July 1, 2022 Recent Legal News
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US v Staley
Sentenced
Dr. Jennings Staley of San Diego was sentenced to 30 days in prison and one year of home confinement for selling hydroxychoroquine as a cure for Covid. He marketed this as a part of his spa treatment business. He said the virus disappears in hours with this med. This was in March 2020 prior to any vaccines.
Georgia v Roberts
Arrested
Shaneika Roberts, RN ,a jail nurse, was arrested for allegedly passing narcotics to an inmate.
Sweden v Macchiarini
Convicted
Dr. Paolo Macchiarini was the surgeon who developed and transplanted synthetic tracheas. He did then in the US, Russia and Sweden and all died except one who had the artificial trachea removed. He was convicted by a Swedish court of causing bodily harm and was given a suspended sentence. He also has been fired from the Karlinska Institute.
US v Gold
Sentenced
Dr. Simone Gold, a physician in Southern California and a member of American Frontline Doctors had plead guilty to illegally entering a restricted federal building on January 6, 2021 and has now been sentenced to two months in prison. She was also ordered to pay a $9,500 fine.
US v Hernandez
Arrested
Lazaro Hernandez of Miami was arrested for suspecion of distributing adulterated HIV drugs. He allegedly illegally obtained the tainted drugs and along with co-conspirators sold the drugs to wholesalers who in turn sold the drugs to retailers who billed fed med. Top
US v Sakr
Settlement
Dr. James Sakr an ENT of Dansville, New York, has agreed to pay $600,000 to settle allegations that he billed fed med for six years for procedures never performed. This was a whistleblower case from another physician. He probably should have gotten jail time as well.
US v Healthkeeperz
Settlement
The Pembroke, North Carolina behavioral health company agreed to pay $2.1 million to settle allegations of billing for services that were not reimbursable. The case was a whistleblower case.
US v Caris Life Sciences
Settlement
The company has agreed to pay almost $2.9 million to settle allegations that they improperly billed for laboratory tests. They had developed a series of lab tests mainly for cancer patients to predict the risk of breast cancer reoccurrence. The tests were not performed for 14 days in order to subvert the non-billing law.
US v Lavache
Indicted
Kateline Lavache of Hampton, Georgia, was indicted in federal court for prescribing unnecessary DME in trade for bribes. She allegedly did this fraud via telemedicine without establishing any meaningful relationship with the patients.
US v Six Physicians
indicted
The feds added six Texas doctors to the indictment involving laboratory testing fraud. It is alleged that the physicians received payments for referring patients for laboratory tests that were not reasonable nor necessary. the physicians are Drs. Doyce Artrett, Jr, Elizabeth Seymour, Emanuel Paul Descant, II, Frederick Brown, Heriberto Salinas, and Hong Davis.
US v Mariarty, Dickens, Brown
Guilty
Arlinda Moriarty, her sister Daynelle Dickens and their uncle Tony Brown all of the Pittsburgh, Pennsylvania, area pleaded guilty of fraud. Moriarty masterminded a plot to defraud fed med of millions of dollars by submitting false claims. As part of the their pleas they agreed to pay $8,700,000, $1,000,000, and $43,113.02 respectively.
US v Singh
Indicted
Dr. Ankita Singh of Maumee, Ohio, was indicted for fraud. It is alleged that Singh participated in a scheme to bill Medicare for DME that was medically unnecessary.
US v Oxendine
Arraigned
John Oxendine of Atlanta, Georgia, was arraigned for allegedly obtaining kickbacks to order unnecessary laboratory tests.
US v Chun, Tondre
Guilty
Dr. Steven Chung and Daniel Tondre of the Tampa, Florida, area were found guilty by a jury of conspiring and receiving kickbacks and bribes. They got speaker fees for talking up Insys Therapeutics's Subsys. Tondre marketed the product by holding bogus seminars and Chun would speak.
US v Wang
Settlement
Dr. Roger Wang a San Francisco rheumatologist agreed to pay just over $1 million for using foreign medications and billing as if they were the FDA approved ones.
