US v Thaxter
Shaun Thaxter, the fore CEO of Indivior was sentenced to six months in prison along with forfeiture of $500,000 and a fine of $100,000. He had plead guilty of putting misbranded Suboxone into interstate commerce.
US v Nyachira
Tamara Nyachira, a pharmacist in Pittsburg, Kansas, was sentenced to three years probation and a $5000 fine for forging prescriptions for narcotics for self use.
Tennessee v Starr
Candie Starr, the former CEO of Lincoln Health System in Fayetteville, Tennessee, was indicted for allegedly stealing funds from the system.
US v Farmer
Richard Farmer, a psychiatrist in Memphis, was sentenced to 48 months in prison for illegal distribution of narcotics. Top
US v Javed
Sajid Javed, the owner of multiple pharmacies in New York city, was sentenced to 30 months in prison plus restitution of $7.5 million and forfeiture of over $7 million. He had pled guilty of health care fraud for submitting false claims to fed med.
US v Barnes
The circuit upheld the convictions of Drs. Sheldon Barnes, Henry Evans, Gregory Molden and Michael Jones who were house officers for Abide Home Care Services. they had been convicted of fraudulently certifying unnecessary hone health products in exchange for sham payments.
US v Great Lakes Medical
The lab has agreed to pay $1.2 million to settle allegations that they illegally double billed and billed for services not ordered in their Michigan operation.
US v Qureshi
Drs. Shoaib Qureshi and Iman Mirza along with Memphis Primary Care Specialists, Luncefor Family Health and Get Well Family Medicine all in Memphis agreed to pay a total of $340,000 for billing for services rendered by nurse practitioners as if they were physicians.
US v Mohamoud
Mesbel Mohamoud and Erlinda Abella of Inglewood, California, pled guilty of billing for charges that did not qualify for reimbursement or not provided. They ran a drug and alcohol abuse program.
Wollman v Massachusetts General
Dr. Lisa Wollman, who worked as an anesthesiologist at the hospital, sued under the False Claim Act as a whistleblower alleging health care fraud. Wollman wanted certain documents from the hospital but the hospital claimed they were protected by peer review. The court said no and the documents need to be produced providing they are relevant and may be protected by other privileges. This had to do with scheduling overlapping procedures on Medicare patients.
US v Raventos
Lisa Raventos of Miami pled guilty of wire fraud, She admitted to lying about subjects in a clinical trial by falsifying medical records.
US v Dube
Regan Dube and her husband Michael dube were the owners of American toxicology Labs. They had pled guilty to fraud as Michael had been barred from fed med years prior. Regan got four months of home detention. Michael will be sentenced later. They had to also pay over $9 million plus interest which includes all the money they received from fed med.
US v Panos
Dr. Spyros Panos of New York pled guilty of wire fraud and health care fraud. The unlicensed orthopod assumed the identity of a second orthopod and received money for reviewing patient files for Worker Compensation cases.
US v Antebi
Dr. Morris Antebi of Long Branch, New Jersey, was indicted for fraud. He is accused of billing over $24 million for services over six years. He is alleged to have billed when he was not available and traveling in Europe as well as billfor over 24 hours of services in one day.
US v Nawaz
Dr. Nava Nawaz of Mechanicsburg, Pennsylvania, has agreed to pay $850,000 to settle allegations that she submitted false travel claims for collecting specimens for her lab company. She also agreed not to seek or be an owner of a lab for 18 months.
US v Perwaiz
A federal jury has convicted Dr. Javaid Perwaiz, an OB/Gyn in Chesapeake, Virginia, of multiple counts of fraud. He was convicted of doing unnecessary hysterectomies and other procedures that were not medically necessary in order to get more money from fed med.
US v Haggerty, Jr.
Dennis Haggerty, Jr., a businessman in Burr Ridge, Illinois, was charged with fraud. He was accused of swindling two hospitals who purchased PPE by using the money to purchase automobiles and other personal matter and not deliver the PPE. Top
Keslar II v Baptist Emergency
Physicians v UnitedHealth
Multiple ED physicians in New York City have banded together to file suit against the insurer for paying them less than owed. The physicians were all out of network for the insurer and not allowed by law to balance bill.
California v Memorial Health
The health system had self disclosed it had overcharged Medicaid for three years. It has agreed to pay the state $31,532,679 is restitution. Of that amount about $12 million will go to the feds and Medicaid will get about $12 million with the remainder going into the deep dark hole called the general fund.
Murphy Medical Associates v Cigna
The practice in Connecticut is suing for just over $9 million. They allege that the insurer did not pay reimbursement to its patients for Covid tests performed. They claim Cigna denied the claims and the appeal before the practice could send in the medical records to back up their claims. The suit also states that Cigna has told patients and labs that the practice is a "fraudulent enterprise". However, all is not what it seems. The NYT filed an article about Murphey's tests. He did tests not only for Covid but for dozens of other viruses as well that ran up the costs for the tests to many thousands of dollars per person. Much of this was not covered under Covid nor insurance so the patients may be put in financial harm. Murphy says he has tested over 60,000 patients in this way. Top
Patients v Saint Francis
The system agreed to pay $350,000 to settle claims by patients impacted by a ransomware attack on the Missouri Ferguson Medical Group. The group did not pay the ransom and did lose all records for a three month period. The victims did get free credit monitoring but found an attorney to sue for negligence. All will get $200 for out of pocket expenses.
HHS v Riverside Psychiatric Group
The California group was fined $25,000 for not giving a copy of a women's medical file to her promptly. This was after the group was warned by the feds about the problem. The group believed rightly that they did not have to give the patient the psychotherapy notes but they did not give her any medical records. They have now given her the records without the psychotherapy notes.
HHS v Wakefern Food Corp
The cooperative based in New Jersey agreed to pay $235,000 for discarding electronic devices into a dumpster that had patient information relating to pharmacy services on them. They not only had to pay the money but also must hire a privacy officer and provide training to its employees.
HHS v City of New Haven
The city agreed to pay over $202,000 and put in a two year monitoring plan. The city's health department said that a terminated employee returned to the office logged on to her computer and accessed PHI .
Patients v Mayo Clinic
The records of over 1600 patients had their medical records invaded by an employee and are now trying to do a class action law suit.
Zoll v Barracuda Networks
Zoll, a medical device vendor, has sued an IT service vender for a breach involving almost 300,000 people. They had a business association agreement with another company that hired a third company to do email archiving. That company merged with Barracuda. The suit claims Barracuda failed to implement adequate security measures. Because of the breach Zoll settled with the victims and wanted indemnification from their original business associate who never responded. Top
Simoni v New Jersey University
Stephen Simoni was a cardiac nurse at the hospital. He was terminated and sued as a whistleblower. The court said there was no nexus between the two. The lower court gave summary judgment to the hospital on the state and federal law claims and the 3rd Circuit affirmed.
Chaudhry v Adventist Health System
Dr. Ahmad Chaudhry was fired from Adventist Health and sued. In the trial court he won $millions of dollars. The case was appealed and the appellate court ordered a new trial due to the wrong jury instructions being given to the jury by the trial judge. He said the jury only had to find the causation needed to be a motivating factor not the "but for" standard. 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.