Bechtold v Sanford Health
Drs. Dustin Bechtold and Bryan Wellman, two physicians at Sanford Health have filed suit accusing their colleague Dr. Wilson Asfora, a neurosurgeon at Sanford and Sanford Health of defrauding fed med by doing unnecessary spine surgeries to use medical devices Sanford purchased from a company owned by Asfora. The suit also alleges billing for care never provided. The pair of Asfora and Sanford conspired in the past and paid fines for violations of the anti-kickback rule. The feds have intervened here. The top brass at the hospital call the charges bogus in an email. Remember the hospital is also named so they may have an ulterior motive.
US v Encompass Health
The nation's largest operator of inpatient rehab facilities has agreed ot pay $48 million to settle allegations that they provided inaccurate information to Medicare to get a higher rate of reimbursement and that some admissions were not medically necessary. This is a qui tam filed by a former contract physician with Encompass, a former Director of Therapy Operations and a former Medical Director. They will get $12 million.
US v Our Lady of Lourdes
The hospital agreed to pay $1,143,881 to resolve claims that it did not perform the necessary criminal checks on individuals working with seniors. Also supervisors and others falsified records.
US v Marcotte
Kyle Marcotte of Jacksonville Beach, Florida, plead guilty of money laundering and agreed to forfeit $10,220.281. He was the owner of a substance abuse center and he got a kickback of 40% from a lab on the urine samples he sent for testing. The lab ran the billing through Campbellton-Graceville Hospital to get favorable rates of reimbursement. He also arranged for other substance abuse centers to do the same thing and he raked in a percentage of each deal. The lab owner then purchased a Georgia hospital Chestatee and they ran the scam via that hospital.
US v Godiali
Dr. Vasso Godiali, a vascular surgeon in Bay City, Michigan, was indicted for fraud and money laundering. The feds alleged he billed illegally for dialysis vascular stents and arterial clearing. He was alleged to unbundle his charges billing for multiple procedures when he was allowed to bill only for one. The feds are looking to get back almost $4 million.
US v Steiner
Dr. Anna Steiner, an anesthesiologist in New York City, was indicted for telemedicine health care fraud. It is alleged that she did fraudulent telemedicine to get money for unnecessary meds and medical equipment.
US v Camillo
Anthony Camillo of Madison County, Illinois, was sentenced to 30 months in prison for fraud and paying kickbacks. He was the owner of Allegiance Medical Labs and paid illegal kickbacks to marketers for sending tests his way. Doctors names were forged on slips for the lab tests. Top
States v Insys Therapeutics
Five states have finally woken up. They have put their suit against Insys on hold in order to keep the company out of bankruptcy. There will be settlements instead.
EMW Women's Surgical Center v
The Circuit several months ago upheld the state law requiring doctors who perform abortions to first do an ultrasound and attempt to show or describe the image to the patient and play an audible heartbeat of the fetus. The Circuit recently refused an en banc review of that decision.
Merck et al v HHS
DHS attempted to get transparency in drugs and was shot down by the federal court. The judge ruled that DHS lacked authority from Congress for their rule to make the drug companies who advertise on TV or other medial include the wholesale price of the drug. He bypassed all the HHS and drug company arguments in this ruling.
US v Reckitt Benckiser
The pharmaceutical company has agreed to pay a whopping $1.4 Billion to end investigation into its marketing Suboxone illegally.
California v Azar
In a rare non-liberal vote the Circuit voted 7-4 along party lines to allow the withholding of federal Title X funds for those who provide abortion referrals. This ruling restores the original ruling of 1988 and which was upheld by the Supreme court in 1991. Top
Patients v Summa Health
Summa Health is known for its poor physician treatment but now for poor IT protection. It has announced that about 500 patient records may have been compromised in a phishing incident. Summa could not be sure that any information had actually been viewed.
Patients v Dominion National
This insurer is notifying patients that it has had a breach for nine years and was not aware of it until now. They deserve a huge fine by the feds for their stupidity and negligence. Top
Bair v Memorial Healthcare
Yvonne Bair sued after the hospital refused to hire her for a medical transcription job after she refused to get a flu shot. Her religious belief is that she can not inject or ingest a foreign substance. She should have been given an option to wear a mask as they have others who can not be vaccinated for medical reasons. They were ordered to pay her back pay, compensatory damages and punitive damages, a total of almost $75,000. The hospital must also train its executives on religious discrimination.
Lagan v Windle
Seamus Lagan, the CEO of Rennova Healthcare, is suing Representative John Windle (D) for libel. In an interview after the closure of Jamestown Regional Medical Center owned by Renova, Windle is quoted as calling Lagan a thief who came to Tennessee to take employee's money and cheat them. Lagan, identified as a Northern Ireland citizen said he was never the CEO of the hospital so he could not have not paid employee taxes to the IRS or other thing that were apparently done illegally at the hospital.
US v Premera Blue Cross
The company had a data breech and is now paying the piper. They agreed to pay $10 million to 30 states plus $74 million to settle a class action federal suit by its customers. Premera had known about the problems with its system and did not fix it in a reasonable time. Top
Echeverria v J&J
In the original trial the plaintiff was awarded $70 million in compensatory damages and an additional $347 million in punis for having the talc a causative agent in her ovarian cancer. The trial judge tossed the verdict as not enough evidence to support the verdict. The appellate court said J&J could not be held responsible only the subsidiary Janssen that manufactured the product. They overruled the judge regarding the cause of the cancer. They also said there was no malice so punis could not stand. Top
Lucas v Stanford
The ex-nurse filed suit after being fired. He alleges that the firing was due to him talking about unsafe working conditions at the Lucille Packard Children's Hospital. He states he was fired just prior to state inspectors being there on an unrelated complaint so he could not talk to the inspectors. The hospital denies all.
Kunkle v Auburn Community Hospital
Dr. Herbert Kunkle is the third physician to file suit against the hospital for being fired after telling the CEO about quality problems at the hospital. Prior Dr. Gegory Serfer filed suit against the hospital alleging the administration terminated his contact after he told them about problems with a former ICU physician. That case settled. Dr. Karen Odrzywolski also filed suit against the hospital also complained about the ICU physician and she was also terminated. A state audit last year blasted the hospital for not promptly investigating the complaints. Sounds like the administration needs looking into by the Board. 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.