US v Sutter, Palo Alto Medical
Settlement
The feds allege that Sutter and its affiliate Palo Alto Clinic are using the Medicare Advantage program illegally by forcing physicians to add false diagnoses in order to collect more money. This was an original whistleblower suit filed by a person hired to audit medical case files. They paid $90 million with no liability offered. This is now part of a larger audit by the feds of Medicare Advantage abuses. Conditions are added that have no bearing on the currant condition. Kaiser and others are now under investigation or have had suits filed against them by the feds.
US v Steward Health
Settlement
The Dallas based company has agreed to pay $4.7 million to settle allegations that they rented space from providers at higher than market price to induce referrals. They also possibly paid a physician for services not performed. This is another whistleblower case.
US v Kochumian
Settlement
Dr. Minas Kochumian agreed to pay $9.49 million to settle allegations that he submitted false claims to fed med for procedures never performed. This is a whistleblower case so the medical assistant and IT consultant will get $1.75 million.
Kapoor, Lee v US
US Supreme Court
Insys Therapeutics founder John Kapoor and a former sales director Sunrise Lee had the appeal of their convictions of bribery not accepted by the Supreme Court.
US v Middle Georgia Family Rehab
MD Georgia
A federal judge ruled that the rehab needed to pay $9,617,679.22 in damages and penalties for billing for services by people who were no longer with the facility.
US v Peterson
Settlement
Dr. Soaries Peterson of Muskeon, Michigan, agreed to pay $500,000 to settle allegations that she billed for services not performed. this was mainly narcotic prescriptions when she was elsewhere. She also agreed to give up her DEA license and never reapply for another one. She still faces prison time.
US v Smilie
Sentenced
Henry Simile, the former owner of Chicago's Home physician services was sentenced to one year in prison and to pay $1.2 million in restitution for billing for care plan oversight for services not performed.
US v Santos
Guilty
Erik Santos of Braselton, Georgia, plead guilty of fraud. He owned a company that did business with medical testing companies. He provided leads for testing that was expensive and not necessary in exchange for kickbacks.
US v Maywalt
Sentenced
Joshua Maywalt, a medical biller of Tampa, Florida, was sentenced to five years and five months in prison for his billing illegally for services of a physician without his knowledge. He was also to forfeit real property and $2,5257,029.
US v Yentzer
Settlement
Rodney Yentzer of Cumberland County, Pennsylvania, agreed to pay $900,000 to settle allegations that he billed for laboratory tests in narcotic clinics he controlled that were not necessary. He has agreed to be excluded from fed med for 22 years.
US v Snap Diagnostics, Raviv,
Burton
Settlement
The Chicago sleep testing company and its founder Gil Raviv and its vice president Stephen Burton agreed to pay a total of $3.9 million for billing for medically unnecessary services. They billed for several nights of home sleep testing when one was sufficient.
US v Haste
Sentenced
Melanie Haste of Trenton, Tennessee, earlier plead guilty to wire fraud for stealing money from Jackson-Madison County Hospital. She has now been sentenced to 18 months in prison alsong with a special assessment of $100 and to repay the hospital almost $210,000.
US v Seemer
Arrested
Catherine Seemer has been charged with fraudulently orchestrating a scheme to get million of dollars of student loans for borrowers who did not qualify. She allegedly charged the fees up to 20% for getting them the false loans.
US v Molina Healthcare
Settlement
Molina agreed to pay $4.5 million to resolve allegations that they and a subsidiary violated the law by filing claims related to the licensure and supervision of staff.
US v Finney
Settlement
Dr. Patrick Finney of Paducah, Kentucky, has agreed to pay $ 561,800 to settle allegations that he illegally used telehealth to order un-needed DME for kickbacks.
US v Wisner
Convicted
Dr. Gary Wisner, a California surgeon was convicted on six counts of fraud for doing hundreds of unnecessary X-rays at his Lodi office.
US v Weckerly
Sentenced
Ryan Weckerly was a owner of two marketing agencies. He and a co-conspirator fleeced Mercyhealth in Janesville, Wisconsin.
US v Hammer
Sentenced
George Hammer of Palm Desert, California, was sentenced to 15 months in prison for facilitating illegal payments to physicians to do surgery at Pacific Hospital in Long Beach. He was also fined $8000 and ordered to repay $500,000.
