Health Care Lawyer Blog

A federal judge for the District of Las Vegas has ordered the University Medical Center to void a report made with the National Practitioner Data Bank (NPDB) against a physician whose privileges were suspended by the hospital’s medical staff.

The order resulted from a 2008 lawsuit filed by OBGYN Dr. Richard Chudacoff. In 2007, Chudacoff was granted staff privileges at the University Medical Center of Southern Nevada in the Obstetrics and Gynecology department. In April 2008, Chudacoff wrote an email to the OBGYN chair, expressing concerns over the skills of certain OBGYN residents that he supervised at the hospital. The email included several recommendations for improving the quality of care.

Several weeks later, Chudacoff received a letter from the hospital’s Chief of Staff stating the hospital’s Medical Executive Committee had “suspended, altered or modified his medical staff privileges.” Before Chudacoff could be afforded a Fair Hearing, the hospital filed a report with the NPDB stating that Chudacoff’s privileges had been “suspended indefinitely for substandard or inadequate care and substandard or inadequate skill level.” The report cited four cases where Chudacoff caused “serious operative complications during gynecological surgery,” one incident where Chudacoff failed to respond to a medical emergency, and numerous complaints of disruptive behavior.

After the jump - legal analysis

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The Troy, Michigan law firm of Frank Haron Weiner, PLC, in conjunction with the United States Department of Justice and the Texas Attorney General’s Office, today announced a settlement of $2,470,000, plus statutory attorney fees of $130,000, with the City of Dallas to resolve allegations of improper Medicare and Medicaid billings.

The settlement stems from a lawsuit filed by the firm in 2009 under the qui tam provisions of the federal False Claims Act and the Texas Medicaid False Claims Act. The federal False Claims Act (and similar state legislation, such as the Texas Act) allows private individuals with knowledge of fraud against the government to file lawsuits on the government’s behalf. If the case is successful, the private plaintiffs, known as “relators,” are entitled to a percentage of the monies recovered by the government.

Relator Douglas Moore’s complaint, filed in the U.S. District Court for the Northern District of Texas, alleged that from January 2006 to May 2010, the City of Dallas knowingly defrauded the Medicare and Texas Medicaid programs by improperly billing for certain ambulance transport services. Specifically, Moore alleged that the company hired by the City of Dallas to perform ambulance-service billing, Southwest General Services of Dallas, LLC, coded 100 percent of the City’s 911-dispatch ambulance transports at the Advanced Life Support (“ALS”) level, regardless of whether the patient’s medical condition justified the claim or if an ALS-level service was actually furnished. Relator alleged that many runs should have been coded and billed as basic life support (“BLS”), which is reimbursed at a lower rate by both Medicare and Medicaid. Accordingly, Moore alleged that the City received higher Medicare and Medicaid reimbursements than it was entitled to and was at all times aware of Southwest General Services of Dallas, LLC’s activities.

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