December 1, 2019 Recent Legal News
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US v Crow
Indicted
Dr. Deane Crow of Prunedale, California, was indicted for prescribing opioids without medical reason. He was a former ER director in Salinas Valley Memorial Hospital whose entire family were either killed or affected by the drugs.
US v Pugh
Guilty
Catherine Pugh, the former mayor of Baltimore, was indicted and plead guilty of wire fraud and tax evasion. She sold her books to various health agencies and funneled the money to her re-election campaign. She is accused of creating false business expenses to offset income.
US v Escobar
Indicted
Dr. Maringn Escobar of Lake Milton, Ohio, was arrested for over prescribing of narcotics. Top
US v Perwaiz
Indicted
Dr. Javid Perwaiz, an OB/GYN in Virginia, was arrested for healthcare fraud. He is accused of performing unnecessary hysterectomies along with removing one woman's fallopian tubes without her knowledge nor consent. He is accused of lying to patients about having cancer so he could remove their uteri. He had in 1982 lost hospital privileges for performing unnecessary surgeries and had been found guilty of tax evasion in 1996.
US v Sutter Health
Settlement
Sutter has agreed to pay $30 million after being accused of illegal kickbacks. The prior compliance officer and now whistleblower stated that Sutter had paid money to physicians to induce them to send patients to Sutter. Sutter is accused of paying the salaries of three physician assistants to the Sacramento Cardiovascular, a group of heart surgeons. They paid $900,000 to the group for call and gave them exclusivity. Sac Cardio also participated in this settlement.
US v The Assistance Fund
Settlement
The fund will pay $4 million to settle allegations that it acted as a go between with pharmaceutical houses to pay patient's co-pays for high price multiple sclerosis drugs. The drug companies funded the charities and the charities helped patients pay for drugs.
US v Asfora
Filed
Soon after Sanford Health paid money to settle allegations of false billing, the feds filed against the cause of the false billing, Dr. Wilson Asfora. the neurosurgeon used device in surgeries at the South Dakota hospital that came from medical device distributorships owned and operated by Dr. Asfora. This may be construed as illegal kickbacks.
US v Haar
Settlement
Sandra Haar, the prior CEO of California's Horisons Unlimited, will sell 13 properties and pay the proceeds to the feds and state to settle fraud charges. She has already been convicted and sentenced to prison. She is also barred from fed med for 20 years and her husband Norman Haar is excluded for 15 years.
US v Esformes
Sentencing
The Miami multi-millionaire had been convicted of healthcare fraud and sentenced to 20 years in prison along with reimbursement of $5 million to Medicare and $39 million for punishment. To add more injury he was also billed $617,000 for the cost of his incarceration.
US v Jewish Hospital
Settlement
The Kentucky system agreed to pay $ 10 million to settle allegations that they filled prescriptions and billed Medicare for prescriptions that did no meet Mediocre requirements such as obtaining the treating physician's signature, confirm refills were reasonable and necessary and establishing medical necessity. They also did not document that the meds were delivered. Also they gave free glucose testing supplies and waived co-pays and deductibles for insulin. This was a whistleblower case from a pharmacist who will get $1.18 million.
US v Pikus
Guilty
After a 2 week trial the manager of multiple NYC medical clinics Aleksandr Pikus was found guilty of cons;irac to commit money laundering.
US v Capen
Sentenced
Dr. Daniel Capen, an orthopedic surgeon in Manhattan Beach, california, was sentenced to 2.5 years in prison for his part in receiving kickbacks to do spinal surgery at Pacific Hospital. He also has to pay a $500,000 fine. The hospital's owner is serving a five year term.
US v Boston Heart diagnostics
Corp.
Settlement
The Framingham, Massachusetts, laboratory company is paying $26.67 million to settle allegations that they paid for patient referrals. It was alleged they paid physicians by setting up phony MSOs to funnel money to physicians to order tests via their labs. This was done in Eastern Texas. Top
Patients v UMPC Susquehanna
Filed
The hospital admitted that an employee looked at PMI of a co-worker. This is part of a suit against the hospital and the employee by the co-worker for invasion of privacy and negligence. The hospital is actually fighting the claim when they should have just paid it.
Patients v Google
To Be Filed
Google has admitted that for employees were fired after they did systomatic peeking at other employee PMI. A blog from the employees state they were fired for being activists, whatever that is.
