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US v Wilson
Arrested
Hyrum Wilson, a pharmacist in auburn, Nebraska, was arrested for intent to commit arson and distribution of drugs. He with a drug dealer have been alleged to be selling drugs the dealer purchased from Wilson with Bitcoin on the dark web. Wilson had maxed out his allocation of oxy from his wholesaler so he and the dealer thought if they destroy his competitors pharmacy he would get his oxy allotment increased. He could then sell more to his dealer. They had planned to burn the rival down. Foiled by the FBI.
Pennsylvania
v Green
Arrested
Dr. Richard Green of Cambria County was arrested in connection with a patient death in 2018. He is accused of over prescribing to the patient in violation of the CSA. Top
US v Maury regional Medical Center
Settlement
The hospital agreed to pay $ 1.7 million to settle allegations that they billed for DRGs not supported by medial records. This was prompted by a hospital internal investigation.
US v Hirsch
Indicted
Scott Hirsch, the owner of JI Medical a California DME, has been indicted for paing kickbacks to physicians to sign false medical records to get DME billed.
US v Staley
Indicted
Dr. Jennings Ryan Staley of San Diego and the owner of Skinny Beach Med Spa has been indicted with mail fraud. He was selling Covid 19 treatment packs which included chloroquine and azithromycin as a "100%" cure. This was sold for the bargain price of $3,999 for a family of four along with access to Staley and anti anxiety meds to help one sleep. He could get 20 years for this.
US v Encore Rehabilitation
Services
Settlement
The Farmington Hills, Michigan, company agreed to pay $4 million to settle allegations that they provided medically unnecessary services or billed for individual minutes when it was actually group therapy. The company also entered into the dreaded corporate integrity agreement.
US v Saber Healthcare Group
Settlement
This skilled nursing facility agreed to pay $10 million to settle allegations that they provided unnecessary medical services systematically to increase Medicare billings. The feds alleged that Saber established general goals that all patients should be provided Ultra High level of therapy, an unreasonable assumption.
US v Logan Laboratories
Settlement
The company agreed along with Tampa Pain Relief Centers both in Tampa, Florida, to pay $41 million to settle allegations that they submitted billings for Urine Drug Testing that were not necessary. They automatically billed for this at every visit. Noting was individualized according to the allegations. This was a whistle blower case and they got $7.8 million.
US v Quainoo
Settlement
Baltimore internist Dr. Ebanezer Quainoo agreed to pay $ 436,000 to settle allegations that he did unnecessary autonomic nervous system tests and trigger point injections using ultrasound. He was not a specialist who should be doing these tests. He did not identify a muscular knot prior to injections.
US v Pilania
Settlement
Dr. Pramod Pilania, a psychiatrist in the Philadelphia area, has agreed to pay $91,109 to resolve allegations that he over billed times for patient visits. He contended that he saw over 100 patients per day including children. Sounds like he got off very easy.
US v Choudry
Settlement
Dr. Mubashar Choudry and his practices have agreed to pay $750,000 to resolve allegations that he and the practices billed for services proved by then after kickbacks were paid to the referring physicians. A former operation employee turned them in.
US v Centra Health and Blue Ridge
ENT
Settlement
The system and the medical practice agreed to pay $9,345,945 to settle allegations that they had illegal financial relationships. They self -reported this. These were recuitment contract violations.
US v Mok
Indicted
Dr. Charles Mok, of Washington, Michigan, was indicted for billing Medicare for Varithena injections on veins which had been previously ablated. He also is alleged to have done many more procedures than are medically necessary. He also allegedly billed for high dose vitamin C intravenous injections for Covid treatment, another no-no. Top
Planned Parenthood v Texas
5th Circuit
The 5th Circuit reversed not only the lower court but its own ruling by now stating that all abortions in the state except those where the patient would be past the state legal limit by the time the Governor's order is to expire. Abortion is a non-essential service as defined by the state. Doctors who violate the order can be fined up to $1000 or 180 days in jail. This includes medical abortion.
New York State Nursing Association
v NewYork
Filed
The union filed suit against the state and Montefiore Medical Center along with Westchester Medical Center. The issue is no protecting the safety of their staff. They alleged that no or substandard PPE was provided for the staff.
Health Insurers v US
US Supreme Court
The high court ruled that we tax payers must fund the insurers under OCare rules to the tune of $12 Billion. The Dems promised when they passed Ocare to fund losses for the insurers via the risk corridor program. They then reneged on that promise. Now we have to pay. This was a 8-1 ruling that overturned a lower court ruling.
US v Banner Health
Settlement
The Arizona system agreed to pay $8.9 million to settle a sit after they were hacked and allowed in 2016 2.9 million patients to have their information exposed. Each person will get $500 and the attorneys will get $2.9 million. Top
Seymour v Seattle Children's
hospital
Filed
Baby Seymour had non-emergent open heart surgery at the hospital. The parents state that they were not told about the hospital problem with Aspergillosis. The OR the baby had the his surgery in was not equipped with a HEPA filter and he got the disease. This problem has been going on at this hospital for two decades.
Curtis v Highfill
Virginia Supreme Court
Mary Jo Curtis sued Dr. Christopher Highfill. He operated on her for a broken ankle and then prescribed Percocet for the pain post operatively. However over the next 44 months he wrote 144 presumptions for Percocet for her. Curtis was found dead of an accidental overdose and the suit wanted punitive damages. The trial court did not allow the damages but the Supreme Court said the physician's conduct rose to the level of willful and wonton, so allowed the punis to be heard.
Family v Arbor Terrace
Filed
It has begun. The plaintiff bar is starting. The families of those that died from covid at this nursing home have filed suit for failing to properly protect their residents, as if they could. This also flied in the face of an executive order signed by Georgia Governor Kemp that limits legal liability for providers, hospitals and long them facilities during the pandemic. The attorneys are going for broke stating that this was gross negligence and perhaps fraud. Let's hope they do go broke. Top
El-Khalil v Oakwood Healthcare
ED Mich.
Dr. Ali El-Kahali, a Podiatrist, sued the hospital for retaliation under the False Claims Act. His admitting privileges were not renewed at various hospitals owned by the system. El-Kahali alleged his privileges were not renewed due to a prior reporting to the feds the hospital's fraud. Her contested teh denial of privileges and the panel ruled for him. Then a JCC ruled against him. He sued stating the revocation was due to the fraud reporting. The court said he was an employee or agent as he had admitting privileges when he reported the fraud. The court however tossed most of the complaint due to statute of limitations. The only thing that needed to be decided is whether the date the JCC met or when they rendered their verdict was the relevant date for the statute. If the former it too would be tossed but if the latter (five days) it would be OK . 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.