The following hospital lawsuits, settlements or legal developments were reported within the past month, beginning with the most recent.
1. South Shore Hospital in Massachusetts to Pay $750K for Data Breach
South Shore Hospital in Weymouth, Mass., agreed to a $750,000 settlement over charges tied to a 2010 data breach that leaked the personal health information of more than 800,000 patients.
2. UPMC Answers West Penn's Antitrust Suit; Claims Highmark is Monopolistic
University of Pittsburgh Medical Center filed a written response to an antitrust suit filed by West Penn Allegheny Health System, the same suit UPMC recently tried to halt. West Penn Allegheny opposed the stay, so UPMC filed suit claiming "WPAHS has secretly and artificially been propped up by Highmark as a vehicle to help Highmark protect itself from insurance competition and maintain its health insurance monopoly."
3. Kickback Scheme at Florida's Memorial Healthcare Lands 4 Vendors in Prison
Four people connected to a bribery scheme at Ft. Lauderdale, Fla.-based Memorial Healthcare System were sentenced to prison by U.S. District Judge Kenneth Marra. The defendants were hospital vendors convicted of conspiracy to commit bribery of an agent of an organization receiving federal funds.
4. Class Action Suit Filed Against Tenet Over Facility Fees
Two St. Louis residents filed a class action suit against two Tenet Healthcare hospitals — Saint Louis University Hospital and Des Peres (Mo.) Hospital — in an attempt to recover alleged undisclosed hospital facility fees for non-hospital services at affiliated physician offices and outpatient clinics.
5. Humana Expects to Pay $45M to Tenet, Sacred Heart From 2007 Lawsuit
Health insurer Humana expects to pay approximately $45 million to several hospitals, including Sacred Heart Health System in Pensacola, Fla., and Dallas-based Tenet Healthcare, related to a lawsuit from 2007. February 2007, several hospitals run by Sacred Heart, Tenet and others sued Humana's military healthcare business — Humana Military Healthcare Services — alleging it had breached outpatient reimbursement network agreements.
6. Law Firm to Pay $6M Settlement Over Faulty Bert Fish Medical Center Merger
Southeast Volusia Hospital District and Bert Fish Medical Center in New Smyrna Beach, Fla., reached a settlement with the law firm it accused of giving faulty legal advice during a merger with Altamonte Springs, Fla.-based Adventist Health System. The district board accepted a $6 million settlement from Lowndes, Drosdick, Doster, Kantor & Reed.
7. Temple University, Physician Agree to Pay DOJ $1.09M for Fraudulent Billing
Temple University in Philadelphia and Joseph J. Kubacki, MD, former chairman of the medical school's ophthalmology department, agreed to pay a combined settlement of roughly $1.09 million over Temple's voluntary disclosure of fraudulent billing. Dr. Kubacki has agreed to pay $676,101 back to the government. Temple has agreed to pay $412,474.
8. Former Beverly Hospital Executive Pleads Guilty to Soliciting Bribes
Paul Galzerano, a former associate vice president at Beverly (Mass.) Hospital, pleaded guilty to soliciting bribes and kickbacks from hospital contractors between 2003 and 2007, and stealing artwork from the facility while it was under renovation. Mr. Galzerano was sentenced to serve 18 months of a two-year jail term on four larceny counts and two years of probation for two counts of commercial bribery.
9. Parkland Memorial Hospital, UT Southwestern Physicians Face Fraud Allegations
Parkland Memorial Hospital in Dallas and physicians from Dallas-based UT Southwestern Medical Center are facing a whistleblower lawsuit alleging Medicare and Medicaid fraud. The suit was filed a former UT Southwestern resident who trained at Parkland. It alleges Parkland and UT physicians falsely submitted "hundreds of thousands" of claims for rehabilitation consultations that were never requested by primary care physicians, thus rendering them non-reimbursable.
10. Lenox Hill Hospital in NY Resolves Alleged Medicare Overbilling With $12M
Lenox Hill Hospital in New York City agreed to pay close to $12 million to resolve alleged violations of the False Claims Act. The hospital allegedly inflated Medicare charges to obtain larger supplemental reimbursement from February 2002 through August 2003.
11. Highmark Drops False Advertising Suit Against UPMC
In early May, Pittsburgh-based Highmark will drop its federal lawsuit contending University of Pittsburgh Medical Center organized a false advertising campaign against the insurer. Highmark dropped the suit part of a recent contract agreement with UPMC that gave Highmark subscribers in-network access to UPMC providers until 2015.
12. Former CEO of New York's Parkway Hospital Gets 4 Months in Prison
Robert Aquino, the former CEO of Parkway Hospital in Queens, N.Y., was sentenced to four months in prison for bribing a former state senator. Mr. Aquino pled guilty in January to bribing former New York State Senator Carl Kruger. Mr. Aquino claims he made the payment with the understanding that Mr. Kruger would keep Parkway open in return, as it was scheduled to close in the summer of 2008.
