October 1, 2018 Recent Legal News
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California v Ouskouian
Arrested
Ariya Ouskouian was arrested for impersonating a physician. He did this at Children's Hospital of Orange County and the University of California, Irvine seven times.
California v Robicheaux
Arrested
Dr. Grant Robicheaux and his girlfriend Cerissa Riley were arrested and charged with rape by drugs, oral copulation by anesthesia and other crimes. About 12 women have come forward to date to be part of the case. Prosecutors have fond perhaps hundreds of videos of attacks on women by the two. Top
Massachusetts v Partners
Healthcare
Settlement
Partners and Massachusetts Eye and Ear Infirmary have agreed to pay $175,000 to settle allegations that they failed to disclose to patients billing information. They failed to disclose policies that led to unexpected charges. Partners will pay $150,000 and the Infirmary will pay the rest. They got away with it. The fine is very small compared to the harm done by billing for facility fees, not telling patients that some of their urgent care centers are not recognized as such by insurers and by requiring patients to pay co-pays for diagnostics provided during a preventative care appointment which patients usually do not pay.
US v Janick
Sentenced
Dr. John Janick of Port Charlotte, Florida, was sentenced to five months in prison and ordered to pay $118,831.62 in restitution to Medicare. He lied to an auditor. He said office space used by his wife was paid for by a third party. It wasn't and she got information to gain referrals for her third party employer.
US v Leach
Guilty
dr. Charles Leach of Arlington, Texas, plead guilty of conspiracy. He is one of 16 people charged with delivering hospice care which was not delivered or warranted. Some patients died in this scheme after he wrote blank prescriptions but this physician denied knowing anything about the over medication to justify higher billing.
US v Khanna
Guilty
Kristen Khanna, NP, signed blank prescriptions and had an office worker write out the meds given to drive-by opiod seekers. She then billed these drive-bys as office visits. She has agreed to pay Medicare $127,300 for her greed.
US v Young
Sentenced
Lawrence Young, DPM, was sentenced to over two years in prison for falsely claiming the application of a Unna Boot which was really an Ace dressing. He is to repay $330,000 in restitution.
US v Adams
Arrested
Dr. Charles Adams in Fort Oglethorpe, Georgia, has been accused of healthcare fraud. He allegedly injected chelation for lead poisoning in 4500 patients and falsified that it was medically necessary. The blood lead levels were lower than necessary for treatment.
US v Kanakeswaran
Guilty
Dr. Kanagasabai Kanakeswaran of LA was convicted by a jury for referring patients to a Home Health agency for cash kickbacks.
US v Ambulance Companies
Settlements
Three ambulance companies settled allegations that they filed claims to fed med that violated the anti-kickback rules. The companies included Paramedics Plus in Texas, Alameda County California, Pinellas EMSA Florida. Alameda paid $50,000 and Pinellas paid $71,000. Paramedics did not fare as well. They settled for $20.649 million plus an additional $300,000 for another company. The whistleblower in this last case will get almost $5 million.
US v Dermatology Healthcare
Settlement
The company and its owners Robert Norman DO and his wife will pay $4 million to settle allegations that they failed to supervise the administration of superficial radiation therapy and upcoded claims.
US v University of Michigan
Settlement
The University agreed to pay $4.3 million to settle allegations that they violated the Controlled Substance Act. Two medical people overdosed and this led to an investigation that showed "system-wide" violations .
US v Ganesh
Sentenced
Dr. Vilasini Ganesh, a family practice owner in Saratoga, California, was sentenced to over five years in prison for her submitting claims fraudulently to Medicare. Her husband Dr. Gregory Belcher was also convicted.
US v Roque
Indicted
Felina Roque of Sunnyvale, California, was the owner of Medics Choice Home Health. She and three physicians Drs. Abdelsalam Mogasbe of San Jose, Jaime Cortes of Vacaville and James Nickolopoulos of San Leandro were all indicted for breaking the anti kickback law.
US v Calloway Laboratories
Settlement
The lab agreed to pay $1,374,058 to settle allegations that they violated the law by providing free testing supplies to physicians for the use in urine drug screening and then billing for the tests.
US v Krishna
Guilty
Dr. Jayam Krishna Iyer of Clearwater plead guilty of faking face to face patient encounters and wring controlled substance prescriptions without an exam. She agreed to forfeit her Florida medical license, her DEA license and permanent exclusion from Medicare and Medicaid.
US v Ramirez
Guilty
Dr. John Ramirez and Ann Shephard and Yvette Nwoko were convicted by a jury of conspiring to sell false information to home health agencies to bill Medicare for services not performed. Ramirez owned Southwest Total Medical in Houston. They will be sentenced later.
