recent legal cases in healthcare 2020

Cardiologist convicted in 'fountain of youth' billing fraud scam. Nurse gets jail time for $393K billing fraud schemeA nurse was sentenced to one year in jail for stealing more than $390,000 from Medicaid over a five-year period, New York Attorney General Barbara D. Underwood announced June 25. They formed MDL 2767 in the Southern District of New York. Cookie Policy. A lawsuit filed in January 2020 claimed that a pediatric dentist in Las Vegas, NV, breached the standard of care by starting a fire in a 5-year-old girl’s mouth during a routine dental procedure. A California jury recently awarded $22,246 in economic damages and $9.25 million in non-economic damages to a plaintiff who got more than he bargained for when he went in for surgery to remove a mass in his scrotum. Beyond the ACA: Healthcare legal fights to watch in 2020. The boy’s mother, who brought the lawsuit, and the hospital that was sued agreed to reduce the award to $50 million on the condition that the hospital would not appeal. No. 1 hospital in each state for 2021-22, 10 best children's hospitals, ranked by US News. The Department of Justice obtained more than $2.2 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. 30, 2020, Acting Assistant Attorney General Jeffrey Bossert Clark of the Department of Justice’s Civil Division announced today.  Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $64 billion. Select Justice » Legal Education » Top 5 Recent Mass Tort Settlements and Verdicts. Topics addressed in this book include: The history of healthcare marketing practices Physician, patient, and hospital interactions Alignment of strategic marketing efforts to the mission, vision, and values of an organization Ethics of ... The settlement … In November 2019, a jury in Chicago, IL, awarded a record $101 million on behalf of a 5-year-old boy who suffered severe brain damage at birth. ; and Department of Health and Human Services et al. Acting Assistant Attorney General Clark expressed appreciation for all the work over the past year by the many public servants who continued to support the department’s efforts to protect the public fisc:  “I am grateful to all those in the Civil Division and the U.S. Attorneys’ Offices, as well as the agency Offices of Inspector General and the many other federal and state agencies who worked tirelessly, often overcoming daunting challenges, to provide substantial benefits to the taxpayers.”. Whole Woman’s Health. This 2008 Supplement updates the main text with recent developments.  As part of the settlement agreements, each physician admitted to reporting and being paid for consulting hours in excess of actual or documented consulting time.Â. The most important book on antitrust ever written. It shows how antitrust suits adversely affect the consumer by encouraging a costly form of protection for inefficient and uncompetitive small businesses. Judge dismisses anti-kickback suit against UnitedHealth over $25 Walmart gift cards, free in-home visitsA district court dismissed a suit claiming UnitedHealthcare violated the Anti-Kickback Statute by providing $25 Walmart gift cards to Medicare beneficiaries who opted to receive free in-home exams. After the COVID-19 pandemic erupted in early 2020, Dr. Hasan Gokal—who had been practicing medicine for two decades—began working for Harris County Public Health in Houston, Texas. 12 Most Famous Medical Malpractice Cases – Dirty Dozen of Medical Mistakes While we live in a time of great medical advances, serious medical mistakes take an enormous number of lives. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. 5 notes on breakthrough case prevalence, CDC: 74% of people infected in Massachusetts outbreak vaccinated, 455 hospitals with 5 stars from CMS: 2021, Wisconsin hospital replaces anesthesiologists with CRNAs, RN salary by state — California is No. 28 September 2020By Masood Ahmed. By MMLC Group. No. 04/09/21. Found insideInjury Illustrated is the first book of its kind. It is the essential guide on medical illustrations used in the legal context. This book examines the creation of visual graphics known as demonstrative exhibits. Found inside – Page 1978Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. See United States ex rel. 20a96: TEXAS v. NEW MEXICO: December 14, 2020: No. October 2020 . “They’ve taken unprecedented steps as a consequence of litigation to accept responsibility, not for simply the infections occurring, but for them being the legal cause of these [deaths and injuries].”, Geisinger president and CEO Jaewon Ryu, MD, JD, said in a statement: “The loss of a child is tragic, and this settlement can never replace these young children, however we believe we have taken the steps necessary to prevent future infections and spare other families from this loss.”