October 1, 2019 Recent Legal News
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US v Rogers
Sentenced
Samantha Rogers, an Occupational Therapist in the Mason City, Iowa, area stole the information of about 1900 patients and used that information to steal from their homes. She was sentenced to 14 months in prison and some minor fines.
US v Padnes
Indicted
Dr. Stephen Padnes of Glenside, PA, was indicted for improperly prescribing opioids and filing false tax returns. The feds are seeking jail time and repayment of about $1.9 million in an associated civil action.
US v Schwartz
Arrested
Dr. Daniel Schwartz was arrested on federal drug charges after is to have said he wanted to kill and torture an attorney who had litigated and won a $60,000 case against him. He is alleged to have approached a meth addict regarding killing the attorney with fentanyl.
Illinois v Jones
Sentenced
Tina Jones, a nurse at Loyola Medical Center plead guilty of attempted murder and was sentenced to 12 years in jail. She wanted to kill her lover's wife and blame her lover. she hired a hitman for the purpose paying $12,000 in bitcoin.
US v Many
Filed
The feds have filed charges against 41 people for their involvement in pill mills. these included pharmacies and physicians. This was primarily in the southern Texas area.
Ohio v Morris
Indicted
Martez Morris of Hamilton County, Ohio, was indicted for posing as a nurse for four years. He worked at several home health agencies.
US v Neilson
Guilty
Elet Neilson, a RN in the ER at Ogden, Utah, McKay-Dee Hospital, admitted to diverting pain killers for personal use and then using the same syringe injecting patients. At least seven people got hepatitis C from her. Top
US v Montgomery
Sentenced
Brenda Montgomery of Camden, Tennessee, was sentenced to 42 months in prison and ordered to forfeit almost $600,000. She admitted to paid the former CEO of Comprehensive Pain Specialists illegal kickbacks for ordering DME equipment from her.
US v Stockett
Guilty
Lester Stockett, the owner of Video Doctor Network pleaded guilty of healthcare fraud. He was part of a scam that called people to have them sign up for low cost DME.
US v Castrillon
Settlement
Dr. Augusto Castrillon of Mission, Texas, agreed to pay $2,133,959.30 to resolve allegations of submitting claims for medically unnecessary transcranial doppler, emg and autonomic function testing.
US v Esformes
Sentenced
Philip Esformes was sentenced to 20 years in prison for paying bribes and receiving kickbacks. He had a chain of assisted-living and nursing homes in the Miami area that made him super rich. He intends to appeal his trial verdict.
US v DeCorso
Guilty
Dr. Joseph DeCorso of Toms River, New Jersey, plead guilty to a $13 million conspiracy to defraud Medicare on orders of orthotic braces. He admitted he worked for two telemedicine companies and wrote unnecessary orders for the orthotic braces.
US v Kim
Indicted
Yun Sup Kim DDS. of Southern Illinois was indicted for billing Medicaid for fillings and extractions never performed.
US v Mallinckrodt
Settlement
The company agreed to pay $15 million to settle allegations that while known as Questor Pharmaceuticals it paid kickbacks to physicians in the form of dinners and entertainment to induce them to write prescriptions for Acthar.
US v Radinovskly
Guilty
Igor Radinovskly and his son Aleksandr, owners of the Save Ambulette Services in Brooklyn plead guilty to paying kickbacks and billing falsely to Medicaid for services of drivers not enrolled in the system.
US v Womack
Settlement
Dr. James Womack of Clinton, Missouri, agreed to pay $471,000 to settle allegations that he accepted kickbacks for prescribing pain creams not indicated.
US v Shetty
Indicted
Dr. Naglesh Shetty of Huntington Beach, California, was indicted along with six others for being involved with medically unnecessary cardiac treatments and tensting. Also indicted were Drs. Ronald Weaver of Pacific palisades, John Weaver of Alhambra, Ronald Carlish of Pacific Palisades, Howard Elkin of Whittier and Dr. Wolfgang Scheele of Los Angeles.
US v 34
Indicted
In addition to the ones named above the feds also indicted Dr. Keyvan Amirkhorkeh of Seal Beach and oterhs for fraudulent claims for family planning services and testing, Dr. Amir Friedman of Calabasas for prescribing unnecessary pain creams, Susan Poon DC of Dana Point for filing false claims for visits that never occurred, Mahyar Yadidi DC for offering kickbacks to patients for services not performed along with Ivan Semerdjiev DC, Darren Hines DC for billing for services by unlicensed employees.
US v Oceanside Medical Group
Filed
The OIG says that the medical group had billed for services not provided or time was not documented. This led to an overpayment of $5317 for two years and the feds then extrapolated to say that the group owes $2.6 million. The group is deputing the overpayment but the OIG has maintained its findings. The group may appeal.
US v Frey
Settlement
Dr. Richard Frey DO of Pennsylvania will pay $178,000 to resolve allegations of improper billing for "P-Stim " devices. He did this in office settings not in the approved OR and not while the patient was under surgery or anesthesia.
