January 1, 2021 Recent Legal News






Peer Review and Employment


Wisconsin v Pharmacist

An employee pharmacist at Grafton, Wisconsin's Advocate Aurora Health intentionally left 57 vials of Moderna's Covid vaccine out of the refrigerator.  They had to be thrown away.  Let us hope there will be better oversight and that the person will be prosecuted fully.  He is no longer employed at the hospital and has been arrested.

US v Baxter

Timothy Baxter, a former medical director of Indivior, was sentenced to six month of home detention and community service for his part of the marketing of Suboxone.  

US v Akers

Dr. Scotty Akers and his wife Serissa of Pikeville, Kentucky, were sentenced for their unlawful distribution of opioids.  He was sentenced to 60 months and to forfeit all of $12,275.  His wife was sentenced to 32 months in prison.

Pennsylvania v Green

Dr. Richard Green of Johnstown had plead guilty of involuntary manslaughter in the death of a patient from drug overdose and for submitting improper claims for Medicaid reimbursement.  He had given up his DEA and medical licenses voluntarily and ordered to prison for 9-23 months with automatic parole in nine months.  He suspended the prison and ordered house arrest instead if Green would pay the fines of and restitution up front.  Green agreed to do so.

New York Health Commission v ParCare Community Health Network

The state is investigation how ParCare, an urgent care network, got the Covid vaccine and hif they violated state guidelines by diverting the vaccine to the public.  The clinic says it gives the vaccine to only those who have registered and are over 60 or a healthcare worker or have an underlying problem but the state has not authorized shots to be given to that demographic outside of nursing homes.  It is asking for insurance information when the person registrars even though the vaccine is supposed to be at no charge.         Top


US v Alquero

Teresita Alquero is the owner of the Texas home heath companies Providence Home Health and Providence Hospice agreed to pay $1.05 million to settle claims he paid kickbacks for referrals for Medicare patients and billed.  this was from two whistle blower suits.  She paid a medical director fees for referrals while he was incarcerated in 2016.  She is also barred from Medicare for five years.

US v Mesquias

Rodney Mesquias, a San Antonio owner of Hospice companies, was convicted of lying to people about the length off their life expectancy in order to enroll them into hospice care.  He was sentenced to 240 months in prison for his sins.  He was also ordered to ay $120 million in restitution.

US v McLeod-Hughes

Barry McLeod-Hughes, a Georgia PT provider, agreed to pay $500,000 to settle allegations that he and his company billed for sessions done by non-licensed people.

US v Clemons

Cynthia Clemons, Courtney Newman and Holli Womack, all NPs convicted of being involved in a Tennessee pill mill, were sentenced to prison.  Clemons got 42 months, Newman 40 months and Womack 30 months.

US v Texas Heart Hospital of the Southwest

The Plano. Texas hospital and its subsidiary THHBP Management Company agreed to pay $48 million to settle allegations that they violated the false Claims Act by paying bribes to get patients.  This was a whistleblower suit by two physicians who will split $13,920,000 for bringing the case.

US v deGraft-Johnson

Dr. Moses deGraft-Johnson, plead guilty to charges of fraud and identit theft.  He is a heart surgeon in the Tallahassee area who routinely did two invasive diagnostic angiograms, one on each leg when not needed.  He then billed for arthrecomies which he may or may not have done.

OIG v Providence Medical Center

The OIG has said that the hospital received $325,000 in over payments due to failing to comply with billing requirements.  The hospital has refuted the claims but the OIG has maintained its findings.

US v Biogen

The company has agreed to pay $22 million to settle allegations that it illegally used charities to cover out of pocket costs for people to purchase their meds.  

Massachusetts v Maestro-connections Health Systems

The company agreed to pay $10 million to settle allegations that they provided home health services not authorized by a physician.  

US v Kinrys

De. Gustavo Kinrys, a psychiatrist in Natick, Mass., was indicted for falsifying documents, false statements and fraud.  He is accused of billing for treatments not provided then attempting to obstruct and cover up the investigation.  He used TMS therapy for depression and allegedly billed for sessions not done.

US v Berman

Keith Berman, the CEO of Decision Diagnostics, is alleged to have lied to investors about having a 15 second Covid test and also the SEC.  By doing so the stock rose 1500%.  Shades of Theranos.        Top


EM v Shady Grove Fertility

EM was a patient of the fertility clinic and was dismissed from the practice.  She then sued for an injunction to prevent her removal due to discrimination based on marital status.  She lost twice since the court said she could not demonstrate a substantial likelihood of success at trial.

DC Ct App

The American Hospital Association is not faring well.  They lost another case.  The DC Court of Appeals sided with the feds in the hospital's challenge to a rule that requires hospitals to disclose the rates they negotiate with insurers.  It is now urging and giving money to the new administration to re-look at the rule.


Patients v EyeMed
To Be filed

EyeMed, a subdivision of Aetna, had a hack of its data compromised and as a result almost 500,000 people had their data compromised.  

HHS v Elite Primary Care

The Georgia medical office agreed to pay $36,000 to settle charges that they failed to provide a patient promptly their medical record and did not provide it promptly to another provider.  The practice also had to agree to a two year corrective action plan with monitoring.        Top


Trotter v OB-GYN Services 

Elizabeth Trotter, a first time mother, went to the Norwich office for her pregnancy.  She accepted genetic testing but her child was born with cystic fibrosis.  the testing was never performed.  She won $2 million for the care of the child.  This appeared to be not the fault of the physician but of the EMR used by the practice.  

Garcia v KND Development 52 LLC
Ca Ct App

Ramiro Garcia was admitted for treatment and died.  His widow sued and the hospital moved to compel arbitration due to documents signed by the widow and the son.  The court ruled and the appellate court agreed that even thought he hospital testified that the usual and customary routine there was no proof that Ramiro had actually authorized the two to sign the arbitration agreements.        Top

Peer Review and Employment

Kohli v Good Samaritan Medical Center

Dr. Payal Kohli was a cardiologist at the enter who states she was fired one day after reporting unsafe conditions that led to a patient death.  She claims the patient died after no one was available to put in a pacemaker he needed.  The suit alleges the leadership ordered the cardiologists to cover the ICU and ED at times when they were supposed to see patients in their office.  The physician who was qualified to put in pacemakers had to cover multiple hospitals because the system did not have enough cardiologists.  

Chaudhry v Community Regional Medical Center

Dr. Pervaiz Chaudhry, a cardiac surgeon, is under investigation by the hospital for allegedly leaving the OR after heart surgery on a patient prior to the procedure being completed.  The patient went into cardiac arrest and suffered injury.  He sued to get the peer review documents and the hospital defended by stating they are protected.  All know there is no protection for peer review in federal court and now the hospital attorney knows.  The reason for denying the production may be to try to have the physician run out of money using delaying tactics.  The court applied the appropriate law and said to produce the documents except for communications between the attorney and the staff.        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.