Professional Review Activity or Professional Review Action?

Was the Louisville hospital’s restriction of Dr. Ben Reid’s surgery privileges a professional review activity or a professional review action? When Ben sued on various tort theories, the hospital claimed immunity under the Health Care Quality Improvement Act (HCQIA) and moved for judgment on the pleadings. …

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Texas Dentistry Regulation Has No Teeth

A divided Fifth Circuit has affirmed a lower court ruling that an advertising restriction promulgated by the Texas State Board of Dental Examiners violates the First Amendment rights of the plaintiff dentists. The Texas regulation prohibited dentists from advertising as specialists except in the nine areas …

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Twelve-Year Sentence for Medicaid Diaper Scam

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas Medicaid for diapers and other incontinence supplies that were never provided, or never …

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Iowa Supreme Court Recognizes Wrongful Birth Action

On June 2 the Iowa Supreme Court expressly recognized the right of parents to sue for wrongful birth. Pam and Jeremy Plowman allege the following: Pam underwent ultrasound in week 22 of her pregnancy. The radiologist’s report noted fetal head abnormalities and recommended follow-up. But her OB/GYN told her …

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Last Rites for ER Doctor’s EMTALA Claims

ER physician Ryan Kime believed his hospital lacked the resources, procedures, and capacity to meet the requirements of EMTALA, and he repeatedly said so. At an ER meeting he reported two cases as possible EMTALA violations but supplied no details. Because of the ER’s unacceptable wait time, some patients …

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Co-Winners of May’s Low-Return Fraud Award

We have a tie! Danielle Burroughs and Tim Arthur are co-winners of the Low-Return Fraud Award for the month of May. On May 30 a federal court ordered Danielle to pay a whopping $2.8 million in restitution for her role in a health care con that according to prosecutors paid her only $191,000. That means she owes …

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