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Twelve-Year Sentence for Medicaid Diaper Scam

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas...more

Iowa Supreme Court Recognizes Wrongful Birth Action

On June 2 the Iowa Supreme Court expressly recognized the right of parents to sue for wrongful birth. Pam and Jeremy Plowman allege the following: Pam underwent ultrasound in week 22 of her pregnancy. The radiologist’s...more

Last Rites for ER Doctor’s EMTALA Claims

ER physician Ryan Kime believed his hospital lacked the resources, procedures, and capacity to meet the requirements of EMTALA, and he repeatedly said so. At an ER meeting he reported two cases as possible EMTALA violations...more

Co-Winners of May’s Low-Return Fraud Award

We have a tie! Danielle Burroughs and Tim Arthur are co-winners of the Low-Return Fraud Award for the month of May. On May 30 a federal court ordered Danielle to pay a whopping $2.8 million in restitution for her role in a...more

Sometimes It’s Not What You Say But How You Say It

A recent First Circuit opinion demonstrates that sometimes how you say something is more important that what you say. In fact, that principle led the court to reverse the NLRB’s order that a Massachusetts hospital must...more

$4 Million Liability for Bad Legal Advice to a Chiropractor

Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state...more

Who Says Ignorance of the Law Is No Excuse?

If you think that ignorance of the law is no excuse, take a look at the Eleventh Circuit’s opinion in US ex rel. Phalp v. Lincare Holdings. It leaves no doubt that in a False Claims Act case, ignorance can be a solid defense....more

Defendant Seeks Attorney Fees from Whistleblower’s Attorneys

When a qui tam case is dismissed, it’s not unusual for the defendant to seek an order requiring the whistleblower to reimburse its attorneys’ fees. What is unusual is for the defendant to seek an order requiring the...more

Why the Tail Policy Didn’t Cover the Doctor’s Tail

Dr. Steven Svabek may have set a record for the number of reasons why his tail policy didn’t cover the medical malpractice claims against him. According to a memorandum decision issued last week by the Indiana Court of...more

Third Circuit’s Gift to Qui Tam Defendants

It’s so brief—just eleven words in a 23-page, single-spaced opinion—that you could easily overlook it, but the Third Circuit’s recent opinion cites the government’s nonintervention in a qui tam case as evidence supporting...more

CMS Gamed System to Identify Hospitals Gaming System?

You can’t make this stuff up. When CMS conducted a study to identify hospitals that game the quality data reporting system, it used an approach that made the data reporting look better than it actually was. That bottom line...more

5/8/2017  /  CMS , HHS , Hospitals , OIG

Judge Has No Interest in DOJ’s Statement of Interest

In yet another demonstration of the benefits of lifetime tenure, a federal judge in Florida has told the Department of Justice to take a hike. It happened when the DOJ asked for permission to submit a “statement of interest”...more

5/5/2017  /  DOJ , False Claims Act (FCA) , Relators

Do State Med Mal Caps Apply to EMTALA Cases?

State limitations on medical malpractice recoveries seem to be under almost daily attack. The latest serious threat comes from Louisiana, where a federal district court has authorized an interlocutory appeal of his ruling...more

Recovery of Medical Bills: Once Is Enough

Strange as it sounds, Missouri state law allowed federal workers to recover medical bills twice: once under their federal health insurance plan and again from the person (or person’s insurer) responsible for their injuries. ...more

The Downside of the Advice-of-Counsel Defense

Intent is a necessary element of a False Claims Act (FCA) violation. If a defendant reasonably relied on advice of counsel in performing the actions at issue, the intent element is absent. That’s the upside of the...more

Hospital Claim Dismissed for Want of Redressability

The recent decision in Dignity v. Burwell is interesting for three reasons. For one thing, it provides a reminder of the unfortunate fact that the acts (or inaction) of one party can adversely affect the fate of others—as...more

Two Times Twelve Doesn’t Necessarily Equal Twenty-Four

In the august halls of a federal courthouse, things aren’t always what they seem. Say, for example, court rules require that briefs must “be double-spaced and in 12-point font with 1-inch margins.” Knowing that a “point” is...more

Solid Victory for Ind. Med Mal Plaintiffs’ Bar

On April 7 the Indiana Supreme Court handed the plaintiffs’ bar a solid victory in the six-year battle that has raged since issuance of the 2011 Indiana Court of Appeals decision in K.D. v. Chambers. That decision was...more

Medicare Plans Sue Auto Insurers for Illegal Cost Shifting

When Medicare beneficiaries are taken to the ER after an auto accident, they’re likely to have their Medicare cards with them, but not their auto policies. This creates a problem for Medicare because Medicare is supposed to...more

Jurisdiction to Freeze Assets but Not to Thaw Them

A recent Fourth Circuit opinion in a False Claims Act case demonstrates that while the government can freeze defendants’ assets before trial with lightning speed, getting them unfrozen can take anywhere from many years to...more

Hail Mary Passes & Banana Peels

March 23 saw a rare spectacle in the courtroom of the Indiana Supreme Court: lawyers for a medical malpractice case plaintiff, supported by the Indiana Trial Lawyers as amicus, and lawyers for the physician defendant in the...more

Sometimes a Belt & Suspenders Aren’t Enough

Even the most cautious lawyer might think that Columbia North Hills Hospital had done enough to compel arbitration when a former employee sued for sexual harassment, retaliation, and negligence. The trial court thought so. ...more

Indiana Reaffirms Relaxed Rule for Med Mal Complaints

In Indiana a medical malpractice plaintiff doesn’t proceed directly to court. First, a proposed complaint goes to the Indiana Department of Insurance, and the case is heard by a Medical Review Panel consisting of physicians....more

A Contract Be too Good to Be True

If it sounds too good to be true, it probably is. A Florida Supreme Court decision provides a variation on the adage: if a contract looks too favorable to one side to be valid, it probably isn’t. Thirty-nine weeks...more

Government Wants to Settle, Whistleblowers Don’t

What happens when the government wants to settle a False Claims Act case, but the whistleblowers who filed the case don’t? That was the question before the U.S. District Court for the District of Colorado. Airport...more

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