Oklahoma v J&J
Judge
The judge in the trial of J&J by the state for opioid abuse admitted an error of arithmetic and lowered the money J&J was to pay from $572 million to $465 million. He screwed up the cost for establishing an opioid program should have been $107,000 not $107 million.
US v Vibra Healthcare
Settlement
The company has agreed to pay $6,250,000 to settle allegations that it billed for services that required a patient to be seen by a physician three times a week and that did not happen.
US v Louisiana
Settlement
The state Department of Health as agreed to pay $13.42 million to settle allegations that it submitted false claims for long term and hospice care.
US v Brezinski
Settlement
Dr. Damien Brezinski of Wilmington, North Carolina, has agreed to pay $244,000 to settle allegations that he and his practice Wilmington Health submitted false claims for arterial stents he inserted into patients that did not meet the criteria for the stents. His hospital, New Hanover Regional Medical Center, also agreed to pay$ 900,000.
Patients v Children's Minnesota
To Be Filed
Teh hospital has notified over 37,000 people that their PMI has been exposed due to internal errors. They found this out in August and then found that the error goes back to 2011. They are NOW notifying the patients. They deserve a hefty fine for negligence. Top
Santangelo-Santana v Exodus
Women's Center
Trial
This trial has begun. The woman is suing because she claims a delay in diagnosing an ectopic pregnancy lead to her not being able to have any more children. She had a prior tubal pregnancy with removal of her left fallopian tube. She wad pregnant again and imaging showed no fetus in the uterus. The OB did a uterine scraping which showed signs of an ectopic pregnancy and entered the finding in the EMR but failed to phone the OB. The OB never checked the report not did her colleague. A month later she had a ruptured ectopic the required the removal of her right tube. No matter the outcome of the trial this is bad medicine due to the use of an EMR.
Gierek v Goshen Health
Filed
A pond scum attorney has filed a suit against the hospital for sending out a letter warning some patients may have been exposed to HIV, etc. The client has supposedly suffered extreme emotional express. Let us hope he spends a lot of money for this case and loses.
Patient v Lourdes Hospital
Transplant Center
Will not be filed
In a terrible mistake the New jersey hospital transplanted a kidney into the wrong patient. the two patients had the same names and were about the same age and both were on the transplant list for a new kidney. However, the one that got the kidney was not up for one. The one who was supposed to get the kidney finally got one and is also doing fine.
A. Y. v Jansen Pharmaceutical
Superior Court of
In a unsurprising verdict for Pennsylvania the appellate court upheld the verdict of $70 million for a man who developed gynecomastia following the use of the antipsychotic Risperdal. The court also said that punis were in order. I doubt this would happen in other state courts. The Philly courts are notorious for high awards and have given Billions of dollars for men getting the female breasts from the drug. Top
Natarajan v Dignity Health
Ca Ct app
The hospitalist at St. Joseph Medical Center was delinquent in medical records which led to an investigation which showed untimely responses while on call and increased LOS which led to his privileges being terminate which led to this suit. He felt he could not get a fair trial with the use of the hospital's pick for hearing officer. The trial court and court of appeal both denied the doctor's claim as the hearing officer had no direct financial interest n the peer review hearing and that the hospital had sufficiently objective criteria for his termination.
Brown v Howard University
Filed
The former director of nursing for emergency services was fired and is now suing for retaliatory wrongful discharge. She claims she was fired after she informed the DC Dept. of Health that patients were being charged for admission without ever being admitted or provided services required for patient reimbursement.
Duvall v Novant Health
Filed
The former marketing exec David Duvall is suing for reverse discrimination. He says he was fired as part of a campaign of diversity and replaced by two minority hires. It is also interesting that the firing came with prior great reviews and occurred just days prior to his five year anniversary with the company which would have given him longer severance pay and larger bonuses. At least five others were also fired in the same time frame and replaced by minority and / or female replacements.
Long v US Dept Health
D DC
Dr. Long wasted a lot of money. Dr. Raymond Long, an Orthopod, resigned his privileges at Northwestern Medical Center in 2004. This was after refusing a psychiatric exam. A report was filed with the NPDB stating that Long resigned while under investigation for professional competence or conduct. He has denied that it had anything to do with his professional competence or conduct and has twice petitioned the Bank and was denied twice. He now sued for the removal of the report and to no one's surprise, he lost again. 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.