Category Archives: Healthcare Liability

Clay J. Countryman and Alec Alexander to Present at 2015 Physicians Legal Issues Conference

Clay J. Countryman and Alec Alexander, partners in the firm’s Healthcare Group will give presentations at the Physicians Legal Issues Conference to be held June 10-12, 2015 at the Palmer House Hilton in Chicago, IL. The Physicians Legal Issues Conference is co-sponsored by the American Bar Association Health Law Section, Chicago Medical Society and the American Association for Physician Leadership®.  Mr. Countryman is Co-Chair of the conference and he will present as part of a panel on a session titled, “Community Clinics and Pharmacies: Opportunities for Physicians and Attorneys to Work Together” on June 11.  Mr. Alexander will be presenting on a panel for a session titled “Navigating the Perilous Waters of the False Claims Act From Medical Necessity to the Anti-Kickback Statute and Beyond” on June 11.

Alexander, Alec headshot     Countryman, Clay headshot
Alec Alexander                      Clay Countryman

 

Criminal Cyberattacks Against Health Care Providers Are On the Rise

A recent study by Ponemon Institute, the Fifth Annual Benchmark Study on Privacy and Security of Healthcare Data, concluded that the majority of data breaches are not accidental, but intentional.  These cyberattacks against health care providers cost the U.S. health care system $6 billion a year.  According to the report, the average cost of a data breach for healthcare organizations is more than $2.1 million, and the average cost of a data breach for business associates is more than $1 million. Continue reading

$1,000,000 Fine Imposed for Incorrect In-network Information

In a letter from the Centers for Medicare & Medicaid Services (“CMS”) Medicare Parts C and D Oversight and Enforcement Group issued on April 2, 2015, CMS imposed a civil money penalty of $1,000,000 on health insurer, Aetna, Inc. The $1,000,000 fine was based on Aetna’s “failure to disseminate clear and accurate information regarding the number, mix, and distribution (addresses) of network pharmacies from which enrollees may obtain covered Part D drugs,” which CMS found violated obligations imposed by  42 C.F.R. § 423.128(a)(2) and 42 C.F.R. § 423.509(a)(2). Continue reading

Can Healthcare Provider Employers Pay Employees Bonuses Under the AKS?

A $20M lawsuit filed in Florida against the AIDS Healthcare Foundation raises questions about whether healthcare employers can bonus their employees for generating business (marketing) under the anti-kickback statute.  Several whistleblower employees claim that the company inappropriately incentivized/bonused employees for patient referrals.  Employees were allegedly paid $100 for referring patients who tested positive to the company’s clinics and pharmacies.  The company asserts that not only has it done nothing wrong, but that its pro-active approach is critical to stopping HIV in this country.  The government has not intervened in the suit.  See the Associated Press article available HERE for more details.

Link: http://hosted.ap.org/dynamic/stories/U/US_HIV_MEDICARE_SCAM?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2015-04-09-01-42-46

Written by: Emily Grey

Grey, Emily headshot

 

Does a Hospital Have a Brady Obligation to Turn Over Exculpatory Evidence?

A recent decision by the United States Court of Appeals for the Tenth Circuit answered whether hospitals under state contract have Brady obligations. Established by the Supreme Court decision of Brady v. Maryland, a Brady obligation imposes on government agents the duty to turn over exculpatory evidence to a requesting criminal defendant.  373 U.S. 83, 83 S. Ct. 1194 (1963). In Tiscareno v. Frasier, the Tenth Circuit held that a hospital did not have an actionable Brady obligation because there was no clearly established constitutional obligation of the hospital to locate and disclose the exculpatory evidence to the criminal defendant. No. 13-4156, 2015 WL 735668, at *1 (10th Cir. Feb. 23, 2015). Continue reading

A Broader Definition of “Referral” for Anti-Kickback Violations

In U.S. v. Patel, whether a violation of the Anti-Kickback Statute was present depended on the United States Court of Appeals for the Seventh Circuit’s interpretation of the term “referring,” a term not specifically defined in the statute.  2015 WL 527549 (7th Cir. 2/10/15). The Seventh Circuit considered whether Dr. Kamal Patel had “referred” patients to a home health care provider in violation of the Anti-Kickback statute when Dr. Patel signed Form 485 certifications and recertifications for his patients, though did not recommend a specific home health care provider, in exchange for cash. Continue reading

Medical Malpractice Liability for Management Companies

When can a company that manages a hospital be liable for the medical malpractice of the institution and its physicians?  According to one recent New Mexico decision, when its agents knew of pattern of sub-standard conduct and didn’t act to address it.  The case involved one physician performing experimental surgery on over 100 patients over a period of years.  The decision allowing the claim against the manager was rendered in the hospital’s bankruptcy proceeding, which it filed in an attempt to survive the patients’ claims. Review this article on Insurance News Net for a more complete discussion.

Written by: Greg Frost

Frost Gregory headshot

 

The Intersection of HIPAA and Negligence: Pharmacist’s Violation Cost Walgreens $1.44 Million

On November 14, 2014, the Court of Appeals of Indiana affirmed a $1.44 million judgment against Walgreens Company based on a HIPAA violation committed by a Walgreens pharmacist. Walgreen Co. v. Hinchy, 2014 WL 6130795 at *1 (Ind. Ct. App. 2014). In Walgreen Co. v. Hinchy, Walgreens’ pharmacist Audra Withers looked up the prescription information of Walgreens’ customer Abigail Hinchy. Withers then used the prescription information of Hinchy for personal reasons, which allegedly included allowing Withers’ husband to use the private information to pressure Hinchy into not asking Withers’ husband for child support. Upon figuring out how Withers’ husband obtained the private information, Hinchy contacted Walgreens’ regional office to report the matter.

During the investigation, Withers admitted to purposely accessing the information for personal use. Walgreens confirmed to Hinchy that a HIPAA violation had occurred. Id. Per Walgreens, “Withers received a written warning and was required to retake a computer training program regarding HIPAA.” Continue reading