California Physician Loses at Dating Game

A California appellate court has declared physician Visha Dev the loser in his dating contest with Blue Shield Life and Blue Shield California.  The contest arose when the Blues moved for summary judgment in Dev’s action against them for denying three reimbursement claims.  The Blues argued that the date when …

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A Grossly Negligent Claim Isn’t a False Claim

You have to feel sorry for whistleblower Darilyn Johnson.  The former billing clerk thought she had a sure-fire, double-barrel False Claims Act (FCA) case against the medical clinic that fired her. Barrel one was her basic FCA case.  Darilyn could prove that when the allergy clinic filled out its Medicare …

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7th Cir. Won’t Let EEOC Skip Pre-Suit Conciliation

When CVS fired store manager Tonia Ramos in 2011, it offered her its standard severance agreement that included a broad release of waivable claims, including claims under Title VII, but explicitly preserving the right to participate in any proceeding enforcing discrimination laws.  Tonia signed.  A month later …

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Health Facilities May Be Insuring Doctors without Knowing It

A September 29 ruling by the New Jersey Supreme Court effectively makes a health facility liable for the professional negligence of a medical staff member who doesn’t have malpractice insurance or who has insurance that doesn’t cover the acts in question. Dr. Kaul performed a spinal fusion on Jim Jarrell at …

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Suing the Hand that Feeds You

Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group.  Jeff should know because he was recruited under one of the contracts and worked for the group for three years. According to the …

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Third Cir. Holds Hospitals May Sue Health Insurers Directly

Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to cover patient obligations. So back in 2014 when North Jersey Brain & Spine Center …

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