plaintiffs v Allergan
Forest Labs, a subsidiary of Allergan, agreed to pay $750 million to a class of plaintiffs that are direct purchasers of Namenda.
US v Encompass Health
The company agreed to pay $4 million to settle allegations that an owned inpatient facility was wrongly billing Medicare. It was alleged that they assigned inaccurate low admission Functional Independence Measure scores causing higher payments.
US v Haar
Sandra Haar, the former CEO of Horisons Unlimited, a Merced, California, nonprofit that provided health and dental services, was sentenced to five years in prison for billing for services she new were not billable and for services by physicians when in reality patients were given Suboxone in parking lots in baggies. She also received money from labs in kickbacks for using their services.
US v Fagron Holding
The pharmaceutical company agreed to pay $22.5 million to resolve allegations that it inflated wholesale prices for compound meds and submitted false claims.
US v Mesquias
Rodney Mesquias, Henry McInnis and Dr. Francisco Pena were convicted by a jury of health care fraud. They ran a hospice center in Texas and billed for items after falsely telling peole they had less than six months to live. Many were healthy individuals.
US v Kassis
Dr. Spiro Kassis of Plymouth Township, Pennsylvania, was previously criminally convicted of prescribing opioids without a medical reason. He has now agreed to a settlement in the civil action to pay $1.4 million to settle allegations that he prescribed narcotics for several years without a DEA license and that he prescribed without a medical reason. He has also agreed to a 15 year fed med exclusion.
US v Schabert
Dr. Erik Schabert and his wife Mika Kamissa Harris both of Northern Florida were convicted of fraud. They billed for chemical peels for intentionally misdiagnosing patients with Rosacea and actinic keratosis.
US v Life Spine
The spinal implant company as agreed to pay $5.5 million to settle allegations that it paid kickbacks to physicians to use their product. Their CEO and vice president of business development each tossed in a few hundred grand to the settlement. As part of the settlement the company accepted responsibility.
US v Sanford Health
The system got a double whammy. First it got dumped by UnityPoint in a potential merger and then got popped by the feds for billing illegally for the services of a physician and was required to not only pay $20 million but also to sigh a corporate integrity agreement. The agreement mandates they bring on board a compliance officer, conduct annual training in federal kickback laws and get a independent board including non-employees and non-executive members that meet at least quarterly to make sure Sanford is n compliance with fed laws.
US v Soito
Lois Soito plead guilty of fraud for stealing money from the Saint Alphonsus Health system. She deposited checks meant for the hospital into her account.
Massachusetts v Tuerk
Dr. Ingolf Tuerk, of Dover, agreed to pay the state $150,000 to settle allegations tha the caused his employer to bill Medicaid inappropriately. The urologist instructed his residents to document the use of ultrasound probes with partial nephrectomies even if not used. He also billed for office visits even if the patient was being seen by unsupervised residents. Top
People v US
A single Obama appointed judge in Oregon decided that the administration rule that would block all immigrants from coming to this country unless they could prove they would have the means to get health insurance within 30 days.
Pierce v Wyndham Worldwide
The court ruled that a person with an ERISA plan that was administered by Cigna could not sue to get coverage for a procedure that was deemed experimental. Top
Patients v Utah Valley Eye Center
Over 20,000 patients had their information compromised at the Provo clinic after their portal has hacked and an email was sent out. They are NOW taking additional steps to secure the systems.
Patients v InterMed PA
InterMed had a breach of its email by a phish and 30,000 patients information was potentially affected.
OIG v Rochester Medical Center
The hospital agreed to pay $3 million to settle claims that a lost laptop computer was unencrypted. They had failed to take appropriate measures and had not done a risk analysis. Bad hospital Bad.
Patients v Salem Health
The Oregon health plan announced a third party had gained access to email accounts and may have exposed patients PMI.
Doe v Beaumont Hospital
A woman has filed suit against the Royal Oak hospital for leaking information that she had herpes. She blames an employee at Advanced Cardiovascular where she was never a patient but where the former friend worked as an medial assistant. Top
Ohio Valley Physicians v
Williamson Memorial Hospoital
The physician group is suing the hospital for breach of contract. They agreed to cover the ED for money and that the hospital stopped paying them. At the time of filing they claim they are owed almost $600,000.
