The following hospital lawsuits were reported within the past month, beginning with the most recent.
1. Indiana Court Ruling on Hospital Costs Could Result in Flood of Million-Dollar Lawsuits
Two uninsured patients sued IU Health, claiming the system charged them more than insured patients would have paid for the same treatment. The case's trial lawyer, Scott Weathers, has explicitly said he intends to turn the lawsuit into a class action — against IU Health and other hospitals in the area as well — which could open the floodgates for patients to sue over hospital bills from up to 10 years ago. The case is slated for argument May 10 in the Indiana Supreme Court.
2. Vanderbilt University Medical Center Settles Patient Dumping Allegations
Vanderbilt University Medical Center in Nashville, Tenn., and one of its surgeons resolved patient dumping allegations with the Office of Inspector General. The OIG claimed that in 2008, Vanderbilt refused to accept the transfer of a patient who had an unstable emergency medical condition and required specialized capabilities. Shortly after the patient was transferred to another facility, he/she died. The hospital paid $45,000 and an involved physician paid $35,000 to resolve the allegations, but said its decision had nothing to do with the patient's ability to pay.
3. CEO of Spine Network of California Charged With Worker's Comp Fraud
Trudy Maurer, CEO of the Spine Network of California, is facing criminal charges filed by the Santa Clara County District Attorney's Office, which claims she drastically overbilled taxpayers for the cost of government employees' spinal implants. A law allows companies like Implantium to profit up to $250 for each device, but Ms. Maurer is accused of altering invoices for the implants by up to tens of thousands of dollars. The allegedly-altered invoices date back to 2008.
4. Minnesota AG Sues Hospital Debt Collection Agency for Patient Privacy Violations
Minnesota Attorney General Lori Swanson filed suit against Accretive Health, a debt collection agency, for not protecting patient confidentiality and not informing patients of the agency's "extensive involvement" in their healthcare at two hospital systems in the state.
5. West Penn Allegheny Claims UPMC Bribed Physicians to Leave
West Penn Allegheny Health System in Pittsburgh amended its 2009 complaint against University of Pittsburgh Medical Center, alleging the competitor paid bribes to West Penn physicians to leave the system. UPMC attorneys have requested a May 23 deadline from U.S. District Judge Joy Flowers Conti to respond to the complaint.
6. Judge Dismisses Cardiologist's Defamation Suit Against St. Joseph's in Maryland
The defamation lawsuit filed by cardiologist Mark Midei, MD, against St. Joseph Medical Center in Towson, Md., was dismissed by a Baltimore County Circuit Court judge. Dr. Midei's suit stemmed from allegations, beginning in 2009, that he implanted hundreds of unnecessary stents into patients. Dr. Midei's attorney claimed the hospital scapegoated the physician for its reputational and financial turmoil, and the defamation suit sought $60 million for each of its four counts.
7. Wesley Medical Center Claims Ambulance Company Improperly Took Patients to Competitor
Wesley Medical Center in Hattiesburg, Ala., filed suit against AAA Ambulance, claiming the company interfered with patient choice by taking patients to Forrest General Hospital when they did not meet trauma criteria. The hospital filed its complaint Tuesday in U.S. District Court, naming Wade Spruill, CEO of AAA Ambulance, and Forrest General Hospital, which is also in Hattiesburg.
8. UCLA Surgeon Sues Regents for Alleged Racial Discrimination
Christian Head, MD, a head and neck surgeon within UCLA Health System, filed a racial discrimination lawsuit against the Regents of the University of California after he was allegedly publicly humiliated at an event several years ago. Dr. Head has filed a 40-page complaint, complaining UCLA failed to prevent discrimination, harassment and retaliation.
9. Avera McKennan in South Dakota Ordered to Pay $70k in Back Wages
Avera McKennan Hospital and University Health Center in Sioux Falls, S.D., was ordered by the U.S. Department of Labor to pay $70,157 in back wages to 487 current and former employees who were not properly compensated for breaks.
10. Two Sound Shore Hospitals in New York Settle Medicaid Overbilling Allegations
Sound Shore Medical Center in New Rochelle and Mount Vernon (N.Y.) Hospital agreed to a settlement of more than $2.3 million after an Attorney General investigation found the facilities allegedly overbilled Medicaid for physician-administered drugs. Under New York State law, hospitals and physicians are not permitted to make a profit on the drugs they administer. Hospitals are only to bill Medicaid for the price they paid for injectable drugs, not extra costs of physician administration.
