A hospice medical director was sentenced to four years in prison and ordered to pay $18 million for his role in submitting more than $150 million in bogus Medicare claims on behalf of patients he falsely claimed were near death.

Read more at: https://www.law360.com/personal-injury-medical-malpractice/articles/1726856?nl_pk=029cff45-637f-44e3-babf-75563f8e0bfd&utm_source=newsletter&utm_medium=email&utm_campaign=personal-injury-medical-malpractice&utm_content=2023-10-02&read_main=1&nlsidx=0&nlaidx=5?copied=1

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FOR IMMEDIATE RELEASE Wednesday, June 5, 2019 Opioid Manufacturer Insys Therapeutics Agrees to Enter $225 Million Global Resolution of Criminal and Civil Investigations

The post Insys $250M Opioid Penalty for Quality Fraud appeared first on The Thompson Law Firm.

Attorneys argued the hospital violated numerous internal policies by needlessly delaying a critically needed MRI scan and emergency surgery.

The jury found that the hospital was negligent and that the negligence caused the paralysis. This required the jury to evaluate and assess damages for the victim. In cases of this type, there are always two kinds of damages: economic and non-economic.

Economic damages are the financial losses, costs, and expenses caused by an injury. Economic damages normally include lost work time, salary, earnings, and benefits. Business owners might suffer replacement costs for lost time or ability. For injuries that prevent work, these lifetime costs can be significant. Economic damages also include medical and other costs and expenses incurred as a result of the injury – in the past and likely to be incurred in the future. Again, for serious injuries, these costs projected over a lifetime can be very significant – even where the future totals are reduced to present value.

Non-economic damages are the important but necessarily subjective “pain and suffering” damages also taken on by the victim as a result of the injury. Jurors are instructed by the judge on calculating any award of non-economic damages.

Studies of jury verdicts find an indirect but relevant relationship between economic and non-economic damages. Not surprisingly, juries tend to award more non-economic damages where they have been provided sufficient evidence of significant economic damages.

In Texas, a recent ten million dollar plus verdict included the future cost of caring for the paralyzed victim. To be awarded these economic damages, the jury is usually instructed that the costs of the injury and its treatment (past and future) must be “reasonable and necessary”. In a case like this, those costs would necessarily involve medical as well as support care expenses, including modifications to the victim’s home and vehicles and the repairs and maintenance that come with those modifications.

Not surprisingly, the non-economic damage award was also very significant.

Here is the link to the story out of Texas.

Texas Jury Returns $10M+ Medical Malpractice Verdict For Paralyzed Patient, Beating Hospital’s $450K Settlement Offer

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In 2018, the state filed a complaint against J&J, alleging the company misrepresented their opioids as safer than other alternatives in their aggressive marketing campaign to prescribers and patients in New Hampshire. The state further alleged that J&J misrepresented their opioids as rarely addictive, negligently promoted the concept of pseudoaddiction, and disseminated of misleading statements regarding their opioids.

The link is here:

New Hampshire Announces J&J Opioid Settlements

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These kinds of verdicts are awarded against defendants with both good and bad reputations. Each case is determined on its own merits. Which is how it should be. A child with devastating cerebral palsy or an adult on life support shouldn’t be shortchanged just because a lobbyists persuaded a legislature to pass “tort reform”.

Here is an example of a trusted institution in a community being found responsible in such a case. That is a jury doing its job.

Baltimore Jury Awards Record $229 Million in Johns Hopkins Malpractice Case

The post Large Verdicts: The Most Vulnerable Victims Are Most Affected By Caps and Delays appeared first on The Thompson Law Firm.

Prosecutors say Omidi incentivized employees to make sure patients received sleep studies and then falsified the results to show that patients had obstructive sleep apnea.

Here is the story in the LA Times on what started with a billboard campaign across Los Angeles.

Former doctor, company behind 1-800-GET-THIN found guilty of fraud

The post One Doctor’s $355M #QualityFraud: Lap Band Surgeries appeared first on The Thompson Law Firm.

