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Over seven years, Dr. Greenspan referred more than 100,000 blood tests to Biodiagnostic Laboratory, which made more than $3 million off these tests. In exchange, the Lab gave Greenspan and his associates more than $200,000 in cash, gifts, and other benefits. A jury convicted Greenspan of accepting kickbacks, 42 U.S.C. 1320a-7(b)(1)(A); using interstate facilities with the intent to commit commercial bribery, 18 U.S.C. 1952(a)(1), (3); honest-services wire fraud, 18 U.S.C. 1343, 1346; and conspiracy to do all of those things. The Third Circuit affirmed, characterizing the evidence of his guilt as overwhelming. The district court erred in instructing the jury that Greenspan had to “demonstrate” the prerequisites for an advice-of-counsel defense; in excluding as hearsay some of his testimony about that legal advice; in asking only Greenspan’s counsel, not Greenspan personally, whether he wished to speak at sentencing; and in limiting the scope of the defense to five particular agreements rather than all eight, but all of those errors were harmless. The court properly excluded evidence that the blood tests were medically necessary. That evidence was only marginally relevant and risked misleading the jury. View "United States v. Greenspan" on Justia Law

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The Fifth Circuit affirmed the district court's decision to affirm the revocation of two physicians' Medicare privileges. The court held that the physicians billed for services using their own Medicare National Provider Identifiers without providing direct supervision while traveling outside of the country; the ALJ's summary judgment dismissal of the physicians' claims was supported by substantial evidence; the physicians' constitutional claims were rejected; the court agreed with its sister circuits that have determined that participation in the federal Medicare reimbursement program is not a property interest; and the court deferred to CMS's decision to bar the physicians from re-enrolling in the Medicare program for three years. View "Shah v. Azar" on Justia Law

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Ace, a licensed physician, and Lesa Chaney owned and operated Ace Clinique in Hazard, Kentucky. An anonymous caller told the Kentucky Cabinet for Health and Family Services that Ace pre-signed prescriptions. An investigation revealed that Ace was absent on the day that several prescriptions signed by Ace and dated that day were filled. Clinique employees admitted to using and showed agents pre-signed prescription blanks. Agents obtained warrants to search Clinique and the Chaneys’ home and airplane hangar for evidence of violations of 21 U.S.C. 841(a)(1), knowing or intentional distribution of controlled substances, and 18 U.S.C. 1956(h), conspiracies to commit money laundering. Evidence seized from the hangar and evidence seized from Clinique that dated to before March 2006 were suppressed. The court rejected arguments that the warrants’ enumeration of “patient files” was overly broad and insufficiently particular. During trial, an alternate juror reported some “concerns about how serious[ly] the jury was taking their duty.” The court did not tell counsel about those concerns. After the verdict, the same alternate juror—who did not participate in deliberations—contacted defense counsel; the court conducted an in camera interview, then denied a motion for a new trial. To calculate the sentencing guidelines range, the PSR recommended that every drug Ace prescribed during the relevant time period and every Medicaid billing should be used to calculate drug quantity and loss amount. The court found that 60 percent of the drugs and billings were fraudulent, varied downward from the guidelines-recommended life sentences, and sentenced Ace to 180 months and Lesa to 80 months in custody. The Sixth Circuit affirmed, rejecting challenges to the constitutionality of the warrant that allowed the search of the clinic; the sufficiency of the evidence; and the calculation of the guidelines range and a claim of jury misconduct. View "United States v. Chaney" on Justia Law

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The Supreme Court reversed the judgment of the circuit court entered on the jury's verdict finding that Davis Life Care Center (DLCC), a long-term care facility, was not entitled to charitable immunity and denying DLCC's motion for new trial, holding that the circuit court erred in submitting the charitable-immunity question to the jury. Plaintiff sued DLCC alleging negligence, medical malpractice, breach of an admission agreement, and other causes of action. DLCC filed a motion for summary judgment claiming entitlement to charitable immunity. The circuit court granted the motion. The court of appeals reversed and remanded for further proceedings, concluding that reasonable persons could reach different conclusions based on the undisputed facts presented. The circuit court submitted the question of charitable immunity to the jury, which returned a verdict against DLCC. The Supreme Court reversed, holding that the issue of charitable immunity is a question of law for the court, rather than the jury, to decide. View "Davis Nursing Ass'n v. Neal" on Justia Law

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Kentucky’s “Ultrasound Informed Consent Act,” KRS 311.727, directs a doctor, before performing an abortion, to perform an ultrasound; display the ultrasound images for the patient; and explain, in the doctor’s own words, what is being depicted. There is no requirement that the patient view the images or listen to the description. The doctor also must auscultate the fetal heartbeat but may turn off the volume if the patient requests. The Act does not penalize a doctor if the patient requested that the heartbeat sound be turned off or chose not to look at the ultrasound images or if the doctor makes any other statement, including advising a patient that she need not listen to or view the disclosures, or that the patient should have an abortion. A doctor need not make any disclosures if an abortion is medically necessary or in a medical emergency. Doctors brought a First Amendment challenge. The district court permanently enjoined enforcement of the Act. The Sixth Circuit reversed, citing the Supreme Court’s 2018 decision, National Institute of Family & Life Advocates, clarifying that no heightened First Amendment scrutiny should apply to abortion-informed-consent statutes. Even though an abortion-informed-consent law compels a doctor’s disclosure of certain information, it should be upheld so long as the disclosure is truthful, non-misleading, and relevant to abortion. View "EMW Women's Surgical Center P.S.C. v. Beshear" on Justia Law