11. Anticompetitive Lawsuit Against Scripps Health Heads to Trial
A 2009 lawsuit filed by Oceanside, Calif.-based Tri-City Healthcare District — alleging San Diego-based Scripps Health redirected patients from Tri-City's market to Scripps facilities — is headed to trial. Scripps tried to handle the case in arbitration, but the Fourth District Court of Appeal upheld a trial court ruling that Tri-City's anticompetitive claims are not subject to arbitration.
12. Tenet Agrees to $42.75M Settlement for Alleged Medicare Overbilling
Dallas-based Tenet Healthcare agreed to a $42.75 million settlement to resolve allegations that it overbilled Medicare for inpatient rehabilitation admissions. The alleged overbilling occurred from 2005 to 2007 at 25 Tenet inpatient rehabilitation units. The cash payment for the settlement — which is to be divided among the U.S. Attorney's Office, Northern District of Georgia and Depts. of Justice and Health and Human Services — will be paid in Tenet's second quarter 2012.
13. UPMC Hamot, Cardiologists Seek Dismissal of Whistleblower Suit
UPMC Hamot in Erie, Pa., and five affiliated cardiologists want a federal judge to dismiss a lawsuit alleging the providers performed unnecessary heart procedures and overbilled Medicare. The whistleblower suit was filed by former Erie cardiologist Tullio Emanuele, MD, and was made public in January. It claims the hospital allowed physicians to perform eight improper angioplasty procedures from 2001 to 2005 and bill Medicare for the services.
14. In Patent Dispute, Physician Claims Mass General Exec Said Hospital "Owns" His Brain
A physician has sued Massachusetts General Hospital in Boston and its parent, Partners HealthCare System, over who owns the rights to inventions developed in the physician's home workshop. Urological surgeon Joseph A. Grocela, MD, claims Frances Toneguzzo, the top official at Partners' licensing division, said the hospital "trained you, we pay you, we own your brain and therefore own all your ideas."
15. Whistleblower Suit Against Erlanger Medical Center in Tennessee is Dropped
A two-year-old whistleblower lawsuit claiming Chattanooga, Tenn.-based Erlanger Medical Center submitted false Medicare claims was dropped. The state of Tennessee and federal attorneys declined to move forward in the case, which stemmed from a suit filed by Lisa K. Stratienko in 2010. Ms. Stratienko claimed the hospital submitted a series of fraudulent Medicare claims linked to "improper agreements" with third-party physician groups.
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1. Indiana Court Ruling on Hospital Costs Could Result in Flood of Million-Dollar Lawsuits
Two uninsured patients sued IU Health, claiming the system charged them more than insured patients would have paid for the same treatment. The case's trial lawyer, Scott Weathers, has explicitly said he intends to turn the lawsuit into a class action — against IU Health and other hospitals in the area as well — which could open the floodgates for patients to sue over hospital bills from up to 10 years ago. The case is slated for argument May 10 in the Indiana Supreme Court.
2. Vanderbilt University Medical Center Settles Patient Dumping Allegations
Vanderbilt University Medical Center in Nashville, Tenn., and one of its surgeons resolved patient dumping allegations with the Office of Inspector General. The OIG claimed that in 2008, Vanderbilt refused to accept the transfer of a patient who had an unstable emergency medical condition and required specialized capabilities. Shortly after the patient was transferred to another facility, he/she died. The hospital paid $45,000 and an involved physician paid $35,000 to resolve the allegations, but said its decision had nothing to do with the patient's ability to pay.
3. CEO of Spine Network of California Charged With Worker's Comp Fraud
Trudy Maurer, CEO of the Spine Network of California, is facing criminal charges filed by the Santa Clara County District Attorney's Office, which claims she drastically overbilled taxpayers for the cost of government employees' spinal implants. A law allows companies like Implantium to profit up to $250 for each device, but Ms. Maurer is accused of altering invoices for the implants by up to tens of thousands of dollars. The allegedly-altered invoices date back to 2008.
4. Minnesota AG Sues Hospital Debt Collection Agency for Patient Privacy Violations
Minnesota Attorney General Lori Swanson filed suit against Accretive Health, a debt collection agency, for not protecting patient confidentiality and not informing patients of the agency's "extensive involvement" in their healthcare at two hospital systems in the state.
5. West Penn Allegheny Claims UPMC Bribed Physicians to Leave
West Penn Allegheny Health System in Pittsburgh amended its 2009 complaint against University of Pittsburgh Medical Center, alleging the competitor paid bribes to West Penn physicians to leave the system. UPMC attorneys have requested a May 23 deadline from U.S. District Judge Joy Flowers Conti to respond to the complaint.