. Arbitration. Comcast Corp. v. Nat’l Assoc. This year, three states paid a total of over $24 million to resolve allegations that they violated the False Claims Act in their administration of the Supplemental Nutrition Assistance Program (SNAP), previously known as the Food Stamp Program.  Although the federal government funds SNAP benefits, it relies on the states to determine whether applicants are eligible for benefits, to administer those benefits, and to perform quality control to ensure that eligibility decisions are accurate.  The settlements resolved allegations that the states submitted false quality control data and information to the U.S. Department of Agriculture for which they received performance bonuses to which they were not entitled. Recent Decisions (All cases) Recent decisions lists contain the 20 most recently rendered court judgments for each BAILII court/tribunal database, in reverse chronological order. Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. Hospice operator pays $8.5M to settle False Claims Act lawsuitHospice chain Caris Healthcare agreed to pay $8.5 million to settle allegations that it knowingly retained overpayments for patients that were ineligible for the Medicare hospice benefit. ... New Jersey Medical Center. ; National Federation of Independent Business et al. Written for health professionals of all kinds--not lawyers-- Medical Law and Ethics covers the full spectrum of topics that affect practice. 1. Medical malpractice lawsuits are all too familiar to physicians. [2020 4 SCC 1] Coram: NV Ramana, Sanjay Kishan Kaul, R Subhash Reddy, BR Gavai, and Surya Kant JJ. As part of a $4.25 million settlement, five individual shareholders of Dave O’Mara Contractor, Inc. (DOCI), an Indiana-based asphalt contractor, agreed to pay a total of nearly $2 million to resolve the United States’ allegations that DOCI violated the False Claims Act by misrepresenting to the government the materials that were used to pave federally funded roads in the state of Indiana.  Specifically, the government alleged that DOCI claimed that its hot mix asphalt mixture contained a sufficient amount of binder or glue to hold the mix together when, in fact, DOCI frequently failed to meet the minimal levels of binder required to properly pave the roads. Three U.S. Supreme Court cases and two federal circuit court cases round out … July 08, 2020 - The healthcare sector saw a whopping 41.4 million patient records breached in 2019, fueled by a 49 percent increase in hacking, according to the Protenus Breach Barometer. We are grateful to all the legal practitioners and court officials who help us source judgments every day. Barclays Bank v. Various Claimants [2020] UKSC 13 and WM Morrison Supermarkets plc v Various Claimants [2020] UKSC 12. University Hospital Birmingham NHS Foundation Trust v AI & K. Summary In this case, the Trust sought a declaration from Hayden J that it was lawful and in AI’s best interests to discontinue any further attempts to provide dialysis. 10. The fifth edition of Nursing Ethics: Across the Curriculum and Into Practice has been revised to reflect the most current issues in healthcare ethics including new cases, laws, and policies. C. Malaria following exposure in a mosquito-infested area. The court in this case is concerned with the legal requirements of the process of obtaining consent for the carrying out of medical treatment. These medical malpractice cases had some of the biggest verdicts in the past year. Risk adjustment: 6 legal and compliance issues to watch in 2020. v. Department of Health and Human Services et al. The suit claims dozens of patients were infected with hepatitis C because the health system failed to report a former worker who stole the opioid fentanyl. Sherod v. This essay is followed by four commentaries by Professors Gordon Wood, Laurence Tribe, Mary Ann Glendon, and Ronald Dworkin, who engage Justice Scalia’s ideas about judicial interpretation from varying standpoints. This work is a sampling of the Hippocratic Corpus, a collection of ancient Greek medical works. In addition to combating health care fraud, the False Claims Act serves as the government’s primary civil tool to redress false claims for federal funds and property involving a multitude of other government operations and functions.  