June 1, 2016 Recent Legal News





Peer Review and Employment



US v Guerrero

Dr. Jaime Guerrero of Kentuckiana, Kentucky, was sentenced to 100 months in jail for fraud and unlawful distribution of controlled substances.  He is a former anesthesiologist who has forfeited his license.  His actions led to a death of one of his patients.  He would bill up to 100 patients a day.

US v Persaud

Dr. Harry Persaud who is in prison for allegedly performing unnecessary stent procedures has been ordered to liquidate a trust holding a timeshare in Hawaii and pay restitution of almost $5.5 million.  This is on top of the $2.4 million he was ordered previously to pay in forfeitures and judgments.

US v LifeWatch Services
ND Ill

The court threw out the counter suit against the whistleblower.  Mr. Cieszynski accused the company of submitting claims to the feds for heart monitoring services that were a violation of federal law.  The company countersued him for HIPAA violations for releasing confidential information to the feds and to his attorney.  The court understood the claims were bogus and unrealistic.

US v DeHann

A suspended Belvedere, Illinois, physician Dr. Charles DeHann, has pled guilty of healthcare fraud.  He billed for the treatment of deceased patients.  I doubt if they got better.

Vincoli v Hospitals

Joseph Vincoli has filed suit against Carolinas HealthCare System and North Carolina Baptist Hospital for using MedCost, a co-owned company to provide inflated expenses for Medicare and Medicaid expenses.  The feds have not interceded in this case.

US v Family Medicine Centers of South Carolina

The feds allege that the large practice allegedly inflated medical bills by adding additional charges for patient visits.  These were blood tests that were not needed.  he charges were originally brought by a terminated physician but the feds investigated the charges before intervening.

US v Ganesh

Drs. Vilasini Ganesh and Gregory Belcher both of the Saratoga, California, area have been indicted for health care fraud.  They are accused of billing for patients never examined or lying about the amount of time spent with the patient in order to increase the payment.  Ganesh billed for over 100 hours per day and for days the practice was closed.  

Washington v J&J

California and Washington have filed suit against Johnson and Johnson regarding pelvic mesh implants.  The states allege the company of not telling physicians and patients about the risks and complications of the mesh.  

US v Prime Health 

The feds have joined a whistleblower suit against the hospital company for admitting Medicare patients instead of treating them more appropriately as outpatients.  They say the hospital organization deliberately instructed its physicians to choose inpatient admission over observation status.  The feds have found that observation status at a hospital that Prime acquired would decrease after the acquisition.  

US v Terry

Dr. John Terry of Wellsboro, Pennsylvania, and Thomas Ray were sentenced to 20 months and 71 months respectively for distributing controlled substances.  Terry was also ordered to pay $4,762 in restitution.  

US v Bryan II

 Los Angeles physician Dr. Washington Bryan II was arrested for making deposits less than $10,000 to keep from the reporting requirements to the feds.  He allegedly made the money by writing scripts for narcotics and HIV meds.  He was the highest user of pharmacies in the state for narcotics.    Top


Little Sisters of the Poor v HHS
US Supreme Court

The Obama administration got a reprieve when Justice Scalia passed away.  This left a 4-4 divided Supreme Court who only make decisions on political lines not legal ones.  In the above case they were obviously divided and thereby punted the cases back to the Circuits to work out a compromise, since they obviously can not.  This means the Circuit court rulings stand at present.

Stinson v Kaiser

In this case discussed last issue, the District Court ruled for Kaiser allowing the hospital to pull the plug on the toddler that has been ruled brain dead.  The parents are attempting to get a feeding tube and a tracheotomy tube inserted and have the child transferred to a long term care facility.  The parents have appealed the decision to the 9th Circuit.  It is interesting that a separate article in the same paper that printed the story on Stinson ran an article regarding a 29 year old, Anahita Meshkin.  John Muir Medical Center in Walnut Creek said the woman was brain dead and wanted to pull the plug but the family got two other UC physicians to say she was not brain dead. After that determination Meshkin got her needed hip surgery and she was returned to the care facility from which she came.  Several days later he was transported to an unknown hospital in some foreign country.  He still does not have a permanent feeding tube and is on a temporary ventilator.  The parents want eventually to bring him back to California depending on insurance coverage.

Highmark v US

Highmark has filed suit against the feds for not allowing the risk corridors in Obamacare to continue.  This means that the insurer will not receive millions of dollars they were counting on.   This is the second suit against the feds for the same thing.  Oregon Health Republic Insurance filed a $13 Billion suit.


The American Academy of Emergency Medicine sued the HHS because Obamacare did not provide failed to ensure reasonable payment to physicians for out of network emergency care.  They have asked that the feds oversee the insurers to be more transparent with the data they use for payments.  They also want the feds to amend their rule about which of three methods are used to pay for the services. 

