July 1, 2021  Recent Legal News

Criminal

Fraud

Healthcare

HIPAA

Hospitals

Malpractice

Peer Review and Employment

Criminal

US v Sherwood
Settlement

Dr. Loren Sherwood of Ridgeway, Colorado had his medical license expire on April 30, 2017.  After that he continued to write scripts for controlled substances.  Dr. Sherwood agreed to settle ths problem by paying $21,000 over time and not practice medicine again nor will he seek reinstatement of his DEA license.  

US v Goldstein
Sentenced

Dr. Jeffery Goldstein of Manhattan was sentenced to 5 years in prison.  He violated th Anti-Kickback statute by accepting money from Insys Therapeutics, the maker of Subsys, to prescribe the drug.  This was part of the Speaker' bureau the Insys had set up to funnel money to physicians.

US v Rinehart 
Sentenced

Dr. Darrel Rinehart of Indianapolis was sentenced to three years in prison for illegally prescribing controlled substances.  He had admitted to prescribing the meds without a legitimate medical reason.

California v Moawad
Indicted

Emad Moawad, a dentist in Los Angeles, was indicted on charges of molesting nine female patients in his office while under anesthesia.  He is also the defendant in a civil suit for the same crimes.  

Patients v Beckley VA Medical Center
Settlement

There is a settlement in the case of 62 patients at the VA who were patients of Dr. Jonathan Yates.  He had pleaded guilty and sentenced to 25 years in prison.  The settlement wasps for about $10.5 million.  

Kansas v Ahlers
Sentenced

Machael Ahlers was sentenced to two years inprison for embezzlement of over $550,000 from the University of Kansas Medical Center.  He was in the administrative office of the Occupational Therapy Department and made fake invoices to conceal his theft.  He also has to repay over $680,000 in restitution.

Tennessee v Haste
Indicted

Melanie Haste was the Director of Risk Management at West Tennessee Healthcare.  During that time the paralegal was accused of stealing over $350,000 from the system.

US v Ballard III
Guilty

Dr. Thomas Ballard III of Jackson, Tennessee, has plead guilty to having inappropriate suxual relations with female patients along with plying them with hydrocodone resulting in the death of one patient.        Top

Fraud

US v Paksn, Inc.
Indicted

The California skilled nursing chain and its owner Prema Thekkek were accused of hiring physicians as directors who promised in advance to refer patients to the facilities.  If they did not refer enough physicians they were fired.  This is a quitam suit by a former employee.

US v Campbell, Dyer
Guilty

Dr. Jeffrey Campbell and Mark Dyer, APN were found guilty of fraud and dispensing controlled substances illegally.  They ran Physicians Primary Care in Louisville.  

US v Shah
Settlement

Dr. Zaheer Shah agreed to pay $650,000 to resolve a civil case against he and Park Square Urgent Care in Rhode Island.  The charge was that providers under Shah's direction billed for urine drug terstsd not performed.

Lutz, Webster v LabCorp
DC SC

The federal court has allowed a lawsuit by Scarlett Lutz and Kayla Webster continue.  The qui tam suit alleges that the lab had phlebotomists draw blood in medical offices with the knowledge that the physicians were getting kickbacks from HDL and Singulex labs in exchange for referring samples to them for testing.  The feds did not intervene in this case.  

Ohio, Mississippi v Centene

The managed care organization agreed to pay Ohio $88.3 million and Mississippi $55.5 million.  This is to settle the allegation that they overcharged the states' Medicaid programs for pharmacy benefit management services.  

US v Rodonaia
Sentenced

Dr. Grigoriy Rodonaia of Port Neches, Texas, was sentenced to 84 months in prison and ordered to pay $195,608 in restitution.  He issued prescription that were not needed for compound medications and bill the TriCare system.  The prescriptions were issued without the patient's knowledge.  

New York v Johnson & Johnson
Settlement

J&J will pay the state of New York $263 million to settle allegations that they fueled the opioid epidemic.  They are also forbidden from selling the drugs nationwide.

US v Seven
Indicted

Dr. Tajul Chowdhury, Mohammad Cowdhury, John Rodriguez, Alex Flores, Hector DeLaCruz, Aracell Gaona  and Erika Hernandez all in the area near McAllen, Texas, have been indicted for fraud.  they are accused of healthcare fraud for making and receiving kickbacks an illegal prescriptions for compounded medications.

US v Osei-Bonsu
Settlement

Dr. George Osei-bonsu of the Greensboro, North Carolina area agreed to pay $330,000 to settle allegations that he and his corporations submitted bills for arterial and nerve conductions studies exams that were not medically necessary.

US v Nguyen

Dr. Albert Nguyen of Oklahoma City paid $325,000 to settle allegations that he left pre printed prescriptions and his offices which non-physician practitioners routinely used illegally.

US v El Paso Ear, Nose and Throat Asssociates
Settlement

The medical group agreed to pay $750,000 to settle allegations that they upcoded illegally.  

