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Docs Hit With Price-Fixing Charges; $4M for Missed Strep Dx; Prison for X-Ray Fraud

<ѻý class="mpt-content-deck">— A weekly roundup of healthcare's encounters with the courts
MedpageToday
Legal Break over a blindfolded Lady Justice statue holding scales.

An independent physician association in New Mexico will pay the Federal Trade Commission $263,000 to settle charges that it violated an . In 2005, San Juan IPA settled allegations that its member doctors set prices that they would accept from health plans, which resulted in higher prices for medical services for consumers, according to the agency.

A couple from Iowa will get $4 million after several providers in their 2-year-old son in 2018, leading to his death. (The Gazette)

Laguna Hills, California doctor Mohamed El-Nachef, MD, pleaded guilty to defrauding Medi-Cal by to more than 1,000 beneficiaries. He didn't give the medications to those patients, but instead diverted them to the illicit market for cash. (Los Angeles Times)

A New Jersey man has agreed to stay away from a reproductive health clinic where, in October 2021, he used on two occasions, according to the Department of Justice (DOJ).

Former nurse practitioner Larry Goisse Jr. pleaded guilty to continuing to and submitting claims to Medicare for office visits under a co-worker's license after his own was suspended, the DOJ reported.

The president of a company that provided portable x-ray services to nursing home residents was sentenced to 15 years in prison for that his company never provided, according to the DOJ.

Christopher Bjarke, MD, of Renton, Washington, entered a guilty plea for his role in a who weren't his patients. He only spoke with them on the phone for a few minutes via a telemarketer, after which Medicare was billed for the test and a telemedicine visit. Bjarke made about $168,000 in kickbacks, the DOJ reported.

The Supreme Court to CMS' vaccine mandate. In January, the Court backed the mandate -- which applied to healthcare facilities receiving Medicare or Medicaid funding -- in its decision in Biden v. Missouri. But in May, those 10 states petitioned for a writ of certiorari, which the Supreme Court just declined to grant. (Becker's Hospital Review)

The Hospital for Special Surgery in New York City has sued HHS for allegedly by more than $50 million during the height of the pandemic. (Bloomberg Law)

A federal judge ruled that HHS for 340B hospitals' drug costs. In June, the Supreme Court ruled that the agency couldn't vary the program's reimbursement as it had done in 2018. At the time, HHS said it would follow through on the order in 2023, but the latest ruling forces the agency to act right away. (Becker's Hospital Review)

A Maryland physician with a suspended medical license due to recent allegations of sexual misconduct was killed and dismembered. His son has been . (Baltimore Sun)

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    Kristina Fiore leads ѻý’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.