Finigan v Burwell
D Mass

 In a case that should never have happened, a patient sued the feds for payment of her glucose testing strips for her Continuous Glucose Monitoring System.  She was initially denied coverage by her Medicare Advantage Plan.  She appealed up to the Medicare Appeals Council which affirmed the rejection.  The court ruled for the plaintiff finding that the council wrongly deferred to an article denying coverage for testing strips.   An article is not law.     

Patients v Washington
District Court

 A federal judge has issued an order to the state of Washington to pay for treatment of hepatitis C by the Medicaid program.  They had been paying only for the sickest patients and now must pay for all patients with the disease.    Top


Patients v Florida Medical Clinic
To Be Filed

Over 1000 patients data were compromised by a vendor Greenway Health that screwed up their website allowing patients to see the information of other patients.  

Patients v New Mexico
To Be Filed

San Juan County had their computers hacked and available for inspection in March.  about 12,000 people's information is at risk.  

Patients V Southeast Eye Institute
To Be Filed

The Florida based practice said its vendor Bizmatics compromised information on about 87,000 individuals when information was breached by unauthorized individuals.      Top


DC v Brown

An indicted was handed down against two guards at MedStar Washington Hospital for involuntary manslaughter.  A patient walked out of the hospital without being discharged and was confronted by the two guards.  He sustained a broken cervical vertebrae and died.  This happened last year and the two guards were removed from their jobs shortly thereafter.  The hospital has settled with the family.

In Re Powell Valley Healthcare
Bankruptcy Court

The hospital filed for bankruptcy protection under Chapter 11 to take care of about 20 law suits against it due to surgeries performed by employed Orthopod Jeffrey Hansen.  Dr. Hansen was employed between 2006 and 2014.  He was removed from the staff in 2014.  The filing is to stop the suits proceeding until a plan is worked out.  The hospital insurance companies have also filed suit against the hospital and say they are not responsible to defend nor cover the losses. 

Cullen v California Department of Public Health

 Some physicians and community leaders have filed suit against the state and the Orange County EMS for agreeing to close the 73 bed Saddleback Memorial  Hospital in San Clemente.  They was a TRO and a permanent injunction to keep the faltering hospital open.  It is the only ED in 40 miles.          Top

Peer Review and Employment

Winger v Meade District Hospital
10th Circuit

Dr. Raymond Winger worked at the hospital under a contract for one year and allowed for termination without cause on 60 days or immediate for cause.  The hospital had complaints about him and after an investigation released him for cause.  Dr. winger sued for a property interest and due process.  The district court gave summary judgment to the hospital but the 10th Circuit remanded since in Kansas if an employer can terminate one without cause the person has a property interest in continued employment.  The hybrid clause in Winger's contract gave him that property interest.  He should have been given an additional 60 days of continued employment.  The Court affirmed the summary judgment on the report on Winger to the NPDB.

Dark v Houston Methodist San Jacinto Hospital
SD Texas

A nurse claimed she got an autoimmune disease after a flu shot and could not work.  She was on short term disability and then got an extension of the leave.  She was warned that she would be terminated unless she returned to work after the extension.  She filed suit.  She lost the racial discrimination part because she presented no evidence.  She lost the disability discrimination part because she failed to present credible evidence.

Doctor v LifePoint Hospitals
La Ct. App

A OB was summarily suspended for not having backup and for being chronically late for surgery.  He was reinstated with specific recommendations that if breached would result in suspension.  He agreed.  He breached the agreement and was suspended for not less than one year and was reported to the NPDB.  He sued and to no one's surprise lost.  

Elkharwily v Mayo Holding Co.
8th Circuit

In yet another waste of money, Dr. Alaa Elkharwily sued a hospital for defamation and other usual causes.  He was fired due to poor performance and lost the case in the district and the court of appeals.  

Shibley v King County Public Hospital District
Washington Ct. App

The waste and losses continue.  Here Dr. Eric Shibley was an employed hospitalist who was fired after being accused of writing a H&P without examining the patient and after a fair hearing.  He signed a severance agreement releasing the hospital from claims relating to his employment.  He then sued in state court and lost in all courts for obvious reasons.        Top


US v B. Braun

B. Braun Medical agreed to pay $4.8 million in penalties and and additional $3 million in restitution to resolve charges of criminal liability in selling syringes pre-filled saline syringes.  The company knew about the problem at the facility that made the syringes prior to purchasing the syringes.  The making company changed the way they sterilized the syringes and had complaints and Braun did not oversee the sterilization process.  They will now be required to oversee all.

Fischer v UPMC

The hospital agreed to pay the daughter of a transplant patient who died of mold infection $1.35 million.  She was one of four transplant patients who contracted the disease.  Other suits have been filed.        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.