August 20, 2013:  Medicare Fraud & Medical Malpractice makes national news

A huge Medicare Fraud case made news on August 13, 2013; Dr. Farid Fata, a cancer specialist in the Detroit Michigan-area, was charged by federal prosecutors with fraudulently billing Medicare over $35 million in claims over a two-year period. Dr. Fata, being held on $9 million bail, is accused of deliberately misdiagnosing patients who did not have cancer, or who were in remission, or who were terminal end-of-life cases, and knowingly ordering chemotherapy and other expensive treatments he knew would not benefit them. While this story plays out in Michigan, it will be followed closely by the legal community throughout the country and  specifically for implication on Pennsylvania Medical Malpractice  law as well.

Dr. Fata’s case will begin in the criminal court system  for which, the standard of proof is beyond a reasonable doubt, a much higher standard than in civil suits. In civil cases, the standard of proof is preponderance of the evidence, which means the allegations are more likely to be true than not true, or, in some instances, by clear and convincing evidence. In the Dr. Fata case, the subsequent civil suits will benefit if he is found guilty of these criminal counts; this is because civil courts recognize criminal verdicts. It is likely that Dr. Fata will subsequently face a slew of Medical Malpractice claims from patients families whom he is alleged to have misdiagnosed and ordered unnecessary chemo therapy for.

The basics of  Pennsylvania Medical Malpractice

To bring a civil medical malpractice suit, the doctor or hospital must deviate from an acceptable medical standard of care and the patient must suffer harm (causing or worsening a condition, or resulting in death) as a result of these actions. A doctor or healthcare professional can be sued for negligence, or for a lack of informed consent. A hospital, HMO or nursing home can be sued for:  direct liability for policies, actions or inactions of the institution; or, for indirect liability for the actions of an employee it knew or reasonable should have known about.

Under these categories, there are many types of cases – failure to diagnose or incorrect diagnoses; medication overdose or pharmacy errors; surgical or emergency room errors; birth injuries; brain injuries; or, nursing home negligence – to name a few.

In Pennsylvania, it is increasingly difficult to pursue medical malpractice claims.  Many attribute this to reform legislation passed in 2002 to 2005. These reforms have instituted, among other things, the requirement of Certificates of Merit.  This means that an expert testimony by a specialist in the same or related field must certify that the medical practitioner deviated from an acceptable standard of care and that these actions caused harm to the patient. In Pennsylvania, medical malpractice suits have decreased over the past 10 years – down almost 45 percent since 2000-2002, however, this should not deter you from having a lawyer look over your case if you feel that you or a loved one have suffered harm due to possible Pennsylvania Medical Malpractice.

If you or a loved one have suffered harm as the result of medical malpractice, consult with an attorney immediately; time is of the essence, a through review of  the facts and all the medical reports, likely by a medical expert will be needed to determine the viability of your potential medical malpractice claim. It is important to find a legal team you can work with effectively and that you have confidence in; the Pennsylvania Medical Malpractice Lawyers at Kaplun|Marx, PLLC are those lawyers, contact us and we will be happy to help you and review your case free of charge.

As important a take-away message is to consider second or third medical opinions when dealing with serious healthcare decisions.

We invite your questions and comments.

Source: http://www.fbi.gov/detroit/press-releases/2013/oakland-county-doctor-and-owner-of-michigan-hematology-and-oncology-centers-charged-in-35-million-medicare-fraud-scheme