The act helps to support our military and first responders by ensuring that government contractors provide equipment that is safe, effective, and cost efficient; to safeguard American businesses and workers by promoting compliance with customs laws, trade agreements, visa requirements, and small business protections; and to protect other critical government programs ranging from the provision of disaster relief funds to nutrition benefits for needy families. Measles resulting from a daycare center outbreak. First Circuit Holds that Harvard’s Admissions Program Does Not Violate the Civil Rights Act. All Rights Reserved. CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT . She was hospitalized for several days and treated for burns to her lips, mouth, tongue, epiglottis, throat, “and other surrounding areas,” according to the complaint. September 2020 . New Trial Order in Medical Negligence Case Against Einstein Upheld. Physicians increasingly face “hybrid” medical liability claims. The largest recoveries in the past year came from the drug industry.  For example, following years of litigation and multiple unsuccessful attempts to have the government’s claims dismissed, Novartis Pharmaceuticals Corporation paid over $591 million to resolve claims that it paid kickbacks to doctors to induce them to prescribe its drugs.  Novartis sales representatives, on the instruction of their managers, selected high-volume prescribers to serve as paid “speakers” to induce the prescribers to write Novartis prescriptions.Â, The department also continued to investigate efforts by drug manufacturers to protect high drug prices by funding the co-payments of Medicare patients.  Congress included co-pay requirements in the Medicare program, in part, to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs.  This year, two pharmaceutical manufacturers – Novartis and Gilead Sciences – paid a combined total of over $148 million to resolve claims that they illegally paid patient copays for their own drugs through purportedly independent foundations that the companies in fact treated as mere conduits for these payments.  In addition, four of the purportedly independent foundations paid a total of $13 million this year to resolve liability for their involvement in the kickback schemes.  In August 2020, the department sued Teva Pharmaceuticals USA, Inc. and Teva Neurosciences, Inc., alleging that they conspired with two purportedly independent foundations to illegally subsidize Medicare co-pays for the drug Copaxone.Â, The department continued to pursue opioid-related fraud schemes.  One of the largest opioid-related recoveries this past year was from Practice Fusion, Inc., a health information technology developer that accepted kickbacks from the opioid manufacturer Purdue Pharma in exchange for implementing clinical decision support alerts in its electronic health records (EHR) software that were designed to increase prescriptions for OxyContin, and caused its users to submit false claims for federal incentive payments by misrepresenting the capabilities of its EHR software.  In addition, the $145 million Practice Fusion settlement reflects that complex EHR-related fraud schemes remain a focus of the Department’s work.Â, Kickbacks in the healthcare industry are pernicious because of their potential to subvert medical decision-making.  In addition to pursuing improper payments by drug manufacturers, the department resolved other schemes involving the willful solicitation or payment of illegal remuneration to induce the purchase of a good or service paid for by a federal health care program.  For example, ResMed Corp., a durable medical equipment manufacturer, agreed to pay more than $37 million to resolve allegations that it paid kickbacks to suppliers, sleep labs, and other health care providers. James Parker. “Somehow I think that deep down inside—when [my son] is a little older—he will know that there were many people who loved him and wanted him to have the best care possible because he did nothing wrong.”. Data, negligence legislation, key cases, and law processes were collated and analysed based on court decision citations, legal impact, and relationships between legislation application and case law. According to the lawsuit, the dentist was using a diamond bur on the girl’s teeth which produced a spark that “caused the throat pack in [the girl’s] mouth to ignite and produce a fire” lasting one or two seconds.  The Oklahoma Center for Orthopaedic and Multi-Specialty Surgery, a specialty hospital in Oklahoma City, its part-owner and management company, an orthopedic physician group, and two physicians agreed to pay a total of over $72 million to resolve allegations that the hospital provided improper remuneration to the physician group in exchange for patient referrals.  