April 15,  Recent Legal News






Peer Review and Employment


Missouri v Lee

Nitica Deonte Lee of Dallas was sentenced to five years in prison.  She came from Dallas to a hotel in Edmundson, Missouri where Daysha Phillips and two others  received butt injections.  Lee has no formal training and is not a physician.  Phillips died from the injection.  The two others are reported not to have suffered any harm.

US v Jospeph

Dr. Francis Joseph, of Highlands Ranch, Colorado, was indicted on theft of $300,000 by making false statement to illegally obtain Covid funds.  It is alleged that after he was fired from a clinic he applied for a loan for the clinic which he spent personally and also applied for bankruptcy of the clinic.          Top


US v Murali

Dr. Ravi Murali of Madison, Wisconsin, plead guilty to fraud for working for a telemed company and ordering DME without doing a medical exam or calling the patients.  He apparently billed for $26 million and received half that.  At his hearing he said he was just trying to get by.

US v UCI Medical Affiliates of South Carolina

The urgent care company will pay $22.5 million to settle allegations that they billed and certified that the services were done by credentialed providers.  They were not.  

US v Bakari

Julius Bakari and his wife Mboutchock Kabiwa a/k/a Eugenie Bakari of Silver Springs, Maryland, owners of Holy Health Care Services, along with Dominic Forka were indicted for receiving and giving kickbacks.  It is alleged they paid homeless of DC to go to their facilities and apply for services.  They then billed Medicaid for the mental health and other services never performed.

New Mexico Oncology and Hematology Consultants v Presbyterian Healthcare Services
10th Circuit

The Circuit affirmed the judgment in favor of Presbyterian was was sued for antitrust by the medical practice.  The practice said the hospital had the audacity to open its own cancer center in competition with the medical practice.  They accused the center of refusing to deal and to no one's surprise lost in the district and again in the appellate court.

US v Today's Youth

The Connecticut organization agreed to pay $273,000 to settle allegations that they billed for the work of unlicensed individuals for behavioral health issues.  

US v Fleming and Storey

Stephanie Fleming and Helen Storey were convicted of health fraud.  Fleming owned North Florida Mental Health and Storey was a licensed counselor at the facility.  They submitted bogus claims for treatments.  Fleming had agreed to a prior five year debarment from the state Medicaid program for fraud in New Jersey.          Top


Fabick v Evers
Wisconsin Supreme Court

This is the second mid west state to rebuff its governor.  There is a tug of war between the powers that Governors have and their mandates.  The Court said the Governor overstepped his authority when he mandated masks and mandated a public health extension beyond the mandated 60 days.  

US Anesthesia Partners v United Health

The large anesthesia group is suing united health for using their clout to forbid physicians from referring to their group.  This is a pure money issue as the physicians want to paid more than what the insurer wants to pay.  They alleged that United "bribed" physicians with larger contracts if they would not refer to US Anesthesia.  

Churches v California
US Supreme Court

The high court in a 5-4 decision again overruled the 9th Circuit.  The court barred the state from enforcing a rule that for now limits both religious and non-religious gathering in homes to no more than three households.  The 9th said the it was OK since it applied to both secular and non-secular groups.  The high court said government regs are not neutral when they treat any comparable secular activity more favorably than religious activity.

Lawyers v Sutter
California Supreme Court

The California AG office and five law firms that sued Sutter and won a $575 million judgment wants 32% of the award or $184 million.  They say they worked together as one law firm for the suit filed by the self-funded plans in a class action.          Top


Patients v Trinity Health
To Be Filed

Acellion, a data file transfer services provider, was hacked and the information on patients of Livonia Michigan's Trinity Health were exposed.  This included not only PMI but Social Security information as well.          Top


Giacalone v MedicWest Ambulance

The daughter of the suing family in Las Vegas for a convention ate a pretzel with peanut butter and went into anaphylactic shock.  She was treated with IM epinephrine instead of the the required IV.  She became brain injured due to lack of oxygen.  The family won $29.5 million.        Top

Peer Review and Employment

St. Louis Heart and Vascular v SSM Health

The physician group is suing the hospital system for going to a exclusive cardiac provider shutting the medical group that had provided services to the hospital for many years.  The Hospital says it is purely business and there are many other hospitals in town to the medical group to ply their trade.  The group had built a building to house their practice across the street from one of the hospitals.  The next nearest hospital to that location is 13 miles away.  

Haganman v MercyOne Mitchell County Regional Health Center

Dr. Mark Haganman, was terminated from employment at the hospital.  He contends that it was due to his blowing the whistle on the hospital's allegedly shoddy Covid practices.  He states that he wanted to start an off campus clinic to care for respiratory patients as he and others believed the hospital in rural Iowa could not handle the patients.  The hospital instead opened their own clinic on campus.  The community is filing a petition to reinstate Dr. Haganman.

Abumasmah v Beckley Oncology Associates
4th Circuit

Dr. Rami Abumasmah is an oncologist who worked at Beckley in West Virginia.  After several years he left the country to care for his mother and Beckly terminated him on his last day and sent him a separation agreement.  The two were at odds over the amount owed the departing physician and they went to arbitration.  The arbiter ruled for the physician and Beckley went to district court to overturn the decision.  The lower and now the higher court both ruled for the physician.  

Brovont v EmCare
Missouri Ct. App.

Dr. Raymond Bovont claimed he was fired by EmCare after complaining regarding the staffing in the ER at Overland Park Regional Medical Center.  He worked nights covering both regular and pediatric emergency departments as the only physician.  this was an EmCare decision.  After he was fired he sued and won a $29 million judgment which included a $20 million punitive damage claim.  The trail judge reduced it by about half but the Appellate Court restored it up to $26 million and then added interest making it $29 million.  The state high court refused the case leaving the award intact.  They collected the full amount.        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.