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Tayoun v Seven MCOs
Penn. Muni Court
Dr. Tayoun, a vascular surgeon, has filed suit separately against seven different managed care organization for non-payment of claims. This is unusual since he risks being tossed off the panels. Dr. Tayoun, however is a high profile physician who is leading the charge in the Philadelphia area in the malpractice crisis.
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Zuckerman v Board of Chiropractic
Ca. Supreme Ct.
The supreme court dispelled the notion that those disciplined by the different medical boards could not recoup their expenses for "the reasonable costs of investigation and prosecution of the case" from the disciplined licensee. This was distinguished from a prior case of California Teachers v CTA. The latter case stated that teachers had to pay the hearing costs where this case was only about pre-hearing costs. The high court ruled that the chiropractor may challenge the reasonableness of the money attempted to be recovered. The ALJ before which the case is heard can also find the costs reasonable or not. The court also stated that the Board did not have to reimburse a successful claimant for their costs since that would decrease the amount of money in the kitty to prosecute other cases. A strange reasoning and decision. Top
Anti
Union by HCA at Norton Audubon Hospital in Louisville KY
NLRB
The NLRB has ordered HCA, the prior owner of Norton to pay four nurses money for either demoting or causing them to lose their jobs due to their union activities. One nurse, a lactation specialist, was not allowed to apply for a job at a sister facility when the units were consolidated. She got money for the difference between what she made at a new job and what she would have made if allowed to stay on plus interest and make-up 401 (k) contributions. The three other nurses were demoted and the NLRB stated that they should be offered charge-nurse jobs. The hospital complied but stated the jobs were supervisory, costing the three their union rights. The NLRB also took Norton to task for other illegal anti-union activities their managers did.
In Bradenton, Florida at Blake Medical Center three nurses won $275,000 for retaliation after complaining about lax patient care. One of the nurses was fired from the HCA hospital and the other two later resigned after supervisor harassment. The hospital spokesperson stated that this was about disgruntled employees and not patient care, which started the complaints in the first place. Top
US v Physicians and Others
USDC NY
The US Attorney has accused six doctors and 12 others of illegal conspiracy to defraud using faked accidents and bogus medical claims. In the past five years the conspirators were accused of obtaining bogus payments of over $3 million. Each face up to five years in prison. Top
Greenway v Fusia, MD
Case not yet filed
In a case not yet filed a patient Greenway died after robot assisted kidney removal. The cause of death was a laceration in the aorta. The company that makes the robot has denied that the robot had anything to do with the inadvertent laceration. They state that the physician went from the robot to straight laproscopic surgery at the time of the laceration. The family has asked for a copy of the operative tape.
McCall v PacifiCare, et. al.
CA Superior Ct.
In a case coming to trial this week the estate of McCall is suing PacifiCare and Dr. Lakshmi Shukla of Greater Newport Physicians Inc. The issue is whether there should have been an earlier decision to have a lung transplant which would have saved his life. The case is interesting since it comes after the California Supreme Court ruled that HMOs can be sued in state court for not providing expensive treatments that Medicare will not pay for. Prior to this, only administrative hearings were allowed.
On the eve of trial, and after the California Supreme Court's
ruling the parties settled. This saves face and precedent for the
HMO. However, after the high court ruling, there will be more of these
suits until one doesn't settle. The
plaintiffs would have asked for an injunction to require PacifiCare (and
therefore other HMOs) to disclose to patients how treatment options affect their
doctors' profits. Gustamas
v Bethesda Memorial Hospital The confidential settlement was reached
at the Palm Beach, Florida hospital after a cleaning woman accidentally
mistook a bundled body of a dead baby in the morgue for medical waste and it
was incinerated.
Rosenberg v Aetna A Los Angeles Jury found Aetna guilty in a suit the
accused the company of illegally withholding benefits and causing the death
of a patient. However, the jury would not award punitive damages
because they found the insurer did not act with malice, fraud or oppression.
The sides settled the underlying amounts for compensatory damages prior to
the jury awarding $426,000. This case is one of a Medicare HMO patient
and the mismanaging of the coordination of care between providers. A
nursing home involved had previously settled for $250,000. NYC Health v Morgenthau The state's high court ruled
that patient confidentiality holds when law enforcement agencies attempt to
get medical records to identify criminals. The case involved a man who
may have been bleeding stabbed another man to death two years ago. The
DA attempted to subpoena 23 New York hospitals to get their medical records
from that time. The over broad subpoena was for medical records of any
and all records of people who fit a generic description of Caucasian and in
his 30s or 40s. Top
Oregon v Ashcroft The
California Medical Association has filed an amicus brief in the above
case. Oregon has a legal assisted suicide statute and the Feds have stated
they will go after the physicians who participate in the process. The
Federal Court has already issued an injunction against the Feds from following
though on that threat. The Appeals court is will be reviewing that
injunction. All organized physician groups have backed the state and the
Church is against the state. 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.
Settlement
CA Superior Ct.
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NY Ct. App.