Patients v Medei
In a nationally watched case, Dr. Medei of Baltimore's St. Joseph Medical Center is accused by patients of implanting cardiac stents that were not necessary. There are other cases involving Dr. Medei suing the hospital and Dr. Medei is also being looked at be CMS and Congress. In a deposition last June obtained by the Baltimore Sun, Dr. Medei stated that many Abbott salespeople were in the cath lab with him despite hospital rules against it. He admits to telling the salespeople how to sell the hospital on the stents that he preferred and also admitted to being paid by Abbott about $37,000 for consulting work not for using the stents. The hospital personnel allowed the salespeople into the lab in spite of the hospital's rule. The hospital enforced its rules for a time and then did not.
Boston Medical Center v Massachusetts
Boston Medical Center and several other safety net hospitals sued the state for more money to treat Medicaid patients. The court dismissed the case as it had no jurisdiction over how the state spend limited resources. They said that was for the executive and/or legislative branch to take care of. This is refreshing to see a not legislating judge. This is so even as the Republic requires all licensees to treat their Medicaid patients, and you thought slavery went out after the Civil War.
Tennessee Medical Assn. v
Tennessee School Sys.
The Tennessee school system capitulated and are paying back the state's physicians that they forced to repay the system for "overcharging". They also will refrain from claiming the physicians overcharged. The scheming people that were hired by the school system had not seen any evidence that there was any overcharging but was entitled to keep 40% of all monies recovered. The company's website is no longer active and the CEO could not be reached for comment. Top
Physicians v CMS
Physicians have been asking to and not receiving any answers from CMS as to how and when they are going to pay the $200 million owed to them. Obamacare promised the physicians retroactive money but has not funded it. There were also cardiology codes that CMS made calculation errors on and those need to be corrected and the physicians paid the proper amount.
Stand Up Mid-America MRI v Western Mutual Ins. Minn App Ct
The MRI was chiropractor owned and only reported its findings without any diagnosis. Minnesota has a Corporate Practice of Medicine prohibition. Therefore, the MRI was supposed to be owned by a physician not a chiropractor. The insurance company found out the owner was a chiropractor and would not pay for the scans performed. The insurance company sued for returns of money paid and the MRI company sued for unpaid money. The lower court ruled for the MRI company. The court of appeals agreed stating that the MRI company did not knowingly and intentionally violate the Corporate Practice Act. Top
Mr. Pedro Espada and his son pled not guilty to embezzlement charges that he took money from a network of Bronx health clinics and spending it on personal items. Mr. Espada is the Democratic State Senate Majority Leader. His son is a former state assemblyman. Mr. Espada founded the clinics and has a $9 million severance package that would bankrupt the clinics.
US v Brown
Bernice Brown, the owner of a Detroit physical therapy clinic, and her vice-president Daniel Smorynski were sentenced to 151 months and 108 months in prison respectively. This finishes the $23 million fraud on submitted claims and the payment of $6.5 million on those claims. The two were ordered to pay restitution but that remains to be seen whether or not they do it. This is why Medicare loses so much money on fraud.
US v Silber
Dr. Alan Silber was sentenced to 36 months in prison and ordered to repay Medicare $649,000 for his part in an infusion scam in the Detroit area.
v John Archbold Hospital
The Georgia hospital paid the government $13.9 million to settle false claims allegations that it lied saying it was a public hospital to get more money from Medicaid. A physician caught the hospital in its lies and sued on a qui tam. He gets $695,000. Top
Dr. Lisa Bardon, aka Lisa Degner, has pled guilty of drug theft, using other physician's prescription pads to write phony prescriptions that she would pick up using stolen identities for her personal use. She practiced in the Palm Springs, California, area.
Assn of Amer Phy & Surg v Med Board Texas
The Circuit overruled the lower court and reinstituted the lawsuit against the Medical Board of Texas. The charges are incompetency and fraud. They allow conflict of interest, they retaliate if anyone criticizes them and generally harass physicians.
Texas v Arafiles
Dr. Rolando Arafiles of Winkler County, Texas, has been arrested and charged with two third-degree felonies of misuse of official information and retaliation. He was the stupid physician who got the two nurses at his hospital arrested after they turned him in to the Texas Medical Board for incompetence. The two nurses were charged, one was dismissed prior to trial and the other went to trial and dismissed by the jury after a hour deliberation. The nurses then sued the physician, the hospital, the Sherriff and other government officials and split a $750,000 settlement. It is my fondest hope that Dr. Arafiles spends some time in the prison system and then loses his license. The charges against Dr. Arafiles carry a potential fine of $10,000 plus ten years in prison.
California v Asch
In another feel good story, Dr. Ricardo Asch has been arrested. Fifteen years ago he was part of the scandal at UC Irvine that entailed switching embryos to make his statistics look good. When about to be arrested he fled the United States and has been practicing medicine in Buenos Aires. He will be extradited and stand trial for fraud and tax evasion.
California v Donbach
Kurt Walter Donbach has pled guilty to 13 counts on various medical related charges. These include practicing medicine without a license and selling medications fraudulently. The 75 year old is getting a plea deal for a short sentence and probation. His attorney states Donbach was not practicing medicine but only giving advice on alternative treatments. Donbach founded a clinic in Rosarito Beach, Mexico and "practiced" in Bonita, California. Top
New York city has settled a discrimination suit against it by an orthodox Jew who has never worked a day. She is a nurse who was offered a job and then was turned down when it was learned she would not work on the Sabbath. The case was settled. 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.