The Government Rests Its Case Against Forest Park

After a morning session on Wednesday, the government rested its case against Forest Park Medical Center. They allege that the for-profit, physician-owned medical center located near Forest Lane and Central Expressway conducted a bribery scheme where it sent payments to doctors to direct surgeries to their facility, resulting in around $200 million in insurance payments between 2009 and 2013. What began as 21 defendants has been whittled down to a weight-loss surgeon, three back surgeons, a pain management doctor, a former top executive and three others affiliated with the hospital, according to the Texas Lawbook. They all deny any wrongdoing,… Full Story

Department of Justice Alleges Unsanitary Conditions at Dallas-Based Guardian Pharmacy

The Department of Justice filed a complaint in U.S. District Court for the Northern District of Texas alleging that JMA Partners Inc., a compounding pharmacy doing business as Dallas-based Guardian Pharmacy Services, and their owner Jack R. Munn failed to rectify unsanitary conditions at their drug-compounding facility. The District Court for the Northern District of Texas entered a consent decree of permanent injunction which will stop the defendants from “distributing adulterated, misbranded, and unapproved new drugs in violation of the federal Food, Drug, and Cosmetic Act.” The defendants were allegedly distributing misbranded and unapproved drugs without patient-specific prescriptions. The complaint says the drugs were… Full Story

North Texas Hospital CEO Pleads Guilty to Millions in Fraud

Former Palo Pinto General Hospital CEO Harris Brooks pleaded guilty to defrauding BlueCross BlueShield of Texas, CIGNA Texas, and United Healthcare for millions of dollars, according to U.S. Attorney for the Northern District of Texas Erin Nealy Cox. An FBI investigation revealed that Brooks and his co-conspirators used the hospital’s in-network contracts with the insurance companies to defraud them for laboratory services from September 2017 to June 2018. They used a process called pass-through billing, where a physician orders a service but that physician does not actually complete the service for which he or she billed. They submitted claims for allergy… Full Story

Forest Park Founder Says They “Didn’t Hide Expectations” for $40 Million in Kickbacks

Forest Park Medical Center co-founder Wade Barker testified that the organization “didn’t hide expectations” from doctors and staff that the $40 million they received was for steering surgeries to the hospital, according to Law 360. Barker, a bariatric surgeon who pleaded guilty last fall, said that the payments were to get surgeons to operate at their facility, and that he knew what he was doing was illegal. Law 360 reports that Barker will be sentenced to 60-77 months in federal prison for the kickback scheme. Barker was the seventh of the 21 indicted individuals to plead guilty to being a part… Full Story

What You Might Not Know About Medicare

As Baby Boomers retire in greater and greater numbers, they often look to Medicare to provide their healthcare needs as they age. Navigating the web of Medicare plans can be arduous and time consuming, so here are some important things to know about enrolling. First, you are not enrolled in Medicare automatically. If you are not receiving Social Security benefits, then you have to enroll yourself. Secondly, Medicare is not free. While Medicare Part A (hospital stays, hospice, home health, and skilled nursing) is covered, Medicare Part B (outpatient doctor visits) will cost around $135 a month. It is automatically… Full Story

Local Lawmaker Introduces ‘Landmark Legislation’ to Fight Surprise Medical Billing in Texas

North Texas State Senator Kelly Hancock authored Senate Bill 1264 to address surprise billing in the state, prohibiting out-of-network providers from sending surprise bills when patients don’t have a real choice of provider. The bill will make patients responsible for applicable co-pays, coinsurance, and deductibles with no additional charges after mediation between the provider and health plan. Data from the Texas Association of Health Plans says that 30 percent of all ER physician services are out of network, even though 65 percent of those services occur at hospitals that are in network. Freestanding emergency rooms account for 83 percent of all out-of-network… Full Story

TMA President: “Our Vision for Improving the Health of All Texans”

With the 2019 Texas Legislature now well underway, the time is right to issue a stark reminder: Patient care in Texas is at a critical crossroads. Let us collaborate thoughtfully and purposefully to choose the right path forward and improve the health of all Texans. Among our concerns: Texas still ranks 47th nationally in active primary care physicians per 100,000 population. Not every Texan has timely access to affordable, quality lifesaving services. Not enough of our health care dollars are going to actual health care. Corporations are pressing harder to micromanage patient care decisions in an effort to boost profits.… Full Story

Convicted McKinney Surgeon Pleads Guilty to Additional Sexual Assault

McKinney orthopedic surgeon Donald Ozumba, 46, pleaded guilty to four additional sexual assault charges this week, after being convicted of assaulting an elderly patient last year and sentenced to 10 years in prison, according to the Dallas Morning News. The recent pleas will not increase the time he spends prison. According to DMN, a 71-year-old victim says Ozumba penetrated her with his finger while she was receiving steroid injection in 2016 at OSSM Orthopedics in McKinney. Ozumba was arrested in 2017 when a second woman reported the same behavior, DMN reports. His newest guilty pleas all resulted in eight year… Full Story

Texas Medical Board Suspends Orthopedic Surgeon for Missing Drug Tests

The Texas Medical Board has temporarily suspended a surgeon who formerly had privileges at area hospitals for failing to undergo drug and alcohol testing and testing positive two different times. The TMB says that Dr. Michael Francis O’Brien, an orthopedic surgeon, “poses a continuing threat to public welfare” if he continues in his practice. Past incidents impaired O’Brien, causing him to be put in a Texas Physician Health Program Monitoring and Assistance Agreement. When he missed his drug and alcohol tests, he violated the agreement. O’Brien had privileges at Children’s Health Plano Hospital from November 2015 to June 2017, but… Full Story

Bipartisan Texas Bills Go After “Unconscionable” Freestanding ERs

A bipartisan group of State Senators and Representatives, including local Democratic State Senator Nathan Johnson, filed legislation to allow the Texas Attorney General to address the unreasonable prices charged by freestanding emergency rooms. Johnson joined author Senator Kirk Watson, D-Austin and Representative Dade Phelan, R-Beaumont in filing legislation similar to an existing law that allows the AG to stop price-gouging for goods and services during natural emergencies and disasters. Freestanding ERs in the state represent 83 percent of all out-of-network emergency room services and end up costing Texans more than $3 billion a year in avoidable health care costs, which continues… Full Story