May 15, 2020 Recent Legal News
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US v Genova Diagnostics
Settlement
The Ashville, North Carolina, lab agreed to pay $43 million to settle allegations that they billed for medical unnecessary tests. The feds state that they billed for IgG allergen, NutrEval and GIEffects lab test profiles that were not necessary and were done by phlebotomists that broke the Stark Law. This was a qui tam and the whistleblower got $6 million.
US v Peters
Sentenced
Jesse Peters, of Lake Worth, Florida, was sentenced to 15 months in prison along with three years of supervised release and pay restitution of $3,405,000. He was a co-conspirator in a scheme to bill for unnecessary urine drug tests from Liberation Way.
US v Carlson
Settlement
Dr. Jeffery Carlson, an Orthopededic surgeon in Newport News, Virginia, has agreed to pay $1.75 million to settle allegations that he accepted kickbacks from SpineFrontier, Inc. He is the sixth orthopod to settle. He is alleged to have received sham consulting fees based on the number of hours he used a SpineFrontier product.
US v Frame
Indicted
Charlene Frame, the owner of Royal Physician Network and Envision It Perfect in Georgia has been indicted for paying nurses and physicians for providing duplicate orders for DME.
US v Florida Cancer Specialists
& Research Institute
Settlement
The oncology group in Fort Meyers, Florida, has agreed to pay a $100 million criminal penalty and admitted to antitrust crime. The group participated with competing radiology oncology groups in Collier, Lee and Charlotte counties. They agreed not to compete for patients in Southwest Florida.
US v Li
Settlement
Dr. Frank Li and his pain med clinics Seattle Pain Center and Northwest Analytics agreed to pay $ 2.85 million to settle allegations that they billed for medically unnecessary urine drug tests. These clinics were shuttered after Dr. Li had his license revoked for improperly monitoring prescriptions. This is only a civil settlement meaning a criminal one may be forthcoming.
US v Donald
Guilty
Dr. Felicia Donald of Great Falls, Virginia, plead guilty of organizing and leading a illegal prescription drug and fraud scheme. She prescribed pills to a close associate when she knew they would be resold on the street. She falsified medical records to make it look like people she had never seen were her patients.
US v Lexington Foot and Ankle
Settlement
The Kentucky podiatry practice agreed to pay $750,000 to settle allegations that they billed for nail debridement when they did lesser procedures.
US v Vora
Indicted
Dr. Kishor Vora of Owensboro, Kentucky, was indicted on charges of getting kickbacks from a lab for pharmacogenoics testing that was not necessary.
US v Connecticut Counseling
Centers
Settlement
The clinics agreed to pay $295,000 to settle allegations that they billed separately for services that were included under a bundled rate.
US v Anderson
Guilty
Marcus Anderson, the owner of a treatment center in St. Petersburg, Florida, plead guilty to healthcare fraud. He stole the credentials of doctors to submit false claims for services never provided.
US v Plaisance
Kacey Plaisance of Altamonte Springs, florida pled guilty of fraud. He operated Ark Laboratory that did genetic testing. He allegedly paid Dr. Mathew Ellis to order the testing even though he was not licensed in some states where the patients resided.
US v Hasan
Settlement
Dr. Nosheen Hasan and his Center for Pain Management agreed to pay at least $1.35 million to settle allegations that they received kickbacks from Midwest Laboratory in exchange for ordering drug urine tests performed by Midwest. Midwest had previously settled with the feds.
US v Apotex Corp.
settlement
The generic drug company agreed to pay $24.1 million to settle allegations that they fixed prices on pravastatin.
US v CVS Health
Settlement
The pharmacy's Omnicare unit that does nursing home pharmacy allowed opiods to be dispensed without valid prescriptions. This will cost them $15.3 million. Top
Morgan v Azar
SD WV
Dr. Breton Morgan was accused by CMS of problems and he lost his Medicare billing privileges and sued. The court said the feds action was arbitrary and capricious. Morgan then filed for costs and attorney fees. The court awarded $60,792 in attorney fees. Top
Hlaky v Steward Health
Massachusetts Supreme Judicial Court
The court ruled that Steward must pay Dr. Lynn Hlaty $10.2 million. She has sued and won in the lower courts alleging breach of contract causing destruction of her cancer research lab. Good on her.
Doe v Lurie Children's Hospital
Filed
A mother was notified by the hospital that a nursing assistant had accessed her daughters medical record without a work related reason. The mother hired an attorney to make sure her daughter's records were protected in the future. The hospital, according to the suit, did not take it seriously but later reported to the HHS the records of over 4000 children were accessed illegally in 12 months. The attorney is now attempting to make this a class action case. He may need the money.
Patients v Nebraska Medical Center
To Be Filed
The hospital had an individual who accessed over 1300 patient records illegally. They said that the individual was fired and they will now begin to regularly audit its EHR system and re-train their staff. Horse is out of the barn. Top
West Virginia v J&J
Settlement
The company has agreed to pay the state $3.9 million to settle allegations that they misrepresented the risks of their pelvic mesh. This also resolves allegations regarding their metal or metal hip prosthesis.
Ungurian v Beyzman
Pennsylvania Supreme Court
In this med mal case the plaintiff wanted the hospital Wilkes-Barre General Hospital to provide five documents; an event report completed on the day of the incident, summary of the Serious Safety meeting, minutes of the Patient Safety Committee, a root cause analysis report and a QA report by an outside agency. The hospital refused but the trial court ordered then to produce the docs. The high court agreed. Part was due to the hospital's screwing up how the reports were generated, The event report was akin to an incident report and not shielded. The root cause was not protected since the dumb hospital attorneys failed to identify the members of the committee that produced the report as professional healthcare providers. The outside peer review person had his license lapse and was therefore not a professional healthcare provider. Hospital needs new attorneys.
Young v Frist Cardiology
Tennessee Supreme Court
In this med mal case a person died after having a stroke following a cardiac cryoablation. The plaintiff named an expert witness to testify for them. The expert was not licensed to practice in Tennessee but was licensed in other states. The Tennessee Board had given the expert an exemption to practice without a license while a fellow at Vanderbilt. The high court would not allow his testimony as the statute states that an expert meets the license and practice requirements.
Vazquez-Colon v Cribe Physicians
PlazaCorp.
D PR
How dumb can a hospital be? The patient arrived by ambulance and the EM as well as the triage nurse made notes that he had intense chest pain. No EKG as required by hospital protocol. Patient died. Estate sued under EMTALA and is allowed to go forward on this claim. Top
Jurenovich v Trunbull Memorial
Hospital
Ohio Ct App
Dr. Michael Jurenovich, an orthopod had privileges at the hospital. In 2014 he was sued for Medicare fraud. This was settled and dismissed. He did not tell the hospital about the settlement but they found out and terminated his privileges without a hearing. He sued and the trial court agreed with the hospital. He appealed. The higher court agreed with the lower court as Article 8 said he was entitled to a hearing under the general bylaws but article 3.3(k) sets forth a different procedure for failing to provide notice of a settlement. That controls. 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.