6. Judge Dismisses Cardiologist's Defamation Suit Against St. Joseph's in Maryland
The defamation lawsuit filed by cardiologist Mark Midei, MD, against St. Joseph Medical Center in Towson, Md., was dismissed by a Baltimore County Circuit Court judge. Dr. Midei's suit stemmed from allegations, beginning in 2009, that he implanted hundreds of unnecessary stents into patients. Dr. Midei's attorney claimed the hospital scapegoated the physician for its reputational and financial turmoil, and the defamation suit sought $60 million for each of its four counts.
7. Wesley Medical Center Claims Ambulance Company Improperly Took Patients to Competitor
Wesley Medical Center in Hattiesburg, Ala., filed suit against AAA Ambulance, claiming the company interfered with patient choice by taking patients to Forrest General Hospital when they did not meet trauma criteria. The hospital filed its complaint Tuesday in U.S. District Court, naming Wade Spruill, CEO of AAA Ambulance, and Forrest General Hospital, which is also in Hattiesburg.
8. UCLA Surgeon Sues Regents for Alleged Racial Discrimination
Christian Head, MD, a head and neck surgeon within UCLA Health System, filed a racial discrimination lawsuit against the Regents of the University of California after he was allegedly publicly humiliated at an event several years ago. Dr. Head has filed a 40-page complaint, complaining UCLA failed to prevent discrimination, harassment and retaliation.
9. Avera McKennan in South Dakota Ordered to Pay $70k in Back Wages
Avera McKennan Hospital and University Health Center in Sioux Falls, S.D., was ordered by the U.S. Department of Labor to pay $70,157 in back wages to 487 current and former employees who were not properly compensated for breaks.
10. Two Sound Shore Hospitals in New York Settle Medicaid Overbilling Allegations
Sound Shore Medical Center in New Rochelle and Mount Vernon (N.Y.) Hospital agreed to a settlement of more than $2.3 million after an Attorney General investigation found the facilities allegedly overbilled Medicaid for physician-administered drugs. Under New York State law, hospitals and physicians are not permitted to make a profit on the drugs they administer. Hospitals are only to bill Medicaid for the price they paid for injectable drugs, not extra costs of physician administration.
11. Anticompetitive Lawsuit Against Scripps Health Heads to Trial
A 2009 lawsuit filed by Oceanside, Calif.-based Tri-City Healthcare District — alleging San Diego-based Scripps Health redirected patients from Tri-City's market to Scripps facilities — is headed to trial. Scripps tried to handle the case in arbitration, but the Fourth District Court of Appeal upheld a trial court ruling that Tri-City's anticompetitive claims are not subject to arbitration.
12. Tenet Agrees to $42.75M Settlement for Alleged Medicare Overbilling
Dallas-based Tenet Healthcare agreed to a $42.75 million settlement to resolve allegations that it overbilled Medicare for inpatient rehabilitation admissions. The alleged overbilling occurred from 2005 to 2007 at 25 Tenet inpatient rehabilitation units. The cash payment for the settlement — which is to be divided among the U.S. Attorney's Office, Northern District of Georgia and Depts. of Justice and Health and Human Services — will be paid in Tenet's second quarter 2012.
13. UPMC Hamot, Cardiologists Seek Dismissal of Whistleblower Suit
UPMC Hamot in Erie, Pa., and five affiliated cardiologists want a federal judge to dismiss a lawsuit alleging the providers performed unnecessary heart procedures and overbilled Medicare. The whistleblower suit was filed by former Erie cardiologist Tullio Emanuele, MD, and was made public in January. It claims the hospital allowed physicians to perform eight improper angioplasty procedures from 2001 to 2005 and bill Medicare for the services.
14. In Patent Dispute, Physician Claims Mass General Exec Said Hospital "Owns" His Brain
A physician has sued Massachusetts General Hospital in Boston and its parent, Partners HealthCare System, over who owns the rights to inventions developed in the physician's home workshop. Urological surgeon Joseph A. Grocela, MD, claims Frances Toneguzzo, the top official at Partners' licensing division, said the hospital "trained you, we pay you, we own your brain and therefore own all your ideas."
15. Whistleblower Suit Against Erlanger Medical Center in Tennessee is Dropped
A two-year-old whistleblower lawsuit claiming Chattanooga, Tenn.-based Erlanger Medical Center submitted false Medicare claims was dropped. The state of Tennessee and federal attorneys declined to move forward in the case, which stemmed from a suit filed by Lisa K. Stratienko in 2010. Ms. Stratienko claimed the hospital submitted a series of fraudulent Medicare claims linked to "improper agreements" with third-party physician groups.
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