Univ. California v California Clinical Trial LLC
The university has filed for a TRO to stop the company from enrolling students to fake clinical trials. This got the students insurance information (university health insurance) which allowed billing of the university insurance for un-needed things.
The feds arrested 21 physicians and other health care professionals in California in a scam where they wrote prescriptions for un-needed tests or creams and then the Kings billed insurances for many times their value.
US v Brooks
Dr. Norman Brooks of Encino has paid $2.7 million to resolve allegations he falsely diagnosed skin cancer and then did un-needed Mohs Surgery. This is a qui tam from a former employee who will get $482,652.
US v Young
Podiatrist Lawrence Young was arraigned for fraud. He is alleged to tell patients they neede weekly shots to prevent hammer toes.
US v Clark
Dr. Brent Clark and an office employee were arrested and charged with distribution of Oxy and fraud.
v International Tutoring Services
The tutoring company along with several Dallas hospices have agreed to pay the feds $12.21 million to settle allegation that htey paid kickbacks for referrals. This was a qui tam case.
US v Farha
Todd Farha, the former CEO of Wellcare and the former CFO Paul Behrens should have paid restitution of $6 million by the time you read this newsletter. They are both in prison at this time. Farha had appealed his conviction to the US Supreme court which declined to hear it.
US v Pacific Pulmonary services
The Novato, California, company agreed to pay $11.4 million to settle a qui tam suit that alleges the company did kickbacks and filed false claims. The whistle blower will get $1.84 million.
US v Crittenton Hospital
Crittenton Hospital had the dubious distinction of being the recipient of Dr. Farid Fata, the person who gave people cancer diagnosis so he could make money on unnecessary treatment. The hospital did the tests ordered by Fata which had no merit and billed for them. They get to pay $791,000 to th feds for this.
US v Kuhn, Jr.
Dr. Forrest Kuhn, Jr. of Louisville, Kentucky, agreed to pay $751,681 to settle allegations he committed fraud by billing for services never rendered.
US v Partners
Healthcare and Brigham Women's
They agreed to pay $10 million to resolve allegations that a researcher fraudulently obtained grant money. Maybe this is the reason they are laying off so many people.
Indiana University Health and Health Net
The entities agreed to pay $18 million to settle allegations of illegal kickbacks. It is said that IU gave a line of credit to Health Net to receive maternity patients. It was also alleged that midwives worked in high risk area and their services were billed as physicians. The whistleblower physician tried to change the system from within but was fired. She now gets a huge payout from her suit. They should have listened but hospitals do not do that. Top
West Virginia v US
The high court declined to hear an appeal from the state on whether or not the Obama administration's change of Ocare were legal. The lower court ruled that the state did not have an injury so could not sue. The administration had removed the enforcement of the mandatory benefits after insurers canceled plans.
v Dignity Health
Minton needed a hysterectomy as part of a transition from female to male. The physician scheduled the surgery at Dignity Health, a Catholic organization, They cancelled the surgery the day prior. The hysterectomy was done at another local hospital but a suit was filed due to emotional stress by the ACLU. Minton is a state Capitol legislative aide.
The merger between Anthem and Cigna was again denied but this time by the court of appeal.
Healthcare v Bell
A nursing home may pursue an action for payment of a widow of a resident under the state "necessities" law. This law allows for spousal suit providing he could not pay and neither could his individual estate. The dissent was right in stating the patient had Medicare and they were paid by that entity. Top
v Virginia Mason
About 21 employees of the Yakima hospital accessed 419 patient records illegally. The hospital has purchased credit monitoring for the individuals. This was a hospital issues of not training employees well enough.
v St. Charles Health System
A caregiver illegally hacked 2500 patient records and was fired. The people got a year free credit monitoring. The hospital said they will NOW put security measures in place.
v Bangor Psychiatric Center
The Maine hospital was hacked and information on over 4000 people were compromised. The information may have re-sold on the net.
The vendor of cardiac monitoring products, agreed to pay a fine of $2.5 million for having a poor risk analysis in place when a laptop was stolen.
A laptop was stolen from an employee's car. the idiot did not password protect the information nor was the information encrypted. About 22,000 people are affected. Watch for a major fine.
v Center for Digestive Health
The idiots at the Center had no business associate agreement with a third party vendor. Mistake cost them $31,000 and a two year term of the feds looking into their practices. Top
v EMQ Families First
A jury awarded the boy $11 million, $4.55 in compensatory and the rest in punis, for being sexually assaulted while in a group home. The home did not look after the boys and was a cesspool to corruption. This was all chronicled in ProPublica.
Women v NHS
About 800 women have file suit against the government for problems with vaginal mesh implants.
Add a seventh case to sue the hospital after they got a deadly mold infection while waiting for or after a transplant. In this case it was pre-bone marrow transplant and like the others she died. The hospital claims she had a pre-existing mold infection prior to coming to the hospital.
Cadenas-Garcia v HIMA
In yet another EMTALA case from Puerto Rico the plaintiff loses. In this case the relatives of a person who died with acute pancreatitis sued for not making the diagnosis soon enough. Small problem, under EMTALA only hospitals or people harmed may sue. The relatives had no standing.
The Dallas eye surgery center had dozens of patients lose vision after cataract surgery. The reason was traced to a steroid injection from Guardian Pharmacy. Top
v Largo Medical Center
Dr. James Marshall, a surgeon at the hospital, had his privileges revoked and he sued for fraudulent peer review. The hospital attempted to have the case removed to the federal court along with the pendent state claims since it involve the National Practitioners Data Bank. The court did not buy it as HIQIA may be used as a defense but the plaintiff never raised it so the case gets a remand back to the state court.
Tiefer v New York University
Dr. Lenore Tiefer, a clincal associate professor of psychiatry was removed from that position after she did not get a vaccination for flu. She was not involved in direct patient care. As all know the flu vaccination evidence is considered weak by the feds but hospitals continue to insist upon it. Top
There are 13 chiropractors in the state that have signed with Wellmark. they are suing the insurer for antitrust and have sued them in the past for some of the same things but in Arkansas along with many other providers. The lower court said this suit would have to wait until the Arkansas case was settled. The Iowa high Court said that was not necessary as it is in another jurisdiction and many issues did not overlap.
Practitioners v Alabama Board of Nursing
In what sounds like bureaucratic stupidity the plaintiffs sued after a national certifying agency stopped automatically sending proof of compliance to the state. The board suspended the licenses but did not notify the nurse practitioners. When they found the practitioners were still practicing they accused them of illegal practice. They all paid fines and plead guilty as required by the state. Those nurses found another nurse practitioner married to a judge did not get the same treatment and they filed suit. 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.