Stark, Quality Fraud, and CMS

CMS is trying to change some of that and the new rules are beginning to go into effect. One of those rules allows to consumers to comparison shop medical billing and reimbursement practices. Here is the link to the CMS page:

CMS Announcement of Medical Expense Transparency for US Consumers

The new rules are far broader than those that went into effect last year requiring hospitals to post their negotiated rates for the public to see. Now insurers must post the amounts paid for “every physician in network, every hospital, every surgery center, every nursing facility,” said Jeffrey Leibach, a partner at the consulting firm Guidehouse.

“When you start doing the math, you’re talking trillions of records,” he said. The fines the federal government could impose for noncompliance are also heftier than the penalties that hospitals face.

The post A Health Care Cost Price Comparison Tool From CMS appeared first on The Thompson Law Firm.

This study in the stroke context suggests we have a lot of work to do in making rehab more effective. The analysis would seem to apply in any setting, from car accident victims to brain-damaged babies.

Patients should have the opportunity to demonstrate rehabilitation potential by participation in therapy. As therapy resources are limited and responses to therapy may be context-dependent, early decisions about a lack of potential should not limit longer-term opportunities for rehabilitation.

Here is the link.

What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services

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All government programs get an acronym and the acronym for this burden-shifting agency is NICA (The Florida Birth-Related Neurological Injury Compensation Association). As anyone would have anticipated, it turned into a racket for politicians with little notion of the issues (despite the enormous implications to these vulnerable kids and families).

If you log onto the NICA site here,  you’ll be told that “NICA ensures birth-injured children and adults receive the care they need while reducing the financial burden on medical providers and families.” This kind of gaslighting is too prevalent in politics today. The sole purpose of NICA is and has always been to shift the enormous cost of medical errors occurring at birth. The legislature did not want these kids to have the same right to a jury trial (protected by the state and federal constitutions) that other injured Floridians enjoy.

The cost of brain injury caused by medical error amounts to tens of millions of dollars per child. If all you care about is unloading that cost from the healthcare and insurance companies that would be responsible for those damages, you wouldn’t really care that the cost got shifted off on the public trough. That was the result of NICA: Families of brain-damaged children have limited legal remedies (without top-notch legal help and brave judges). Here is the link,

A Program Promised to Pay for Brain-Damaged Infants’ Care. Then It Sent Families to Medicaid Instead.

Perhaps embarrassed by the cruelty of this scheme, the Legislature slowly began making exceptions for some families that managed to fight their way through the bureaucracy. That has happened more than once lately, reflecting the hint of movement toward acknowledging the catastrophic error of locking these kids out of court in the first place. Links to those small moves of remorse are found

here

and

here

These token payments – fought for valiantly by families and their lawyers – don’t begin to cover the costs necessary to take care of all the children with catastrophic neurological injuries caused by medical error.

With other Florida trial lawyers, I am working to get these children and their families around this inequitable regulatory scheme.

The post On Top Of Locking Many Brain Damaged Children Out Of Court, Florida Begins Gaslighting Them appeared first on The Thompson Law Firm.

“Today, medical science recognizes
That some folks aren’t helped by relaxing exercises.
In cases of difficult tension,
And nervous apprehension,
Doctors are now prescribing medicine.
It makes those who fear they’re about to quit
Feel like they’re ready to begin.
Bidding their darkened spirits goodbye
For the calming peace of a cloudless sky.”

Everclear, Ataraxia

Every tragic exploitation in our markets contains layers. Layers upon layers of profit made from “interested parties” who wet their beaks in the trough of cash bled out of the pain and suffering inflicted from labs and board rooms far away from the rural communities they wrecked.

The Opioid Saga Continues: America’s Big Pharmacies Are Under Court Scrutiny This Time

From the periodical, Risk & Insurance

The post Normal Like You (More Opioid Fallout: Pharmacies Are Next On The List) appeared first on The Thompson Law Firm.