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Acting as the personal representative of his father’s estate, plaintiff Dennis Sloan brought a medical negligence action against defendants Providence Health System-Oregon and Apogee Medical Group, P.C. Plaintiff claimed defendants were negligent in their care of plaintiff’s father because they failed to diagnose and treat the father's rib fractures and internal bleeding. On November 3, the father, then 85 years old, came to Providence’s hospital after falling at home and was initially treated at the emergency room. He was later admitted to the hospital, where he was treated by Apogee’s doctors. On November 7, Apogee’s doctors discharged Sloan to a skilled nursing facility, Three Fountains. On November 17, Sloan’s condition worsened significantly. Two days later, Three Fountains returned Sloan to the hospital. At the hospital, Sloan was found to have multiple displaced rib fractures and bleeding in his right chest cavity, which had caused his right lung to collapse. Later that same day, Sloan died of respiratory failure due to the bleeding in his chest cavity and the collapse of his lung. Plaintiff claimed the trial court erred in refusing to give his requested jury instruction concerning a tortfeasor’s liability for the subsequent conduct of another. The Court of Appeals agreed and reversed the trial court’s judgment in part and remanded the case to the trial court for a new trial. On defendant’s petition, the Oregon Supreme Court granted review of the appellate court's judgment, and finding no reversible error, affirmed the Court of Appeals decision, which reversed the trial court’s judgment in part. The case was remanded for a new trial. View "Sloan v. Providence Health System-Oregon" on Justia Law

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The Alaska Department of Health and Social Services required most healthcare facilities to document the need for proposed services before the state approves construction of a new facility. The agency determined that an ambulatory surgical facility seeking to relocate from Anchorage to Wasilla did not need to submit such documentation because it was moving within the same community as defined by the relevant statute. Competing medical facilities in the Matanuska-Susitna Borough objected to the determination, arguing that Anchorage and Wasilla were not the “same community” and that the proposed relocation required the usual certification of need. Because Anchorage and Wasilla were not the same community as contemplated by the statute, the Alaska Supreme Court reversed the determination that the facility was exempt from the required certification process. View "Alaska Spine Center, LLC v. Mat-Su Valley Medical Center, LLC" on Justia Law

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In this Kansas Sexually Violent Predator Act (KSVPA) case, Kan. Stat. Ann. 59-29a01 et seq., the Supreme Court remanded Thomas Easterberg's action seeking a petition for writ of habeas corpus, holding that there was a fact question for the district court to resolve in order to determine whether Easterberg's writ should be granted. Easterberg pled guilty to kidnapping and aggravated battery. On the sentencing guidelines journal entry of judgment for these convictions, the district court indicated that Easterberg's crimes were not sexually motivated for purposes of the Kansas Offender Registration Act, Kan. Stat. Ann. 22-4902(c)(14). Thereafter, the Attorney General's Office filed a petition seeking to involuntarily commit Easterberg as a sexually violent predator. Easterberg moved to dismiss the action, arguing that the State had no statutory basis to file the petition for his commitment. The district court denied the motion to dismiss. Easterberg then filed this original action. The Supreme Court remanded this case to the district court for a determination of whether the issue of sexual motivation was litigated in Easterberg's criminal case. If so, the State would be estopped from relegating that point in the KSVPA proceeding and Easterberg would not be eligible for involuntary commitment. If not, the KSVPA proceeding would continue. View "In re Care & Treatment of Easterberg" on Justia Law

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The Eighth Circuit denied Wal-Mart's petition for review of OSHA's citation for two purported violations of the Occupational Safety and Health Act's regulation relating to bloodborne pathogens. OSHA alleged that Wal-Mart failed to comply with regulations pertaining to providing hepatitis B vaccinations to employees who voluntarily served on a Serious Injury Response Team (SIRT) at Wal-Mart's Alachua, Florida, distribution center. The court held that substantial evidence supported the ALJ's finding that the collateral duty exception did not apply in part because SIRT employees did not respond to workplace injuries "generally at the location where the incident occurred" as subparagraph b. of the Occupational Exposure to Bloodborne Pathogens Enforcement Procedures required. The court also held that substantial evidence supported the ALJ's decision to uphold Citation One where Wal-Mart did not provide four SIRT members with the third dose of the vaccine. Furthermore, substantial evidence supported the ALJ's decision to uphold Citation Two, and the ALJ did not err by finding that Citation Two was a repeat violation, where Wal-Mart failed to articulate through record evidence how the failure to offer the hepatitis B vaccine to the SIRT employees resulted in a different hazard than occurred from the failure to offer the vaccine to the retail store employees in 2012. View "Wal-Mart Stores East, LP v. Acosta" on Justia Law

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Blue Valley Hospital, Inc., (“BVH”) appealed a district court’s dismissal of its action for lack of subject matter jurisdiction. The Department of Health and Human Services (“HHS”) and the Centers for Medicare and Medicaid Services (“CMS”) terminated BVH’s Medicare certification. The next day, BVH sought an administrative appeal before the HHS Departmental Appeals Board and brought this action. In this action, BVH sought an injunction to stay the termination of its Medicare certification and provider contracts pending its administrative appeal. The district court dismissed, holding the Medicare Act required BVH exhaust its administrative appeals before subject matter jurisdiction vested in the district court. BVH acknowledged that it did not exhaust administrative appeals with the Secretary of HHS prior to bringing this action, but argued: (1) the district court had federal question jurisdiction arising from BVH’s constitutional due process claim; (2) BVH’s due process claim presents a colorable and collateral constitutional claim for which jurisdictional exhaustion requirements are waived under Mathews v. Eldridge, 424 U.S. 319 (1976); and (3) the exhaustion requirements foreclosed the possibility of any judicial review and thus cannot deny jurisdiction under Bowen v. Michigan Academy of Family Physicians, 476 U.S. 667 (1986). The Tenth Circuit disagreed and affirmed dismissal. View "Blue Valley Hospital v. Azar" on Justia Law