September 1, 2020 Recent Legal News
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US v Sakkai
Sentenced
Dr. Saad Sakkai of Hamilton, Ohio was sentenced to 20 years in prison for his part in the illegal distribution of narcotics. He had been warned by others about his practice but kept doing it.
US v Korzelius
Dr. John Korzelius of Amarillo, California, was indicted along with 9 others of running a fraudulent pain clinic.
Georgia v Banks
Arrested
Heather Banks of Lithia Springs, Georgia, was arrested for posing as a Registered Nurse. She used false identification to get a job at Omni Healthcare Services. Top
US v Luthra
1st Circuit
The court affirmed the conviction of Dr. Rita Luthra of Springfield, Massachusetts for wrongful disclosure of PMI. She got money from Werner Chilcott and was hired by them as a speaker. She gave PMI to a Chilcott rep in order to get paid for prescribing the med Atelvia.
US v Metropolitan Jewish Health
System
Settlement
The Hospice agreed to pay $4.85 million to settle allegations that they billed for increased levels of care that were not justified.
US v Kim
Sentenced
Yun Kim, DDS of Benton, Illinois, was sentenced to one year and one day in prison for health fraud. He submitted bills for cavity fillings and tooth extractions to Medicaid that were not done.
US v Teva
Filed
The feds have filed a false claim complaint against the company alleging they illegally paid the co-pays for people who took their MS drug via sham foundations. They followed this with a separate suit alleging that Teva colluded with others to drive up the prices of meds.
US v Gerner
Sentenced
Jason Gerner of Shamung, New Jersey, was sentenced to 36 months in jail for being a founder of Liberation Way, a rehab facility with several branches. The company purchased sham insurance policies for patients so they could bill for treatments never provided. He is also ordered to pay restitution of over $9 million and forfeit almost $55,000.
Arizona v Ashcroft
Sentenced
Sharon Ashcroft of Mesa was sentenced to six years in prison for stealing insurance checks paid to physicians she worked for in the Tempe area. She is to repay over $600,000 to the physicians. Lotsa luck with that one.
US v Matthews
Guilty
Donald Matthews, the former VP of Market Development for Proove Bioscience, plead guilty to paying kickbacks to physicians to order the company's DNA tests. The company then billed Medicare for the illegal tests.
US v James
Settlement
Ean James, DMD of Bristol, Connecticut, paid $148.000 to settle allegations that he billed for anesthesia services even though he was not licensed to perform those services.
US v Shafa
Indicted
Dr. Rahim Shafa and his wife office manager were indicted for money laundering and importing illegal drugs. The Lexington, Massachusetts, couple purchased drugs from Hong Kong that were not FDA approved to treat addiction.
US v Drug Firms
The feds are trying to get over $24 Billion from three drug distributors along with J&J to settle opioid litigation. The companies are McKesson, Amerisourcebergen and Cardinal Health.
US v U. of Cincinnati
Settlement
The university will pay $3.1 million to settle allegations that they billed illegally for transcatheter aortic valve replacements. this is a whistleblower case and Dr. Donald Lynch will get $800,000 of that money.
US v Phoenixville Hospital
Settlement
The hospital has agreed to pay $100,000 to settle allegations that they violated the False Claims Act by altering claim forms to get money for patients from Medicaid who were not eligible. Their billing company Firstsource paid $225,000.
US v Nasir
Settlement
Dr. Syed Nasir, a pain management physician in Houston paid $530,000 to settle allegation that he billed for the implantation of neurostimulator electrodes when in fact he did electro acupuncture.
California v Germany
Arraigned
Alan Germany, the former CFO of HCCA or Tulare County, California, was arraigned for embezzlement and plead not-guilty. He and Yorai Benzeevi are accused of taking over $750,000 from the hospital by using funds from the federal program to alleviate the bond burden on taxpayers to their own devices.
US v Tackett
Guilty
Denver Tackett, DMD of McDowell, Kentucky, plead guilty of health fraud for submitting false claims for procedures done. These procedures were not medially reasonable nor necessary. He also surrendered his DEA license as he was indicted for that problem as well.
