December 1, 2009 Recent Legal News
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Sears v US
9th Circ
The 9th Circuit ordered benefits to be paid to Sears who married his partner during the five month period in California when gay marriage was legal. Against Sears was Holder who stated that the Defense of Marriage Act prohibits the feds from recognizing gay marriage.
Med Assn. of Alabama v Blue
Cross/Shield
Filed
The Medical Association of Alabama has filed suit against Alabama Blue Cross and Shield stating that the insurer has not lived up to its side of a class action settlement. The physicians state the insurer has not given adequate notice of changes in the contract, never formed a required specialty physician specialty society and has failed to pay for claims with modifiers -25 or -59.
In Re HealthNet
To Be Filed
HealthNet has confessed that up to 1.5 million people had their medical records and physician billing details missing. A computer drive has been gone for six months from the Northeast headquarters. The information was on people in four states. Top
Saguaro Med Assoc. v Banner Health
D Ariz
The hospital terminated the contract with the physician group stating the group violated HIPAA and did not meet performance objectives. The group sued the hospital for breach due to intentional interfering with business relations. The court denied both sides summary judgment request for breach of contract since that is a matter for a jury. The hospital was able to get a summary judgment against the 1981 claim and a claim for punis.
Perinatal Medical Grp v Children's
Hosp Central CA
USDC E CA
In a power play for economic credentialing the hospital forced the Group to either resign from another hospital or have their contract not renewed. The group refused and did not have their contract renewed. The group sued the hospital and their co conspirator IPA for Antitrust under both Section 1 and 2. The hospital filed for summary judgment and won on Section 1 but not 2. The Court stated that there was not information pled to show divergent matters between the hospital and the IPA which has as CEO a hospital person. The Group may refile this action. Section 2 forbids a conspiracy to monopolize and the Group pled enough here. The hospital may have a problem. Top
Mawulawde v Bd Univ. Georgia
SD Ga
Dr. Mawulawde sued the University for civil rights violation and lost. He was ordered to pay the University's costs. He now is appealing that order and lost again. The surgeon failed to rebut the presumption that if the plaintiff loses a civil rights case they will pay the cost of the defendant. Top
US v Trinitas
Settlement
Trinitas Medical Center of New Jersey has agreed to pay $3.02 million to settle charges of inflating billing to Medicare in order to get more money in supplemental outlier payments. At the same time the feds filed a motion to intervene in a qui tam on the same issues against New York's Brookhaven Memorial Hospital. Top
Patients v Blue Cross
To Be Filed
Blue Cross Blue Shield of Tennessee had a hard drive stolen at one of its facilities. They don't know how many of their 3.1 subscribers have had their medical and social security information breached. They have started to notify those whose information they know have been taken.
Patients v University Hospital
To Be Filed
University Hospital in Los Vegas had the records of its accident patients stolen and given to attorneys. They were warned of this months ago but did nothing until this week. As is typical for a county run hospital the administrators just ignored the mounting evidence of the breach. The hospital is the only level one trauma center so it gets most, if not all, seriously injured patients. This is a gold mine for unscrupulous attorneys. This hospital has been in trouble in the past with the former CEO being charged criminally and members of the facilities department were found to be using hospital supplies for their own outside businesses. Top
Miller v Johnson
Kansas Supreme Court
The Kansas malpractice caps will be reviewed by the Supreme Court in this case. The jury had awarded the plaintiff $750,000 and the judge reduced the award to the $250,000 cap on all PI cases non-economic damages. The Supreme Court took the case directly.
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.