Colorado v Fernandez
Carlos Fernandez was found guilty of second degree assault and criminal impersonation for posing as a cosmetic surgeon in Denver. He agreed to pay $189,000 in restitution and was sentenced to six years in prison. He also told the judge he does not have the money to pay the $189,000.
California v Brill
Dr. Judith Brill, an anesthesiologist at UCLA, is being investigated for the potential to hasten the death of a 8 year old boy in order to harvest the organs. This incident occurred in 2013. The boy had fragile X Syndrome and was found pulseless with his head in a washing machine at home. His heart was re-started and he came to the hospital. The physicians said he had no chance of normal brain function nor waking and the parents decided to stop treatment. He was given 500 mg. of Fentenyl to ease his suffering. The coroner, Denise Bertone, RN, is the one pushing this case and the police are investigating. No charges have been filed. Bertone is also suing her former employer for retaliation.Top
US (Flexon) v Meadows Regional
In a summary judgment motion Dr. Phil Flexon pled with enough specificity to allow the trial to continue. He was employed by the hospital and then terminated. He filed suit not only for retaliation but also for fraud. He alleges that the hospital and Dr. Wayne Williams billed for unnecessary procedures and for procedures Williams did not perform. Flexon named two particular Medicare patients and showed the billing was erroneous.
US v Freedom Health
The Medicare Advantage organization agreed to pay the feds $32.5 million to settle claims that they submitted unsupported diagnosis codes to get more pay. The payments included $750,000 from Siddartha Pagidipati the COO of the organization. This is a whistleblower case so the former employee will get a bunch of money.
US v eClinicalWorks
The electronic health record vendor will pay $155 million to settle claims paid kickbacks to customers in exchange for promoting its products which were over promoted. The feds state that the company falsely obtained their certification necessary to sell their product. They fudged their data. The settlement also requires the company not only to enter into a CIA but also to provide for free upgrades to its customers updated versions of software. The whistleblower in this case gets $30 million.
US v Andover Subacute and Rehab
Center Services Two
The Sussex County, New Jersey, facility has agreed to pay $888,000 to resolve charges that they billed for worthless services.
US v Kudmani
Dr. George Kudmani, an OB from Louisville was sentenced to 48 months in prison for unlawfully distributing controlled substances and health care fraud. He did vaginal ultrasounds without a medical reason.
US v Tesher
Dr. Martin Tesher of New York was arrested for illegal distribution of narcotics. The feds allege he wrote in his GP office over 14,000 prescriptions for Oxy.
US v Hamdan
Dr. Aiman Hamdan along with his wife Kristina and Dr. Yousef Zibdie all of Paterson, New Jersey were arrested for accepting bribes to refer patients to the infamous Biodiagnostic laboratory services. They got a $500,000 loan, a private jet trip to Florida, and household expenses. This was all done via Mrs. Hamdan who paid for all this via the kickback.
US v Fredericksburg Hospitalist
The medical group paid $4.2 million to settle allegations of false claims for knowingly and intentionally upcoding. They routinely billed the highest codes.
Connecticut v Betser
Georgy Betser, DDS and his wife Irina have agreed to forfeit $755,956.30 and will be excluded from Medicaid for 10 years as well as lose his license for participating in a scheme to submit false claims for dental services in long term facilities. The billings were for the services that were never provided or dentures that were improperly made. Top
In Re Illinois
The state is not in compliance with a previous order to to pay Medicaid fees owed. The judge recognized the state Comptroller was in a tough spot but again order that significant payments be made by June 20.
Stapleton v Advocate Health
In an 8-0 decision the court agreed that church affiliated hospitals do not have to comply with ERISA. The hospitals were accused of under funding pension plans which ERISA says must be funded. The court said the religious exemption applies to pension plans both of churches and those established by organizations affiliated with churches.
Novartis AG v Amgen Inc.
The Court unanimously agreed that generic biosimilars could come on the market under Ocare immediately after approval. The lower court sad thee needed to by a six month waiting period. The biosimilars are just that similar, not a duplicate. Top
Patients v Trios Health
The Washington state organization had an employee that looked at 600 patient files illegally. They should have caught it after one or two but like most organizations only give lip service to security.