US v DUSA Pharmaceutacals
Settlement
The company agreed to pay $20.75 million to settle allegations that they caused physicians to file false claims. They encouraged physicians to take shortcuts with its products.
US v Heller
Settlement
Dr. Jennifer Heller, DC of Brunswick, Georgia, agreed to pay $5 million to settle allegations that she and her practice Heller Family Medicine, LLC for filing for implanting neurostimulators instead of using acupuncture as the correct code.
US v Woodlee
Indicted
Vinson Woodlee, a the owner of Med Left LLC, a pharmacy and lab service company, was indicted for receiving and paying kickbacks. He is alleged to have received over $60 million in kickbacks from physicians and paid them $16.8 million.
US v Bhambhani
Settlement
Dr. Ghganshyam Bhambhani, a Queens cardiologist, agreed to pay $2 million to settle allegations that he paid kickbacks to other physicians for referrals.. He had previously given up his medical license after being convicted of kickbacks and was sentenced to 34 months in prison.
Lambda v US
Federal Judge
A federal judge ruled correctly that because of an earlier Supreme Court decision the administration's rules to reverse ACA reg that stated discrimination based on sex should apply to sex.
Arizona Chamber of Commerce v
Arizona
Maricopa County Judge
the judge tossed a ballot measure backed by the SIEU that would have blocked insurers from discriminating based on pre-existing conditions. The measure was misleading and had hundreds of thousand of faulty signatures to get it on the November ballot. Top
Patients v Advocate Aurora Health
To Be Filed
The healthcare's billing agent erroneously sent bill to patients with the wrong information. The information was of other patient PMI. This affected almost 2000 people.
Patients v Utah Pathology Services
To Be Filed
The medical service was hacked and over 112,000 people had their information compromised. Top
SEIU v Community Hospital
Filed
The union sued the Riverside, California, hospital and its owner HCA for facilitating the spread of Covid. They say this is a public nuisance. I wonder if the union is trying to get more people to join or more money as the suit itself is a joke.
Southeastern Emergency Physicians
v Centene Corp.
DCEArk
The jury ruled Centene underpaid the physicians for their ER care. They are liable for $9.4 million.
Prisma Health v South Carolina Ob-GYN
Response
After Prisma filed against the physicians for leaving their nest the physicians responded in unkind words regarding the hospital. The say they left due to unsafe and abysmal conditions that put the group's patients in danger. They accuse the hospital of shabby maintenance of facilities and tools along with a shortage of qualified physicians and staff. The hospital want over $300,000 for lease payments but it will cost them a bunch more than that to press the case along with the terrible publicity it will engender. The hospital should lose a lot of patients over this. Top
A. H. v Willis-Kinghton Medical
Center
Filed
The four year old came to the ED for wheezing and was seen by the ED physician.
According to the mother the child was still wheezing on discharge and was not
seen by the physician again. She was found unresponsive shortly after and
died. she sued under EMTALA. The court ruled that the hospital must
answer the EMTALA charges as it is a question of fact as to the child was
stabilized at the time of discharge.
Patients v Bayer
Settlement
Bayer will pay about $1.6 billion to settle most US claims regarding its birth control device Essure. Top
Nurse v River City Care Center
Filed
An anonymous nurse has filed suit against the San Antonio nursing home after she was fired. According to the suit she cooperated in an investigation against the nursing home after several people died following the air conditioning failing in an over 100 degree day. A second nurse confirmed the account and she had resigned. The temperature inside the home was 83 degrees and according to the suit people were dehydrated and stripped to their underwear. The home has said they have made upgrades but have not addressed the firing.
Kinnie v Kindred Hospital
Filed
An ICU nurse has filed suit after she was fired for, according to the suit, reporting the facility to the Joint commission. The suit contends that he was suspended twice before being terminated after he reported the facility for poor patient safety. While the ICU was being repainted patients were moved to other rooms without ICU equipment. When Kinnie attempted to move equipment from the ICU to the rooms he was reprimanded. 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.