US v East Alabama Medical Center
Settlement
The hospital and its subsidiary Aperian Laboratory Solutions agreed to kick in an additional $4,250,000 plus expenses and fees to settle allegations of violations of the Anti-Kickback rules and False Claims rules. The claim was by a whistleblower that Aperian paid illegal commissions to Summit Diagnostics to refer toxicology tests to Aperian.
US v VCU
Settlement
VCU agreed to pay almost $4 million to settle allegations that they over billed fed med for radiation oncology services. VCU discovered the error an self disclosed to the feds.
US v Health Management Associated
Settlement
The former hospital chain agree to pay over $260 million to settle allegations of billing for inpatient care that should have been outpatient services and for renting offices to physicians at less than FMV. Top
States v US
USDC Texas
The states sued the fed for being required to pay to help fund OCare. The court ruled in favor of the states. The states getting money back will be Texas, Indiana, Louisiana, Kansas, Wisconsin and Nebraska. This may still be appealed.
Broad Institute v UC Berkeley
US Court of Appeals
This patent fight may now be over. Broad Institute has won a decision to not allow UC to have exclusive rights to patent and use gene editing.
Oswald v Illinois
Illinois Supreme Court
The state high court ruled that non profit hospitals can use charity to offset their property tax bills. In an unanimous decision the court affirmed a state law that allowed the not for profits to pay less property tax.
UnitedHealth v California
Ca App Ct
The state appellate court ruled that California fines totally about $91 million are legal. The state accused the insurer of more than 900,000 violations of California law. This overturns a lower court judgment in favor of the insurer and UnitedHealth will appeal to the state Supreme Court.
Calvary Chapel Pearl Harbor v
Suzuki
USDC Hawaii
The court struck down a Hawaii statute mandating anti-abortion pregnancy enters inform women that they can obtain state-funded abortions elsewhere. The judge rightly cited the California law about the same issue that was ruled illegal by the US Supreme Court.
American Clinical Laboratory
Association v HHS
USDC DC
The association sued the feds after the feds reduced reimbursement to the outpatient labs because when considering price the fed did not count the more expensive hospital labs in the equation. The court ruled they had no jurisdiction in the matter and punted it to Congress. Top
King v CompPartners
California Supreme Court
King sued after suffering seizures. The seizures came after a physician under the workers compensation utilization review that a medication Klonopin ordered by his treating physician was not necessary and decertified it. He sued the physician and CompPartners for the seizures. The trial court ruled that the claim was preempted by the Workers Compensation Act (WCA). The appellate court affirmed but allowed a leave to amend against the physician. The Supreme Court said the trial court wins with no leave to amend as all came out of an injury and the physician is an extension of the employer. If the actions was so extreme and reckless that it stepped outside the boundaries of its role there may not be exclusivity. That did not apply here.
Flute v Indian Health Services
Filed
The plaintiff was treated at a podiatry clinic on Winnebago, Nebraska. He received a letter from the HHS stating that he and his wife were treated with a device that was not properly sanitized. They suggested the patients get tested for HIV and hepatitis. This is the basis for the suit, that they were exposed to infection, not that they actually got the infection.
Patients v West Chester Hospital
Settlements
The hospital has settled to date with about 350 patients of Dr. Atiq Durrani. This person was accused of doing unnecessary spine surgery and billing fed med illegally. He has fled to Pakistan and it is doubtful he will be extradited. A federal case against the physician is still pending.
Sanders v Children's Hospital of
Philadelphia
Filed
Twenty three infants were infected with viral infections after eye exams in the NICU. At least one died, the infant daughter of the plaintiff. Top
Feiner v Orlando Health
Filed
Dr. Jeffery Feiner, a plastic surgeon, has sued Orlando for $100,000,000 for retaliation. He alleges that there was a conspiracy between Orlando Health and Allergen where physicians ordered excessive and unnecessary products in return for compensation. These, he alleges, were then billed to patients and fed med. He states he refused to do this and was fired in retaliation and then Orlando began a smear campaign.
Women v Advocate Illinois Masonic
Medical Center
Jury Verdict
A jury awarded seven women former employees of the hospital $10 million for a physical attack on one by Dr. Stephen Laga and then reporting the attack. She was asked to drop the report by hospital administration. The next year six nurses were illegally recorded while going to the bathroom and changing clothes. The camera was placed by Dr. Robert Weiss. The employees were awarded $,175,000 in compensatory damages and an additional $7 million in punis.
Gayton v Brett
Filed
Sandi Gaytan, a patient of Dr. Peter Brett, an oncologist, accused him of having a relationship while she was a patient. She also names Sutter Medical Group in the complaint because they should have known about the relationship. The relationship was alleged to have lasted over ten years. She alleges that after they met outside any medical practice and became friends he prescribed Wellbutin to help her quit smoking but did not tell her of side effects. Later, the suit says, they became lovers. 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.