December 1, 2017 Recent Legal News
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New Mexico v Presbyterian Healthcare
Settlement
The system agreed to pay the state $18.5 million to settle allegations of fraud to avoid Medicaid premium taxes. This whistleblower suit was quickly settled in four months. The whistleblowers will get 20% of the settlement. The system will pay from reserves and operating income. The system may still be on the hook for an additional $14 million.
US v Lopez
Arrested
Dr. Ernesto Lopez and Sharon Washington-Bhamre, a pediatric NP both of NYC were arrested for writing for un-needed prescriptions for oxy and fentanyl.
US v Zielke
Arrested
Dr. Andzei Zielke of Pittsburgh was indicted for prescribing Schedule II narcotics for illegitimate purposes.
US v Mercy Hospital of Portland (Maine)
Settlement
The hospital paid $1,514,000 to settle allegations that it overbilled for unine drug tests. It used falsely a modifier code for same day drug screening tests. They did the worse thing possible, they unbundled.
US v Morrison
Sentenced
Deborah Morrison, the former Providence Hospital exec was sentenced to 18 months in prison plus payment of $391,600 in restitution plus a fine of the smae amount for her theft of money from the medical staff of the hospital.
US v El Soury
Sentenced
Dr. Ahmad El Soury of Monmouth Junction, New Jersey was sentenced to 33 months in prison for taking bribes in the infamous Biodiagnostic Lab Services case. He admitted to taking bribes for referrals of patients for tests. He got $66,000 and accounted for 10 times that amount in billings for the lab. To date 37 physicians have been convicted in this case.
US v Hamdan
Guilty
Another physician, Dr. Aiman Hamden a cardiologist and his wife Kristina plead guilty in the Biodiagnostic physician sweep. Hamden was given a $500,000 loan by Biodiagnostic in exchange for referring patients there. Kristina was a sales employee for the lab and got physicians to fall for the illegal scheme. The couple agreed to pay back over $1.2 million in illegal proceeds.
US v Trotter
Sentenced
Dr. Johnny Trotter of Bloomfield Hills, Michigan, was sentenced to 15 years in prison and payment of $9,199,946. The same sentence was handed to his co-defendant Elaine Lovett. They were convicted of submitting false billings for nerve block injections not done.
US v Meadows Regional Medical Center
Settlement
The medical center has agreed to pay $12,875,000 to resolve allegations that they submitted claims for services from physicians with whom they had illegal contracts or paid kickbacks for referrals.
US v Vaid
Guilty
Dr. Mustak Vaid, Marina Burman, and others plead guilty of a Medicare scheme where they paid patients for unnecessary medical services, tests and supplies. Alexandr Burman, another co-conspirator, illegally opened medical clinics in Brooklyn and hired physicians to front for them.
US v Dailey
Sentenced
Dr. John Dailey, a podiatrist in Missouri, was hired by Aggeus Healthcare to treat nursing home patients. He made up diagnosis and treatments that did not occur to increase his salary. He was sentenced to 27 months in prison and to repay $291,000.
US v Mednez
Sentenced
Dr. Joaquin Mendez or Miramar, Florida, was sentenced to one year in prison and ordered to pay restitution of $2,198,520 for being a medical director of a sober home which was a scam.
US v Akoda
Guilty
Charles Akoda of Bowie, Maryland, stole a SSN and then posed as a physician. He illegally got into a residency program in New Jersey and was fired two years later when they finally learned the SSN was a fake. He faked the Maryland into giving him a license and then faked getting on a hospital staff to practice OB. He will be sentenced to six months in prison and six months home detention. Top
Scharpen Foundation v California
Superior Court
A judge has handed California a setback in its progressive policies. She decided that the state's law requiring pregnancy centers to notify their clients that the state offers low cost and free abortions violates freed of speech. The pro-life center was required to tell women about abortions that they didn't believe in. The state will appeal.
American Hospital Association v US
Filed
The AHA and others filed suit against the HHS for their cutting the 340B program by 30 percent. This program means well but has been abused by hospitals to buffer their bottom line. They say they abuse the program to fund care for care for the poor but that does not hold water since all are now covered by Ocare.
Jenkins v Maine
Filed
Jenkins is a NP who is suing the state because under the law only physicians can perform an abortion including giving pills to create an abortion. This is being backed by the ACLU here since it is one of the 40 states with the law that is primarily rural. The problem in Maine is that the law covers all abortions not just those who get a vacuum abortion. It was set up in 1979 after the Roe decision. Top
Buckeridge v Lucey
Filed
Kila Lucey, a former billing employee of the University of Washington is being sued by her ex-husband and his family for illegal accessing of his medical records. The suit also name the University as a defendant.
Patients v Ball Memorial Hospital
To Be Filed
Muncie, Indiana, Indiana University Health Ball Memorial Hospital had some paper work of patients in a bag on a street. How does that happen??
