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 …
Another Study Undercuts Physician-Owned Hospital Suspicions
September 4, 2015 Leave a Comment
Physician-owned hospitals cherry-pick well-insured patients, disfavor Medicaid and minority patients, and charge more that their nonprofit counterparts, right? Wrong, says a new study published on September 2 by respected BMJ (formerly, British Medical Journal). The study, “Access, Quality, and Costs at …
Court Rejects Claim that a Doctor’s Loss of Privileges is an Antitrust Injury
August 27, 2015 Leave a Comment
A federal appeals court held that a doctor who lost his privileges at a local hospital failed to establish an antitrust injury sufficient to confer standing under the Sherman Act. The United States Court of Appeals for the Third Circuit affirmed a district court ruling that Dr. Victor Novak could not show that he …
Free Patient Parking May Trigger False Claims Act Violation
August 20, 2015 Leave a Comment
Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick. That’s one of the lessons of an August 14 federal court decision in Florida. Whistleblower Thomas …
Hospital Chain Pays Heavy Price for Being Too Clever
August 12, 2015 Leave a Comment
Finding that Community Hospital Systems had been “too clever by half” in negotiating a global settlement agreement for seven whistleblower suits, a federal judge ordered the chain to pay the attorneys’ fees of all the whistleblowers—not just the first to file. That’s on top of the $97 million Community …
Court Adopts Tough Interpretation of 60-Day Repayment Rule
August 4, 2015 Leave a Comment
New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid overpayments, but an additional $13,000,000. Why $13,000,000? Well, $1,000,000 trebled is $3,000,000; the …