Connecticut v Mansourov

In an exercise in futility and grandstanding, the AG filed claim and received a judgment against Dr. Maansourov for triple damages in his fraud against the state.  the state will not see any of the $15 million judgment (triple damages).        Top

Healthcare

Insurers v US
United States Supreme Court

The court refused to hear an appeal from the insurers of a US Court of Appeals for the Federal Circuit judgment for the government.  The case was the insurers asking for full reimbursement instead of partial reimbursement under Ocare for having thenm offer Medicaid insurance.  The case will continue as to how much they are entitled to

Texas v US
United States Supreme Court

The states sued the feds to strike Ocare since the Congress voted to stop the tax penalty for not purchasing the expensive insurance.  The court did not rule on the merits of the case but said the state did not have standing to bring the suit in a 7-2 decision.  It is amazing it got this far without that argument being flushed out.

City of San Diego v Kaiser
Filed

The city DA filed charges against Kaiser, Molina Health and HealthNet for falsely representing what services are available via their networks by having inaccurate panel information.

AHA v US
US Supreme Court

In a spark of sanity the court refused to hear the drivel put out by the AHA saying the government could not decide on site neutral pay cuts.  Of course they can.  The AHA has been buying up physicians offices and are now going to feel the cuts.

Members v UnitedHealthcare
Filed

The class action suit filed alleges that the insurer is not routinely covering deep inferior vein epigastric perforator flap breast reconstruction surgery.  The insurer is balking at the use of co-surgeons and assistant surgeons on the procedure.        Top

HIPAA

Patients v South Texas Health System
To Be Filed

The system emailed almost 7000 people's information to an unknown recipient.  The system discovered the error the next day but has no idea who the unidentified recipient is nor what they did with the email.

Patients v CVS
to Be Filed

CVS had a vendor who exposed over one Billion people's information on line.  This was found by a cybersecurity researcher and CVS nor the vendor knew of the breach.  

US v Bacor
Sentenced

Jennifer Bacor of Las Vegas was sentenced to probation after she plead guilty of wrongfully obtaining PHI .  She accessed her ex-boyfriends medical information and had a friend put it on Facebook.  She also was fined $1000 and is restricted for five years to having access to PMT.

Patients v St. Charles Health System
To Be Filed

On April 26 about 42 health systems in the country were notified that there was a breach of their Software vendor Eleckra was hacked.  This potentially compromised about 5000 of St. Charles' patients.

Patients v Aultman Health Foundation
To Be Filed

Over 7000 patient  records were compromised by a former employee who was involved in coordinating patient care.

Michigan v Alsughayer
Filed

Dr. Ahmad Alshghaye of Saganaw, Michigan, has been indicted for gross misdemeanor unauthorized computer access.  He has been accused of illegal access of several medical records possible to see naked female images.  He along with Mayo clinic are the targets of a civil case filed by two women in this case.        Top

Hospitals

Minnesota v Hutchinson Health
Settlement

The hospital agreed to forgive $184,000 in medical debt plus another 40% off if the debt in fully paid by a date certain.  This is because the hospital increased patients monthly bills beyond what the agreed to pay.

Nurses v Albany Med Health System
Settlement

The hospital agreed to pay $90,229 to seven former nurses who the hospital forced to pay fees after resignation from the staff.

Dr. A v Pennsylvania Hospital
Filed

In her lawsuit Dr. A claims as a second year psychiatry resident was assigned to tell a patient admitted to the neurology ward that he wasn't to be discharged.  The patient allegedly grabbed her by her hair and while banging her head on the floor he stabbed her repeatedly with a knife and fork.  This all while many others looked on from a nursing station just outside the door.  These people locked themselves in a nearby room leaving the doctor alone.  The doctor is now suing the hospital for failing to take steps that could have prevented the incident.  Another person, a nurse, filed alike claim one year ago against the hospital but it was withdrawn one month later.  

Yebba v AMHC Anaheim Regional Medical Center
Ca Ct App

The appellate court affirmed the lower court decision that dismissed the case against the hospital for not telling him about a separate fee for the use of the ED prior to using the facility.  The courts said the legislature has said what the hospital has a duty to disclose and this was not one of those.        Top

Malpractice

Harmon v Uintah Basin Medical Center
D Utah

Harmon presented to the hospital ED following a suicide attempt.  He was transferred to the University of Utah for more advanced psychiatric care.  He was transferred by private vehicle and without anyone qualified to accompany him.  He jumped out of the care while the care was going about 65 mph sustaining serious injuries.  He sued under EMTALA for not be stabilized when transferred.  The hospital says they admitted him prior to the transfer as required.  The court said this is a problem for the jury to sort out whether an observation is the same as admission.        Top

Peer Review and Employment

El-Khalil v Oakwood healthcare
DC SD Mich

Dr. Ali El-Khalil sued the hospital for retaliation under the False Claims Act after he lost his medical privileges.  He claimed the he was a whistleblower and they retaliated against him.  The problems was his attorney filed the claim too late to avoid the statute of limitations.  The claim was filed on the day he received the letter of termination but the statue ran from the date of his application for renewal or priveleges was denied.  Legal malpractice??

Vinarsky v Health First
Filed

Dr. Simon Vinarsky was fired from the organization for cause.  the employment agreement was cancelled according to the hospital for allegations of aggressive behavior toward others and negative patient feedback.  Vinarsky claims it is due to retaliation for complaints regarding upper management and the EHR.  This is an employment issue.        Top

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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.