US v Perez, Perez
Convicted
Jorge Perez and Ricardo Perez both of Miami were convicted by a federal jury of billing for laboratory tests that were medically unnecessary. They got control of some rural hospitals and turned them into lab testing sites. They made it seem the tests were sone by the rural hospitals for larger payments but they were actually done by other labs.
US v 15 Physicians
Settlements
Fifteen Texas physicians have agreed to pay the feds money to settle allegations that they received kickbacks to order lab tests from several labs. The doctors and their fines are: Louis Coates $87,694; Jason DeMattia and Candice Demattia $316,142 and $207,009 respectively; Emanuel Descant II $256,400; Mitchell Finnie $582,522; Mark Le $57,900; Richard Le $41,000; Robert Laningham and Rodney Laningham $470,560; Andres Mesa $45484; Melissa Miskell $100,392; Marco Munoz $54.240; Kozhaya Sokhon $160,456; Annie Varughese $213,888; Paul Worrell $237,487.
US v Gallups
Sentenced
Dr. Jeffrey Gallups of Atlanta was sentenced to 36 months in prison owned ENT clinics and had his physicians order unnecessary lab tests. He was also ordered to pay $700,000 in restution and fined $25,000. In a separate civil case last year Gallups and his Milton Hall Surgical Associates agreed to pay $3million to settle a civil whistleblower suit.
AAEMPG Envision Healthcare
DC ND California
The court refused to dismiss an action fled by the American Academy of Emergency Medicine physicians against Envision Healthcare for violations of the California Corporate Practice of Medicine Act. They say that Envision's method of practice is a run around the law. The court denied the motion to dismiss.
Gallardo v Florida Agency for
Health Care Administration
US Supreme Court
Gallardo was 13 when she was hit by a truck and sustained a permanent vegetative state. The family sued the truck owner and got a $800,000 settlement of which about $35K was for past medical expenses and an unspecified amount was for future medical expenses. The state Medicaid program paid over $800 K when she was injured and now wants $300 K back. The 11th circuit agreed with the state and so did the Supremes. In a 7-2 decision Florida was entitled to pay for past and future medical expenses. She is still under Medicaid.
MO v GEICO
Missouri Court of Appeals
MO contends that she contracted HPV from a sexual partner in a care insured by GEICO. She petitioned GEICO and her claim was denied. She then arbitrated the case and the arbiter ruled she should be paid $5.2 million. The lower court affirmed the arbitration and so did the court of appeal. GEICO did not get involved until after the arbitration. They refused to defend the insured. Sounds like a complete screw up by GEICO and its attorneys.
AHA v HHS
US Supreme Court
The Supreme Court sided with the hospital association and agreed the HHS exceed its authority when it cut the subsidies for 340B drugs. This was a 9-0 decision.
Doe v Meta
Filed
John Doe filed a lawsuit against Meta for patient privacy violations. This stems from the recent discovery that Meta Pixel may be used on hundreds of hospital sites. This may allow patient information to go to Facebook.
DaVita v Marietta Memorial Hospital
US Supreme Court
In a 7-2 decision the justices overruled a lower court. they ruled that the hospital's plan did not discriminate against patients with end-stage kidney disease by reimbursing them at a low rate to attempt to force them into Medicare instead of the plan.
Dobbs v Jackson
Women’s Health Organization
US. Supreme Court
In a 6-3 decision the high court ruled that Roe v Wade was previously wrongly decided and overturned the court's prior decision. The decision means that abortion is still legal if a state decides it is. This is the same as prior to the 1973 Roe decision which in my opinion was based on faulty reasoning. I will say that I believe very strongly in a women's right to choose but I believe equally in the law. Remember these are courts of law not justice.
Ruan, Kahn v US
US Supreme Court
Drs. Xiulu Ruan and Shakeel Kahn were both convicted of running "pill mills" and sentenced to long prison terms. They appealed their conviction to higher courts and lost and finally they appealed to the Supreme Court. the Supremes in a 9-0 decision said that once a physician proves he ahs the right to dispense opioids the prosecution must prove that the physician knew there was no legitimate medical purpose. The prescriptions would not be illegal the manner of intentionally prescribing them in an unauthorized way would be illegal.
Oklahoma v AmerisourceBergan.