UTC Laboratories Inc. (RenRX) agreed to pay $41.6 million, and its three principals agreed to pay $1 million, to resolve allegations that they paid kickbacks in exchange for laboratory referrals for pharmacogenetic testing and for furnishing and billing for tests that were not medically necessary. Found inside – Page 173CUMULATIVE TABLE OF CASES In 173 - CUMULATIVE TABLE OF CASES - 174 -. Mabee Petroleum Corp. v. United States, SS 4.4(b), 25.5(a) Malat v. 6. The hospital’s staff also ignored external fetal heart monitoring reports that showed the baby was at risk, according to the claim. November 2020 . By ADAM BEAMApril 14, 2020 GMT. The girl was taken immediately to University Medical Center of Southern Nevada. According to the lawsuit, the dentist was using a diamond bur on the girl’s teeth which produced a spark that “caused the throat pack in [the girl’s] mouth to ignite and produce a fire” lasting one or two seconds. OCR has investigated complaints against many different types of entities including: national pharmacy chains, major medical centers, group … Doing so allowed the jury to skirt the $250,000 cap on non-economic damages for professional negligence. August 2020 . and his surgical practice, Community Surgical Associates, five individual shareholders of Dave O’Mara Contractor, Inc. (DOCI). Essentia Health, cv-16-100-DWF-LIB (D. Minn. Sept. 20, 2018) (holding that a health care plan that excluded health services related to gender dysphoria discriminated against transgender people in violation of the Health Care Rights Law (Section 1557 of the Affordable Care Act), which prohibits discrimination in health care). Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists. June-July 2020 . Legal Cases and State Legislative Actions Related to the ACA. In that capacity, he became “one of the faces of Harris County Public Health during the pandemic, [being] featured in videos and on town hall panels.” Teva Pharmaceuticals USA, Inc. and Teva Neurosciences, Inc. Oklahoma Center for Orthopaedic and Multi-Specialty Surgery, SpineFrontier, Inc., its Chief Executive Officer, Dr. Kingsley Chin, and certain related entities and individuals, Logan Laboratories, Inc., pain clinic Tampa Pain Relief Centers, Inc., and two of their former executives, Bechtel National Inc., Bechtel Corporation, AECOM Energy & Construction, Inc., and their joint venture Waste Treatment Completion Company, LLC, Hybrid Tech Holdings LLC, Hybrid Technology LLC, and Ace Strength International LTD, Glenn A. Kline, D.O. April 2020 Florida health system accused of illegally poaching physicians from competitorPhysicians Regional Medical Group, Physicians Regional Medical Center-Pine Ridge and Physicians Regional Medical Center-Collier Boulevard, all based in Naples, Fla., sued Naples-based NCH Healthcare System in federal court June 12 for allegedly stealing physicians from its practice. In another case, QuantaDyn Corporation agreed to pay $37 million to resolve both its criminal and civil liability for engaging in a bribery scheme to steer government contracts for training simulators to the company.  William T. Dunn Jr., the President and Chief Executive Officer of QuantaDyn, separately agreed to pay $500,000 to resolve his personal civil liability for the alleged scheme. 9. A lawsuit filed in January 2020 claimed that a pediatric dentist in Las Vegas, NV, breached the standard of care by starting a fire in a 5-year-old girl’s mouth during a routine dental procedure. The Court hears oral arguments from October through April. From a former healthcare executive and three surgeons charged in a $950 million kickback scheme to a nurse sentenced to jail for stealing from Medicaid, here are the latest healthcare industry lawsuits and settlements making headlines. Share sensitive information only on official, secure websites. As in years past, the department also resolved a number of matters in which providers billed federal health care programs for medically unnecessary services or services not rendered as billed.  For example, Universal Health Services paid $117 million to resolve allegations that its inpatient psychiatric hospitals and residential psychiatric and behavioral treatment facilities knowingly submitted false claims for inpatient behavioral health services that were not reasonable or medically necessary and/or failed to provide adequate and appropriate services to its patients.  Additionally, Logan Laboratories, Inc., pain clinic Tampa Pain Relief Centers, Inc., and two of their former executives agreed to pay a total of $41 million to resolve allegations that they automatically ordered both presumptive and definitive urine drug tests for all patients at every visit, without any individualized determination that either test was medically necessary for the particular patients for whom the tests were ordered. Recent Ransomware Attack Trends to Note (So Far) in 2020 One of the most notable trends in ransomware this year is the increasing attacks on K-12 schools. Following a $260 million settlement with Health Management Associates, the department negotiated a $4.25 million civil settlement with Glenn A. Kline, D.O. ... A trial will likely be scheduled in 2020. In considering this issue the court has had to consider evidence on the use of PBs, their impact on the patients, both in the short and long term, and the evidence of the efficacy of their use. During a storied legal career, Clyde Bergstresser has become one of the go-to medical malpractice lawyers in Massachusetts... California orders insurance premium refunds during outbreak. June 2020 . The department’s health care fraud enforcement efforts restore funds to federal programs such as Medicare, Medicaid, and TRICARE, the health care program for service members and their families.  