Employees v Hospitals
Five Montana hospitals agreed to pay $6.9 million to settle a suit claiming they cheated by inflating employee health coverage prices in return for a $26 million split between th hospitals. They agreed to buy employee health insurance from BCBS of Montana for six years for the money.
Kaiser v The Queen's Health System
Kaiser sued Queens in Honolulu because the were balance billing Kaiser patents that received care at their hospital. The two had a contract that expired and therefore allowed Queens to get their allotted payments without any discounts. Kaiser says it will appeal.
Ballard Health v Cook
Ballard Health has filed felony charges against a woman who opposes a merger between Mountain States Health Alliance and Wellmont Health System. She has organized sit-ins and is being charged with killing grass from the tents outside the hospital. She is also accused of digging a trench along the sidewalk. Sounds like a fun hospital.
Paradigm v Via Christi Hospital
In a contract dispute where both sides agree that the contract provision at issue was erroneously added the high court ruled that the hearing officer's ruling should not have been appealed but when a board approved the hearing officer's report, the rationale was reasonable. The issues was the words "whichever is least".
Beaumont Hospital v Michigan
The system is suing the state after it was refused the OK to build a new 119 bed facility. It claims the state is overstepping its authority regarding the CONs. Top
Emmons v Jones
The plaintiff alleges that Dr. Paul Jones, a Colorado fertility physician, used his own sperm instead of an anonymous donor to impregnate her. The children did an DNA test and found they shared DNA with cousins of Jones. This occurred in the 1980s.
Yanakos v UPMC
The state high court again screwed its citizens by tossing the state statute of repose. The court says the statute passed in 2002 violates the right of access to the courts. Yanakos contends that the hospital was liable for taking a piece of liver for transplantation from son to mother since both had the same genetic liver disease. The state had a seven year repose, a time that should be adequate if the attorneys were adequate.
Ricciardi v Abingdon Care and
The nursing home had an arbitration agreement mixed in with all the other initial papers to sign and not explained to the residents who signed it. They were also not given a copy after signing it. The arbitration agreement is not worth the paper its written on according to the court.
Patients v Geisinger
Geisinger has announced they have found the culprit in the illness of three infants, several of whom have died. It is equipment used in measuring donor breast milk in premies is the source of the Pseudomonas. Top
Barrick v Ivinson Memorial
Dr. Kenneth Barrick wants $38 million. He alleges that he was forced to resign as CMO after he tattled that an unqualified anesthetist was working in OB because he was having an affair with a top hospital exec. When he went back to being an ED doc he was not given any shifts.
Patel v Meridian Health
Dr. Robert Patel was suspended from the hospital after an investigation into an alleged improper patient transfer. It was alleged that he did not maintain an office in the area as is required by the bylaws and engaged in a transfer of patients contrary to the best interest of the hospital (not the patient). The MEC upheld the suspension and voted to terminate his privileges and the board stamped it. He sued for the usual reasons and lof course lost since HCQIA does not allow the suit.
Burke v Massachusetts General
Dr. Dennis Burke, an Ortho, was fired from the hospital for what he alleges was criticizing the practice at the hospital of double booking. The hospital states he was fired for releasing redacted patient records relating to the double booking. He was offered his job back but declined and took $13 million instead.
Whistleblowers v Northwell Health
The hospital agreed to pay $12.3 million to three whistleblowers who claim Dr. David Samadi, a former Urologist at the hospital, defrauded Medicare by billing for surgeries performed by trainees while he operated on other patients. He also was accused of billing for OR surgeries that could have been done elsewhere. The whistleblowers are still pursuing claims against Dr. Samadi.
Totonelly, Jr. v Health Quest
Dr. Phillip Totonelly, Jr., a cardiologist at Putnam Hospital was denied privileges and is suing. It is interesting that he has held no inpatient hospital privileges anywhere since 2012 so can not document any competencies in the last 24 months as required by the hospital. The hospital was very stupid in not giving him a written statement as to why he was rejected. He is asking for $20 million and be granted privileges. He will never get the second wish and the first is also very doubtful. Top
Mirza v Patients
Dr. Muhammad Mirza of NYC is suing several of his past patients for terrible on-line reviews. His practice is said to focus on Botox injections and sexual health. The review besmirched his professional reputation calling him a cheat and a scam artist. 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.