The following lawsuits, settlements, court decisions or other legal developments involving healthcare providers were reported within the past month, beginning with the most recent.
1. Ex-Sacred Heart CEO Questions Prosecutors' Evidence in Kickback Case
Edward Novak, the indicted former owner and CEO of Chicago-based Sacred Heart Hospital, is arguing evidence gathered in an April 2013 search of the facility should be suppressed due to the alleged questionable credibility of federal prosecutors' key cooperating witness, whose testimony helped prosecutors obtain the search warrant. Also related to that case: A federal grand jury indicted a physician whom federal prosecutors say was a key player in a kickback scheme at Chicago-based Sacred Heart Hospital, six months after authorities dropped charges against him.
2. West Penn Allegheny Health System to Pay $1.5M to Settle Kickback Allegations
Pittsburgh-based West Penn Allegheny Health System agreed to pay the government $1.5 million to settle False Claims Act allegations. The government filed a complaint alleging the health system leased space to physicians at below-market rates to induce referrals of patients to WPAHS, in alleged violation of the Anti-Kickback Statute and Stark Law.
3. Memorial Hospital in Ohio Pays $8.5M to Settle Kickback Allegations
Memorial Hospital in Fremont, Ohio, agreed to pay the government $8.5 million to settle allegations that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute by engaging in improper financial relationships with referring physicians.
4. Novant Health Accused of Charging Millions in Excessive Fees on Retirement Plans
A class-action lawsuit was filed against Novant Health, alleging the healthcare provider charged excessive fees for its defined-contribution retirement plan. The suit was filed in the U.S. District Court for the Middle District of N.C. in Greensboro by the St. Louis-based law firm of Schlichter, Bogard & Denton. Included in those bringing the lawsuit are six current and former employees of Novant.
5. 12 Hospital Settlements Involving Patient Dumping in 2013
A dozen hospitals agreed to pay fines as part of settlements related to patient dumping last year. According to the HHS Office of Inspector General, each settling hospital contested the allegations and denied liability. Fines range from $20,000 to $50,000.
6. St. Luke's, Saltzer Medical Group Want to Maintain Ties During Appeal Process
Boise, Idaho-based St. Luke's Health System and Saltzer Medical Group in Nampa, Idaho, filed a motion to maintain their relationship while they pursue an appeal of a January decision that found their relationship violated antitrust laws.
7. Family of Woman Found Dead in Stairwell Files Claim
The family of Lynne Spalding, the patient who was found dead in a stairwell at San Francisco (Calif.) General Hospital in October, filed a claim against the city this month. San Francisco had 45 days from the filing of the claim to respond, and the claim will lead to a lawsuit if rejected.
8. Lawsuits Allege 500 Patients Received Unnecessary Heart Procedures
Two lawsuits were filed against King's Daughters Medical Center in Ashland, Ky., alleging physicians performed heart procedures on 500 patients that were "medically unnecessary and harmful." The lawsuits name the hospital, several medical practices and Richard E. Paulus, MD, as defendants.
9. Lawsuit: Now-Closed Los Angeles Metropolitan Medical Center Conspired to Fill Beds
A lawsuit alleges that administrators at a now-closed Los Angeles hospital owned by Pacific Health Corp. conspired with a group of physicians for a Medicare and Medicaid kickback scheme. The suit was filed in federal court in Los Angeles by a registered nurse who formerly worked in the psychiatric evaluation unit at Los Angeles Metropolitan Medical Center. Her lawsuit was originally filed in early 2012, but held under seal until early March.
10. Just Before Trial Begins, Halifax Health Settles First Part of Fraud Case
Daytona, Beach. Fla.-based Halifax Health settled the first portion of a whistle-blower suit earlier this month on the same day trial was slated to begin in Orlando. Halifax and Halifax Staffing agreed to pay $85 million. Potential damages and penalties in the suit are expected hit $1 billion, making it one of the largest Medicare fraud cases of its kind and one closely watched by hospitals and legal experts. The second portion of the trial will begin in July.
11. Erlanger Files Federal Suit to Recover $20M Provided in Aid to Hutcheson Hospital
Chattanooga, Tenn.-based Erlanger Health System filed a federal lawsuit to recover the $20 million it allegedly issued Hutcheseon Medical Center under a previous management agreement.
12. 7 Hospital Settlements Involving Physician Kickbacks, Referrals in 2013
Seven hospitals agreed to pay fines in 2013 as part of settlements related to physician self-referral and kickback allegations. The hospitals self-disclosed their conduct to the HHS Office of Inspector General, and the settlement amounts range from $50,000 to $510,000.
13. AHA: CMS' Policy for Observation Status Policy is "Unsustainable"
The American Hospital Association filed a friend-of-the-court brief late last month, arguing that CMS' stance on observation stays is "unsustainable" and puts hospitals in an "untenable position." The AHA filed the brief in response to a case, brought by Medicare beneficiaries, challenging CMS' use of observation status.
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