US v Lubin
Emeline Lubin, a former employee of Tufts Health Plan, was sentenced to three months in prison and payment of $52,000 for stealing patient information of 8700 customers. She sold the information to another to get money from falsified income tax refunds. The others have already been sentenced to over one year in prison.
Patients v North Dakota Health
A citizen found in a dumpster 2000 Medicaid records. One employee improperly discarded the documents on May 8 and they were recovered on May 10.
Patients v Kadri
Dr. Zain Kadri, a Beverly Hills Plastic Surgeon, had about 1500 records stolen from his practice. It is alleged that a former employee stole the records after being fired. This was found after the company phone was returned. She had been taking pictures of the medical files and sending pics of SSNs and other information to others. Top
Wollman v MGH
Dr. Lisa Wollman, an anesthesiologist, filed suit against Massachusetts General Hospital for intentionally keeping patients anesthetized for longer than necessary due to concurrent surgeries. She states she knows of at least five patients put at risk due to the concurrent surgeries. She says this is not only medically unnecessary but also fraud. Top
Messinger v National Board of
Brian Messinger is dyslexic and went to medical school in Grenada. He needs to pass the US Medical Licensing Exam to start a peds residency but flunked it twice, once in 2015 and 2016. He is now suing for them not allowing him more time to complete the exam. The Board has in the past allowed extra time for exam takers with disabilities. He wants the Board to change the way they give tests to people with disabilities and also damages for lost income. Top
Plowman v Fort Madison Community Hospital
The state high court for the first time has allowed a wrongful birth claim. This is a baby born with a genetic defect that should have been detected pre-natal. The radiologist spotted a problem and reported it but the OB ignored it and told the parents all is OK. The father is also a potential claimant along with the mother since it is foreseeable that both will have financial damages from the rearing of this child.
Brenner v Universal Health Services of Rancho Springs
It is always nice to see the right verdict and the attorney lose money when they pursue a case with no merit. Brenner sued after the husband died for negligence, elder abuse and retaliation. The wife says the physician and hospital retaliated after she complained about the nursing care. The lower court granted summary judgment and the appellate court agreed. For the negligence there was not a triable issue. There was no reckless issue for the elder abuse claim and there was no standing fr the retaliation. Retaliation is not allowed against individual physicians and the family has no standing against the hospital. Top
Zeng v Marshall University
Dr. Wei-ping Zeng sued the Marshall University medical school for discrimination. He states that his performance was better than others who were granted tenure. He says he was discriminated against because he is Asian. He goes on to state that after he complained he was fired. He is doing this pro per as no attorney would take the case. Two other Asians were given tenure.
Parungao v Community Health
Dr. R. Sherwin Parungao filed three previous lawsuits and was denied in them all. In this one the former Galesburg, Illinois, surgeon has again stated that the Knox Clinic did not follow their bylaws and then kept him from getting another position. His first suit was voluntarily dismissed. The next day he filed another action but wanted it under seal. That was also denied and the suit withdrawn. He then sued in state court against the Chief of Staff for defamation. The COS told other institutions that Parungao resigned under investigation and that he was not the subject of any disciplinary action. The defendant won the law suit for failure to state a claim and this was affirmed by the state appellate court. He then filed this suit in federal court against others on basically the same claims. He lost on res judicata.
Desai v Lawnwood Medical Center
As most physicians this one lost in all courts on the issue of suing a hospital for wrongful termination when the physician did not partake in an offered hearing. The physician did not fulfill his requirement regarding exhausting all administrative remedies prior to suit. The physician and the attorney should have known better. This pathologist was not reappointed to the staff after the medical staff recommended him for reappointment. The board denied it and the board had a fair hearing process but Dr. Anil Desai did not partake.
Haufrect v Houston Methodist
Dr. Eric Haufrect, an OB, filed suit against the hospital for secretly taping phone conversations between patients and nurses without their knowledge for up to eight years. He found out about the taping from a nurse and complained to the administration. he was soon removed as vice chair of the department and states he was the victim of a whisper campaign by the hospital to damage his reputation. The CEO says the recordings were on a appointment line to improve patient service and Haufrect was removed for not performing his duties. He remains salaried and on staff. An expert said that the taping is illegal no matter the purpose. 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.