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1. South Shore Hospital in Massachusetts to Pay $750K for Data Breach
South Shore Hospital in Weymouth, Mass., agreed to a $750,000 settlement over charges tied to a 2010 data breach that leaked the personal health information of more than 800,000 patients.
2. UPMC Answers West Penn's Antitrust Suit; Claims Highmark is Monopolistic
University of Pittsburgh Medical Center filed a written response to an antitrust suit filed by West Penn Allegheny Health System, the same suit UPMC recently tried to halt. West Penn Allegheny opposed the stay, so UPMC filed suit claiming "WPAHS has secretly and artificially been propped up by Highmark as a vehicle to help Highmark protect itself from insurance competition and maintain its health insurance monopoly."
3. Kickback Scheme at Florida's Memorial Healthcare Lands 4 Vendors in Prison
Four people connected to a bribery scheme at Ft. Lauderdale, Fla.-based Memorial Healthcare System were sentenced to prison by U.S. District Judge Kenneth Marra. The defendants were hospital vendors convicted of conspiracy to commit bribery of an agent of an organization receiving federal funds.
4. Class Action Suit Filed Against Tenet Over Facility Fees
Two St. Louis residents filed a class action suit against two Tenet Healthcare hospitals — Saint Louis University Hospital and Des Peres (Mo.) Hospital — in an attempt to recover alleged undisclosed hospital facility fees for non-hospital services at affiliated physician offices and outpatient clinics.
5. Humana Expects to Pay $45M to Tenet, Sacred Heart From 2007 Lawsuit
Health insurer Humana expects to pay approximately $45 million to several hospitals, including Sacred Heart Health System in Pensacola, Fla., and Dallas-based Tenet Healthcare, related to a lawsuit from 2007. February 2007, several hospitals run by Sacred Heart, Tenet and others sued Humana's military healthcare business — Humana Military Healthcare Services — alleging it had breached outpatient reimbursement network agreements.
6. Law Firm to Pay $6M Settlement Over Faulty Bert Fish Medical Center Merger
Southeast Volusia Hospital District and Bert Fish Medical Center in New Smyrna Beach, Fla., reached a settlement with the law firm it accused of giving faulty legal advice during a merger with Altamonte Springs, Fla.-based Adventist Health System. The district board accepted a $6 million settlement from Lowndes, Drosdick, Doster, Kantor & Reed.
7. Temple University, Physician Agree to Pay DOJ $1.09M for Fraudulent Billing
Temple University in Philadelphia and Joseph J. Kubacki, MD, former chairman of the medical school's ophthalmology department, agreed to pay a combined settlement of roughly $1.09 million over Temple's voluntary disclosure of fraudulent billing. Dr. Kubacki has agreed to pay $676,101 back to the government. Temple has agreed to pay $412,474.
8. Former Beverly Hospital Executive Pleads Guilty to Soliciting Bribes
Paul Galzerano, a former associate vice president at Beverly (Mass.) Hospital, pleaded guilty to soliciting bribes and kickbacks from hospital contractors between 2003 and 2007, and stealing artwork from the facility while it was under renovation. Mr. Galzerano was sentenced to serve 18 months of a two-year jail term on four larceny counts and two years of probation for two counts of commercial bribery.
9. Parkland Memorial Hospital, UT Southwestern Physicians Face Fraud Allegations
Parkland Memorial Hospital in Dallas and physicians from Dallas-based UT Southwestern Medical Center are facing a whistleblower lawsuit alleging Medicare and Medicaid fraud. The suit was filed a former UT Southwestern resident who trained at Parkland. It alleges Parkland and UT physicians falsely submitted "hundreds of thousands" of claims for rehabilitation consultations that were never requested by primary care physicians, thus rendering them non-reimbursable.
10. Lenox Hill Hospital in NY Resolves Alleged Medicare Overbilling With $12M
Lenox Hill Hospital in New York City agreed to pay close to $12 million to resolve alleged violations of the False Claims Act. The hospital allegedly inflated Medicare charges to obtain larger supplemental reimbursement from February 2002 through August 2003.
11. Highmark Drops False Advertising Suit Against UPMC
In early May, Pittsburgh-based Highmark will drop its federal lawsuit contending University of Pittsburgh Medical Center organized a false advertising campaign against the insurer. Highmark dropped the suit part of a recent contract agreement with UPMC that gave Highmark subscribers in-network access to UPMC providers until 2015.
12. Former CEO of New York's Parkway Hospital Gets 4 Months in Prison
Robert Aquino, the former CEO of Parkway Hospital in Queens, N.Y., was sentenced to four months in prison for bribing a former state senator. Mr. Aquino pled guilty in January to bribing former New York State Senator Carl Kruger. Mr. Aquino claims he made the payment with the understanding that Mr. Kruger would keep Parkway open in return, as it was scheduled to close in the summer of 2008.
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