I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach. Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable. Maybe it should have been pronounced in-VAL-id, with the...more
Why would a hospital and one of its physicians demand that a case against them be branded a malpractice case? Why would they sue the trial court to force it to call the action a malpractice case? A recent Nevada case...more
Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government. Ironically, the hefty compensation comes as a...more
On July 7 the Fourth Circuit invoked Flying Pigs to vacate a lower federal court judgment in a Medicaid false claim case, even though neither the lower court nor any of the parties asked it to.
The case started in 2007,...more
On July 7 CMS issued a proposed rule reaffirming its position that the Stark Law prohibits “per-click” rent payments when the lessor is the one referring the patients to the lessee for the “click,” e.g., the test or...more
There was a time when liability—criminal or civil—for drug abuse or forged prescriptions usually lay only with the abuser or the forger and those who actively helped them. Those days are long gone.
First, we had PDMPs...more
Hospitals are in the business of saving lives. So they don’t usually face liability for trying to do just that. But a July 5 Georgia Supreme Court decision is a reminder that it’s up to the patient—not the hospital or...more
Dr. Steven Nathanson is the defendant in a medical malpractice case involving the death of a patient. On June 24 the court rejected his motion for summary judgment on his claim that punitive damages are barred by West...more
Remember the U.S. Supreme Court’s decision against the North Carolina Board of Dentistry last year? The court ruled that a state dentistry board composed mostly of practicing dentists may not have state-action immunity from...more
Health clinics may want to review their auditing obligations and practices in light of a June 23 ruling by the Eleventh Circuit.
Allstate decided to look into the billing practices of a group of Florida health clinics. ...more
Can it be a crime to provide free medical care? That’s the question presented by a post-conviction motion by the so-called King of Nursing Homes, Dr. V. Kuchipudi.
Dr. K was convicted on nine counts of violating the...more
A California federal court has rejected a hospital’s motion for summary judgment in a case brought by a former nurse who claims she was fired for being too old.
Seventy-year-old Lavon Ramsey had worked at Fairchild...more
Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit. How can that inside knowledge be a handicap in pressing his claim? A June...more
On June 20, 2016, The Kaiser Family Foundation issued the first ever broad-based study of Medicare Advantage hospital networks. The study — "Medicare Advantage Hospital Networks: How Much Do They Vary?"— analyzed 409 plans in...more
On June 10 the Third Circuit affirmed a lower court’s dismissal of a physician’s qui tam action against Pottstown Memorial Medical Center (PMMC) for violating the Anti-Kickback Statute (AKS) and False Claims Act (FCA). And...more
Michael Sorenson is an optometrist formerly employed by Outreach Diagnostic Clinic. After he quit, he filed a False Claims action against the eye clinic and the two doctors who owned it. He alleged that the clinic routinely...more
Dr. Alaa Elkharwily lost his job at Albert Lea Clinic, but he didn’t go quietly. He sued the clinic and eight related organizations and individuals alleging just about everything a terminated doctor can allege in Minnesota:...more
If there’s one thing that unites the hospital industry—even the fiercest competitors—it’s hatred of audits by recovery audit contractors, or RACs. Why? For one thing, because RACs operate on a contingency fee basis. They...more
The Balanced Budget Bill Act of 2015 has a site-neutral billing provision relating to off-campus hospital outpatient departments (HOPDs). Those are facilities away from the hospital campus but certified as part of the...more
Oscar Wilde observed, “No good deed goes unpunished.” Whistle-blower Michael Cascio discovered the truth of that saying when a federal court threw out his qui tam case against a national wound care provider that partners...more
What if a whistleblower discloses the protected health information (PHI) of privately insured patients in making the claim that his employer submitted false Medicare claims? And what if that violates a confidentiality...more
On May 2 a New Orleans federal jury found that Psalms 23 DME, LLC—its Biblical name notwithstanding–was part of a fraud scheme that illegally billed Medicare $3.2 million.
In 2013 the government indicted Psalms 23 owner...more
Lawyers are aware of the increasing sensitivity—and hostility—of clients to block-billing: lumping more than one activity into a single time entry. A new Fifth Circuit decision shows that courts can be equally sensitive—and...more
Boston Children’s Hospital says that when it terminated a research fellow’s employment, he took the laptop he used in his work to a computer forensics company and had all the data, including data owned by the hospital,...more
According to The New York Times, Medicare may be punishing hospitals—and academic medical centers (AMCs) in particular—for being too careful. That’s how Northwestern Memorial Hospital’s chief medical officer sees the...more