But just as important, the department’s vigorous pursuit of health care fraud prevents billions more in losses by deterring others who might otherwise try to cheat the system for their own gain. Found insideNew York Times Bestseller • Notable Book of the Year • Editors' Choice Selection One of Bill Gates’ “Amazing Books” of the Year One of Publishers Weekly’s 10 Best Books of the Year Longlisted for the National Book Award for ... With pending legislation, health systems must prepare for the changes to come in 2020. 3. By MICHAEL REZENDESMay 15, 2020 GMT. August 5, 2019. Tennessee hospital settles false claims allegations for $784KLivingston (Tenn.) Regional Hospital, a 114-bed hospital owned by Brentwood, Tenn.-based LifePoint Health, will pay $784,000 to resolve allegations it violated the False Claims Act. Other cases will push the boundaries of Tort law… Copyright © 2021 Becker's Healthcare. Contract Law Uber Technologies Inc. v. Heller. Some of these cases will be non-controversial applications of Tort doctrine to the new circumstances created by COVID-19. Texas hospital's $58M lawsuit against BCBS gets second lifeThe Fifth Circuit Appellate Court revived a Texas hospital's $58 million lawsuit against 16 independent insurers and claims administrators doing business under the Blue Cross and/or Blue Shield trademarks across the U.S. over alleged underpayments. Doi: 10.1377/hblog20210201.561637. To help with this, Crowe has identified the top risks facing healthcare organizations in 2020. But California has a $250,000 cap on non-economic damages in medical malpractice cases. On May 26, 2021, the Department of Justice (“DOJ”) announced a coordinated law enforcement action against 14 telehealth executives, physicians, marketers, and healthcare business owners for their alleged fraudulent COVID-19 related Medicare claims resulting in over $143 million in false billing. 7 new findings about Moderna arm rashes, per Yale study, Vaccine passports: 50 states with bans, limitations & green lights, Swollen lymph nodes after COVID-19 vaccine may indicate prior infection, early research suggests, 12 states banning COVID-19 vaccine mandates & how they affect healthcare workers, ​​Physicians who post COVID-19 vaccine misinformation may lose license, medical panel says, States ranked by COVID-19 hospitalization rates: Sept. 24, Delta variant may have different symptoms, early data suggests, 11 bans on vaccine mandates — What states have them & which might soon, Does a vaccine passport violate HIPAA? AMA J Ethics. As a condition of the settlement, Geisinger admitted fault—an action The New York Times characterized as “extraordinary.”, “Geisinger has taken this extremely seriously in their dealings with me on behalf of my clients,” Casey said. Their share of the legal awards amounted to $244.2 million in 2019, down from $306.1 million the year before. SAFLII is a member of the Free Access to Law movement and is committed to publishing all judgments provided by the courts online. February 1, 2021. Federal court reaffirms individual patients cannot file HIPAA lawsuits: 5 things to knowA U.S. district court judge in Washington, D.C., on June 15 dismissed a case by a patient who alleged Laboratory Corporation of America, or LabCorp, violated HIPAA, reaffirming the precedent that individual patients cannot file lawsuits for alleged HIPAA violations. Trend #1. Case: Dr. Shah Faesal & Ors. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. Heskett v Secretary of State for … Legal and Ethical Essentials of Health Care Administration, Second Edition is the ideal text for courses that combine a study of both the legal and ethical aspects of healthcare administration. As price transparency increases and consumers—and CMS—demand quality care for less, healthcare organizations need new ways to succeed within the VBC landscape. v. Heller-stedt In 2020, the U.S. Environmental Protection Agency (EPA) completed two enforcement actions at the DePue/New Jersey Zinc/Mobil Chemical Site (Site) located in DePue, Illinois to address cleanup of contaminated soil on public and residential property. So it’s highly probable… 3 Indivior plc related to its marketing of the ACA, and Services creation of graphics! 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