Cardinal Health, McKesson
Settlement
The three companies have agreed to ay the state $250 million to settle allegations regarding their involvement in the opioid crisis. Top
Patients v Shields Health Care
Group
To Be Filed
About 2 million people have had their health information potentially compromised due to someone hacking into their data base. Why did they not secure the information before the attack?
Patients v Kaiser Permanente
To Be Filed
Almost 70,000 Kaiser members had their personal data breached in the state of Washington. A employee allowed the breach. The employee is NOW being given additional training on safe email practices.
Class Action v UPMC
Settled
UPMC agreed to settle the HIPAA breach suit for $450,000. This is from a 2020 data breech affedting over 36,000 patients.
US v Ortiz
Sentenced
Dustin Ortiz of Des Moines, Iowa, was sentenced to 27 months in prison for conspiring with an employee at the Des Moines VA to obtain information on a patient/s medical records. He then disclosed the records to a third party. Top
Wesco v Cahill
Filed
Megan Wesko has filed suit against Dr. Kevin Cahill, a tropical disease specialist for sexual assault. She says that in 2006 during an examination he penetrated her anally with his finger or an object. She says that staring in 2009 he pursued her romantically. Another woman who has not filed suit said the same thing happened to her by Cahill.
Pederson v UCSF
Verdict
Anders Pederson donated a kidney to his sister Kelly. following the procedure he had a cardiac arrest and later had resusative measures stopped. The family requested the records but were stonewalled by UCSF and so filed suit in order to get the records. They found that he died of a narcotic overdose which no one tumbled to. He had reduced kidney function immediately post-op and therefore had the overdose of his pain meds. All that was needed to save him was early detection by a pulse oximeter and treatment with narcan. Neither happened. UCSF continued their stonewalling even after the verdict against them. I would expect nothing less from this organization.
Tharpa v Holien, St. Cloud
Hospital
Federal Jury
Anuj Tharpa was playing indoor soccer when he was tackled resulting in a bad injury to his left lower leg. He went via ambulance to the ED at the hospital where he was seen and operated on by Dr. Chad Holien for a broken leg. Post-op he complained of pain, numbness and muscle issues but was discharged. Six days later he returned for severe pain and another person operated for acute compartment syndrome. He had over 20 surgeries to deal with multiple complications. Since he was a Nepalese immigrant he filed a med mal in federal court. The federal jury gave him $100 million for future pain and emotional distress, $10 million for past suffering and just over $1 million for past and future medical bills.
Doe v Jarosz
Filed
The parents of a 4 year old are suing for an unintentional vasectomy. The child had a hernia, hydocoele repair on one side and the specimen contained vas deferens. They are suing for med mal. They want $250,000- $1 million for future care.
Dixon v George County Regional
Correctional facility
Settlement
Stupidity reigns supreme in this county facility. William Dixon was an inmate who died after being without his insulin for a week. He was denied access to it by the nurse Carmon Brannan who is currently serving a 15 year manslaughter sentence for her action in this case. the county is agreeing to pay the family $2.275 million for their role. This is about half of their entire budget for the year. They deserve it.
McCarthy v Brigham and Women's
Hospital
Filed
Everleigh McCarthy was a premie born at the hospital. She weighed two pounds at birth and she died several weeks later. When the funeral home went to claim the body the hospital said they had lost her. The police investigated and said she was possibly mistaken for soiled linen. The parents have now filed a law suit for negligence against the hospital.
Martin, Tyree v UPMC
Filed
In 2020 Michael Martin and Inger Tyree were to be married. About a week prior to the event Martin got sick and went to UPMC for a covid test. He also had a strep test and that was positive. He was called and told he tested positive for covid and based on that information he cancelled his wedding. He lost $about $15,000. After he did all this the office called back and said whoops, made a mistake Martin did not have covid. They still got married that day but not the wedding that was planned. Martin tried to get some help from the errant practice but they stonewalled so he is suing. Hope he wins.
Ready v Daily Harvest
Filed
Carol Ready ate Daily Harvest "Crumbles" and after had severe abdominal pain requiring the removal of her gall bladder. About 100 people had also experienced abdominal pain after eating the "Crumbles" The FDA has done multiple tests and found no common food-borne pathogens, toxins and allergens. 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.