Patients v Valley Family Medicine
To Be Filed
The Staunton, Virginia practice had an employee print and then illegally use the list of 8500 patients to invite them to a new practice. Top
Saint Anthony Hospital v Leapfrog
Filed
The Chicago hospital is suing the organization for defamation. They claim Leapfrog intentionally used incorrect information to lower their rating. The hospital safety rating went from A to C and would not retract voluntarily its rating. Leapfrog apparently used a much lower percentage of electronic medication ordering that was true.
Plaintiffs v Sutter Health
Ruling
A judge ruled that Sutter had illegally shredded large amounts of material requested by the plaintiffs in their suit against Sutter. The hospital system says it was a regrettable mistake but emails say otherwise. The judge has ordered Sutter now to go through all email backup tapes between 2002 and 2005 to search for documents on some of the same topics as the destroyed records. The judge will also consider issuing a jury instruction adverse to Sutter.
US v UPMC Hamot and Medicor
Associates
Settlement
The entities have agreed to pay the feds $20 million for a whistleblower suit that the hospital paid the doctors for patient referrals. A cardiologist had filed suit against the hospital for the hospital giving sham directorships to the physicians at Medicor for referring patients for cardiology procedures. Never spurn a physician!
Reno v Tri-City Healthcare
District
Filed
Reno, an elected member of the district sued after being left out of meetings of the district that she should have been present. This could get ugly.
Emig v West Calcasieu Cameron
Hospital
Louisiana Ct. Appeal
Emig and others sued the hospital and others for double billing. They want a class action suit and the lower court and now this court have agreed that class action is proper.
UC Davis v Sacrament County
Settlement
The county has agreed to pay UC Davis over $98 million for the hospital's treatment of the county indigent back to 2008. They also owe interest on the amount over the time.
Minnesota
Several unions have filed suit against the system for firing about 50 people for refusing to get flu shots. These are workers that do not meet the system's medical or religious criteria for exemptions which are very strict. Top
Cooke-Moore v Curry Health Network
Filed
The 36 year old woman had a double mastectomy as well as a hysterectomy and oopherectomy all due to a NP misinterpreting a genetic study and the physicians she referred the patient to did not confirm the results. She was told after she underwent a test for BRCA 1 and 2 that she had lynch syndrome. The tests were actually negative. The patient did not get a second opinion prior to having the procedures done.
Six Plaintiffs v J&J
Jury
A jury ruled J&J knew its metal on metal artificial hip had deficits and hid them. The awarded $79 million in compensatory damages and additional $168 million in punis. This like the prior cases will be appealed and the total amount reduced significantly.
Adams v Lake Cumberland Regional
Hospital
Kentucky Supreme Court
The state high court ruled there is no tort for negligent credentialing. Therefore the plaintiff case against a hospital is derivative from the physician.
Schoeniger v Colgate Palmolive
Settlement
CP agreed to pay the plaintiff for her getting mesothelioma from their talc products. This is a better case than talc giving ovarian cancer to women.
Holtsclaw v Endo
Defense verdict
The plaintiff sued Endo claiming the companies testosterone product that he used for 6 months to treat chronic fatigue suffered a heart attack. He sued stating Endo did not tell the physician of the risks. The plaintiff had multiple other problems that put him at risk for a MI.
Pennsylvania Professional
Liability Underwriting Assoc. v Pennsylvania
USDC
The med mal insurer sued and won an injunction against the state preventing them from diverting $200 million to their general fund instead of handing it over to the association as they are supposed to do under the law. The money is supposed to to for paying med mal claims but the state says they created the association and they can dissolve it. Top
Pedro v Duke University
Filed
Sara Pedo, RN filed against the University after she informed her new employers that she would not do vaccinations and would not help on any abortions nor pass out contraceptions. She had moved to take the job and now has moved back and the poor thing now suffers from post traumatic stress over this which is preventing her from working.
Blanchette
Porter v Darmouth Hitchcock Medical Center
Filed
Dr. Misty Blanchette Porter, an OB and former professor at Geisel is suing the medicl center saying she was fired due to her disability and whistleblowing. Her position was cancelled when her program closed. She states she was working 20 hours a week after an injury.
Wubbels
v Salt Lake City
Settlement
Alex Wubbels, the nurse who was arrested after she refused to allow an officer to draw blood without a warrant, will receive $500,000 to settle all claims against the city, the officer and University Hospital. Top
Konopka v New Hampsire Board of
Medicine
Filed
Dr. Anna Konopka, a 84 year old physician had her license taken away for not using electronic medical records. The state says she can not access the state the mandatory drug monitoring program. She does not own nor does she know how to use a computer. She has had several complaints to the Board about her practice. The Board says she resigned her license and can ask for reconsideration to get it back. She lost her case at the court. The court said she did not prove she was forced to give up her license.
Dr. Larry Nassar, the former USS team gymnastics physician, has plead guilty twice. Once to a federal court on federal child porn charges and once in a plea bargain to three counts of first degree criminal sexual conduct. He will be sentenced later.
A US judge has dropped federal child porn charges against Dr. Mark Rettenmaier, a gynecological oncologist. The problems was the feds illegally collected evidence. This poses a problem for the physician at his hospital where he lost privileges because of the charge. He has not been found innocent but continues with a cloud. 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.