US v Wheeling Hospital
ND W. Virginia
The court allowed the suit against the hospital, its CEO and its management company by a whistleblower and the feds to continue. The complaint alleges the hospital illegally contracted with physicians.
US v Vaughan Regional Medical
Center
Settlement
A whistleblower suit has cost the Alabama hospital, Integrity Emergency Care Inc and several physicians a $1.45 million for violating the False Claim Act. This came from the use of unlicensed residents in the ED of the hosotal and billing for their services. The regular ED physicians were paid $50 per hour to cosign charts.
US v Avanir Pharmaceuticals
The company agreed to pay $116 million to settle allegations that they were paying kickbacks to physicians and illegally marketing Nudexta. The company was paying speaking fees to physicians who were big users of the meds. One of the physicians, Dr. Deepak Raheja of Ohio, received about $300,000 in fees. He is now indicted for fraud in diagnosing patients with PBA to get Medicare funding for the medicine.
US v University Health Hospital
Settlement
The Louisiana hospital and its owners and managers have agreed to pay over $500,000 to settle allegations that they violated the False Claims Act by billing for implantable automatic defibrillators and not reporting to a qualified registry.
US v Cervantes
Indicted
Three North Texans were indicted on health fraud. They are Demitrius Cervantes of McKinney, Amanda Lowry of Sherman and Lydia Henslee of Denison. The are charged with hacking a physician's EMR to steal PMI and repackage the information to sell to DME providers.
US v Braccia
Sentenced
Dr. Dominick Braccia of Hatfield, Pennsylvania, was sentenced to 37 months in prison and ordered to pay $2,484,864 in restitution. He also got a $15,000 fine and 150 hours of community service. He was the physician in charge of Liberation Way, outpatient rehab facilities. he wrote blank prescriptions for patients.
US v EZ Pharmacy
Settlement
The pharmacy and its owner Shardabren Patel agreed to pay $1.1 million to resolve allegations that they violated the false claims act by billing for meds not dispensed. They are also banned from fed med for 10 years.
US v Trident USA Health Services
Settlement
The company agreed to pay $8.5 million to settle allegations that they provided x-ray services to nursing homes for inducing them to refer patients to them. This settlement happened post bankruptcy filing.
Horizon blue Cross of new Jersey v
New Jersey Doctor Patient Alliance
Filed
The insurer filed suit over a "smear campaign" regarding its plan to increase oversight for some care. They want the group to take down their ads and compensation for loss of money. This suit will never see the light of day because neither side wants the truth to be known.
Many v Purdue Pharma
Settlement Talks
The company has agreed to settle allegations regarding their oxycontin role with many but not all the litigants and claim bankruptcy. The Sackler family would also give up its ownership of the company and sell another company Mundipharma.
Wolfe v VA
US Ct. App for Veterans Claims
In a far reaching verdict the court ruled the VA must pay emergency medical expenses for vets if not covered by private insurance. This could be billions of dollars. This was a class action suit.
AHA v CMS
Federal Judge
A judge said that CMS had overstepped its legal authority by expanding a site neutral policy which is logical and right. This may mean the HHS may have to go back to Congress to get its rightful ruling and meantime waste millions or billions of dollars paying hospitals for nothing.
Red River Women's Clinic v North
Dakota
CD ND
This suit, also backed by the AMA, was against a state law that would require physicians to tell women they could reverse medication abortions if they have second thoughts and that time was of the essence,. This is an unproven statement and the court blocked its implementation. Top
Patients v HealthPort Tech and
Aurora Helathcare
Settlement
This is a $35.4 million dollar settlement for those forced to pay a fee by Ciox, IOD, HealthPort. aurora or Columbia St. Mary's to receive medical records will be paid. The company put on a $22.58 fee for medical records in violation of Wisconsin law.
Patients v Conally Memorial
Medical Center
To Be Filed
The Texas center notified over 7000 patients that a laptop was stolen that contained their records. The laptop wa passowrd protected but not encrypted. Bad protocol.
Patients v Providence Health Plan
To Be Filed
The Oregon plan notified 122,000 people of a data breach. This may go back to 2010 at the administrator Dominion National. Terrible work by Dominion.
Patients v Premier Family Medical
To Be Filed
Another 320,000 people had their data compromised by a group that had a breach and ransomware attack.
Patients v Community Psychiatric Clinic
To Be Filed
The Seattle based clinic had three email security breaches affecting over 15,000 patients. Cheap security relates to poor security.
Patients v Caremark
Settlement
Caremark will pay $4.4 million to settle their improperly disclosing HIV status of 4500 people. They used the clear windowss that disclosed the status.
Patients v Magellan Health
To Be Filed
This group compromised over 56,000 people due to their inadequate security that allowed phishing attacks.
Patients v Warman
To Be Filed
The medical records of hundreds of patients of the offices of Drs. Jonathan Warman and Alexander Chun gastroenterologists in the upper East side of New York City were found in the trash. There were not only the usual names and social security numbers but also pictures from their procedures. The physicians had moved to new offices and the records were to be shredded and were thrown out by cleaning people inadvertently.
