September 15, Recent Legal News

Fraud

Healthcare

HIPAA

Hospitals

Peer Review and Employment

Fraud

US v Christus St. Vincent 
Settlement

In a qui tam case the Christus St. Vincent Regional Medical Center and Christus Health agreed to settle false claims charges by paying $12.24 million plus interest.  They illegally paid money to the New Mexico county governments which in turn were used to fund the state share of Medicaid payments to the hospital.  

US v Floyd
Guilty

Dr. Fredrick Floyd of New Orleans plead guilty of fraud and, selling illegal druga and money laundering.  His Louisiana license was revoked in 2016.  He faces many years in prison.

US v Novo Nordisk
Settlement

The company agreed to pay the feds $58.65 million to settle allegations it illegally marketed its diabetes drug Victoza.  They were accused of downplaying warnings for the drugs and misleading physicians by saying their salespeople were medial educators and paying kickbacks to get the physicians to prescribe the medication.  Almost all the money goes to the whistleblowers with only about $13 million to the feds.

US v Galena Biopharma
Settlement

The comoany has agreed to pay a fine of $7.55 million to settle a suit that it paid kickbacks to physicians for prescribing its opiate Abstral.  The whistleblower will get $1.2 million.

US v Family Medicine Centers of South Carolina

The family practices agreed along with its owner and lab director agreed to pay a fine of $1.56  million for the practice and another $443,000 from the individuals for doing false claims by billing for lab tests ordered by physicians with a financial interest in the tests.  The FMC physicians were paid a bonuses for the lab tests ordered.  The payment also settles claims that they did unnecessary medical lab tests by creating custom panels.  This is a whistleblower case by a former physician at the clinic.       

US v Fingerhut
Indicted

Gary Fingerhut of Solon, Ohio, was indicted for defrauding the Cleveland Clinic out of $2.7 million.  He worked at a company that helped physicians at the Clinic invent and market the inventions.  He was executive director of the spin off in 2013 but was fired in 2015.  Fingerhut was prohibited from receiving any financial benefit of the products.  He however did receive money for "referrals".  To date monies paid for referrals to Fingerhut and others illegally have totaled $2.7 million.  

US v MediSys Health Network
Settlement

 The owners of two NY hospitals agreed to pay $4 million to settle allegation that they did false claims by filling for claims of physicians which they had an illegal arrangement.  They did arrangements against Stark for office leases and compensation.  This was a qui tam suit.        Top

Healthcare

McGrath v UCSF Benioff Children's Hospital
Hearing

The case of Jahi McGrath continues.  This is the then 13 year old girl who was declared brain dead in 2013 but who still lives on a ventilator.  This hearing was for the preliminary determination in a med mal suit whether she is covered under the California med mal law of $250,000 for non economic injury if dead or not covered if still alive.  The judge ruled that the original determination was according to medical standards but now does not fit the criteria for brain death.  Case to be continued.

Three People v New York
New York Supreme Court

The state high court ruled that physician assisted suicide ban will stand.  They found that state lawmakers had a rational reason for the law.        Top

HIPAA

Doe v Mt. Sinai St. Luke's Hospital
Filed

John Doe has filed a claim for outing him as a HIV person to his work.  He states that a clinic faxed his medical records to his mailroom thereby informing all of his diagnosis.  He is suing for $2.5 million for negligence.  He had specifically said the records were to be shipped to a PO Box bt the hospital ignored his instructions.  The hospital admitted the mistake and has paid a fine of $387,000 to the fes for their error.          Top

Hospitals

Tulare Regional Medical Center Medical Staff v Board of Directors
Tried

Now awaiting the result of the trial between the medical staff and the board in this major case in California.  The board unilaterally voted to terminate the medical staff and remove all the medial staff officers.  They then unilaterally appointed a new slate of officers who would do their bidding and created a new set of bylaws without medical staff input.  The medical staff were all given provisional status and had to prove their economic worth to the hospital to become active members.  The result is probably going to be rendered in early spring, 2018.  To date, two hospital board members have lost their seats in elections over this issue and another has resigned.  The medical staff has said their will be no settlement in this case without strong precedent so this can not happen again.

Washington v St. Joseph Medical Center
Filed

The state AG filed a suit against the hospital for withholding charity care.  The hospital is accused for knowingly not complying with the state law on all hospitals requiring screening for charity care and limiting the amount of information the person must provide to get the care. This could cost the hospital millions of dollars in repayments plus penalties.

Pension Plan Participants v Ascension Health 
Settlements

The St. Louis organization agreed to guarantee $29.5 million in pension benefits for settling a class action suit that it improperly claimed a religious exemption for the retirement plan.  

Female Physicians v Carolinas HealthCare Systems
Filed

Three female physicians have filed suit against the organization for being paid substantially less than their male counterpart.  The company of course denies all such claims.      

Gamma Knife of Spokane v CHS
Filed

 Gamma Knife, a private company says the hospital Deaconess Medical Center with which it contracts has not paid according to the contract.  The suit says CHS kept the money and did not pay them after they sold the hospital to Multicare Health Systems.

Patients v Jefferson Regional Medical Center
Filed

The complaint alleges that 362 patients received non-narcotic meds instead of the ordered oxycodone.  A hospital tech was taking the meds and replacing it with another and no one caught it,.  She has been sentenced to jail.  This happened five years ago and the hospital took step immediately after finding out about the problem.    

New Hampshire v Frink
Indicted

Travis Frink went into the ICU of Dartmouth Hitchcock Medical Center and shot his mother to death, according to witnesses.  He then put the gun away and left the hospital.  He has plead not guilty.

Esparza v Medical Management
ED Lou

The hospital was sued for not giving a hearing impaired individual an interpreter.  This is a motion to dismiss by the hospital and it was not granted.  It is a shame when a hospital tries to bully an individual with legal stuff instead of just doing the right thing.       Top

Peer Review and Employment

Rice v St. Louis University
Filed

Rice, surgical resident, has to repeat her fourth year and has filed suit for retaliation.  She believes she is being discriminated for being a nurse in a past life.  She claims to have been told to stop being a nurse and stop being too nice.  She did flunk a training exam and was not provided with a faculty mentor for another year.  She wants to be promoted to her fifth year with the rest of her class.  

Borrell v Geisinger 
For Plaintiff

Angela Borrell was pulled out of a clinical training program for nurse anesthesia and was told by the program director that he had noted a change in demeanor an appearance.  She asked him to clarify but he would not and wanted her to get a drug test.  She decided, after speaking to her parents, to take the test but they would not respond to her and she was expelled.  She says she was never given an opportunity to appeal the decision.  The jurors found for Borrell that she was denied due process but even if she did get them she would have been dismissed. She was awarded $415,000 in compensatory damages and $1.1 million in punis from Geisinger.

Eichbauer v Henry Ford Health
ED Mich

The plaintiff, a certified registered nurse anesthetist, sued for interference with his FMLA.  The guy was found to be using non-prescribed narcotics.  The court found that he was granted full FMLA leave with pay and reinstatement and was fired four months later.  Case dismissed.         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.