Patients v Prisma Health
To Be Filed
How dumb can a doctor be? This one kept notes of patients in the ED and OB/Gyn at Prisma Health Richland Hospital in Columbia, SC. Of course the notebook was stolen. Top
US v Hahnemann
Filed
A US Bankruptcy judge has approved the sale of the Hahnemann University medical residency program to Thomas Jefferson for $55 million. Following this the DOJ filed an appeal to the ruling. After the appeal was filed a federal judge halted the sale of the programs.
Henly v Merit Health
The patient went to the ER in Biloxi, Mississippi, and was charged $17,752. She got a self pay discount and the new bill was $6213 which included a facility fee of $771. The fee was listed on the bill as ER DEPT EXTENSIV. She found some attorneys who are looking to make this a class action for deception although other hospitals in the area also charge facility fees. Top
TC v LifeSouth Community Blood
Centers
MD Ala
The Bank moved for dismissal but the court rebuffed it. TC alleges that at a blood drive at his high school they allowed him to donate even if he was underage and with no consent along with some claims regarding making him miss lunch. This caused him to faint three hours later and sustaining permanent injuries.
Foo v Azar
D Hawaii
CMS refused Dr. Wendell Foo, a physician enrolled in Medicare for 25 years, to continue to be enrolled for two years because he stupidly entered a wrong address on the form and attested to it. He lost.
Ramalingam v Robert Packer
Hospital
MD Penn
The FMG physician needed a general surgery residency to become board certified in the US. He was accepted at the hospital and Packer wanted him to graduate his residency early. They forgot to contact the ACGME for permission but did get permission from the ABS. He did not graduate early and sued since he missed out on a fellowship. The court said that he had no breach of contract claim nor any claim for tortious interference but could go forward on promissory estoppel but at the same time must hear HCQIA defenses.
Alaama v Presbyterian Intercom
Hosp
Ca Ct App
The physician Abdulmouti Alaama worked at Presbyterian and was placed on probation for one year for unprofessional behavior. He signed a contract to comply with the rules etc. He was then terminated after he broke more rules. The hospital did not give him a fair hearing. He sued and won the right to a fair hearing as his behavior impacted patient safety. Very bad hospital lawyering.
Blaine v North Broward County Hosp
Dist
MD Fla
In this case seven oncologists employed by Health First were members of the medical staff of multiple hospitals including North Broward. North Broward was attempting to get its Cancer program certified and needed information which was controlled by Health First. Health First did not give the information and the seven oncologists were terminated. They sued and won as they were not given a hearing. They had their hearing and lost and then were terminated again resulting in this suit. They lost here as well as they have had their admin hearing and the hospital is immune absent fraud. No fraud no case. The seven now have a stain on their record because of Health First, their employer and no fault of their own.
Sorling v Dignity Health
Settlement
The hospital agreed to pay the food service tech $570,000 to settle disability discrimination which they should have never gotten to. Very poor hospital attorney work. Dignity did not live up to its name.
Mitchell v Sanford Clinic
Filed
Dr. Jolene Mitchell was the medical director of the clinic in South Dakota. The clinic sees many people with drug offenses and Mitchell wanted more security especially after a woman was run over by a car. Since Mitchell was pregnant the Sanford powers seemed to want her out and she resigned after the birth of her child. She is now suing the Sioux falls clinic for sexual discrimination.
Trinity Health v Anesthesia
Associates of Ann Arbor
Settlement
Finally sanity rules. The two knuckleheads decided to allow the anesthesiologists to treat patients at the Trinity hospitals and release some of the anesthesiologists from their onerous non compete clauses.
Toranto v Jaffurs
SD Cal
Dr. Jason Toranto is a pediatric plastic surgeon who worked at Children's Hospital of Orange County. He alleges that his former colleague , Dr. Jaffurs made false claims about him leading to his peer review and inability to be hired by hospitals. The court said that there are triable issues that should be deciced by a jury. The hospital tried to throw their surgeon Jaffurs under a bus but the court said there was enough to allow the hospital as a defendant. The court also said that Toranto provided many instances to show his peer review was only a sham. It is also up to the jury whether HCQIA immunity to decide.
Nahas v Shore Medical Center
D NJ
This may finally be the end of this very long case. Dr. Nahas sued the hospital and the physicians for antitrust and discrimination as well as state law claims. He plead guilty of criminal charges related to his billing and then had his hospital membership suspended for three years. When he re-applied he was denied privileges. After he sued in state court he got most privileges back except endovascular. His general and vascular privileges were then suspended for 14 days due to him doing unauthorized endovascular surgery. The court backed the hospital as it had HCQIA immunity in regard to the 14 day suspension. He also did not show any antitrust claim and lost is discrimination claim since the hospital had a non-discriminatory reason to suspending him. This case should never have even been filed. What a waste of money and time. 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.