Guttman, Buschner & Brooks

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A Practitioner’s View Of Institutional Corruption Through The Lens Of The Health Care System: An Essay

These interdisciplinary invaders have come to dominate the faculties of the elite law schools and to influence a great many of the other law schools. The interdisciplinarians are valuable additions to law faculties, but they should not be allowed to displace faculty who bring to the teaching of and research into law a rich background of legal practice in lieu of expertise in a scholarly field or fields outside of law.

—Richard A. Posner, The Federal Judiciary Strengths and Weaknesses, Harvard University Press 2017

INTRODUCTION

Think about this: some of the largest drug companies in the world—the one’s that we rely on for life saving treatments—are convicted criminals.1 Hospital chains and large entities that distribute drugs to the elderly have been charged with defrauding the government and have paid fines, or entered guilty pleas to resolve allegations of conduct that have placed patients at risk. Healthcare fraud is so rampant that each year the government has recovered billions of dollars under the False Claims Act from companies whose television advertising attempts to portray a different image; an image of a benevolent and caring corporate citizen.

Yet, with so many employees inside the company, how do these entities do what they do for so many years before their wrongful conduct is exposed, perhaps by a whistleblower who wakes up one day and questions what others have never thought about questioning? The answer to this question involves an analysis of how people behave when they are part of an institution—or in this case, a large corporation.

 

A Practitioner’s View Of Institutional Corruption – Reuben Guttman.

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American Constitution Society, 2018 Student Convention

The 2018 ACS Student Convention will be hosted by the Northwestern University Pritzker School of Law in Chicago March 9-10, 2018. Plan to join us for two days of networking and dynamic discussions with leading scholars, advocates, and policymakers, including keynote remarks by Lisa Madigan, Illinois Attorney General, Vanita Gupta, president and CEO of The Leadership Conference on Civil and Human Rights, and Jason Kander, president of Let America Vote and Missouri’s 39th Secretary of State. For a list of confirmed speakers and more information, click here.

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The Shadow Government: The Government’s Multi-Billion-Dollar Giveaway of its Decision-Making Powers to Private Management Consultants, “Experts,” and Think Tanks

A book by GBB Legal’s Dan Guttman, Available Amazon Here

The Shadow Government book_Dan GuttmanIn the past two decades the federal budget has tripled. However, popular wisdom to the contrary, the number of full-time civil servants has remained relatively constant. How does the government manage? In keeping with the American ethos that private is better than public, a large part of the business of government has been contracted out to accounting firms, think tanks, management consultants, and industrial corporations like McKinsey and Co., Peat, Marwick, Mitchell, and Co., the Stanford Research Institute, the RAND Corporation, Booz, Allen, and Hamilton, Westinghouse, and the Brookings Institution, among many others. The contractors do not merely build hardware and carry out a myriad of mundane tasks. They increasingly perform the functions of government itself, albeit in the guise of private efficiency and disinterested expertise, without accountability to the public. They make and implement policy recommendations, staff and restructure government agencies, reorganize railroads and hospitals, and produce the findings that allocate the spending of the federal budget dollar.

What is their track record? How well is the public interest served by the burgeoning and costly private bureaucracy which government contracting has spawned? Is it proper to delegate public affairs to a shadow government of private, corporate, and governmental constituents? These are the questions at the core of this important study, which was prepared for Ralph Nader’s Center for Study of Responsive Law.

Available Amazon Here

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Federal prosecutors launch investigation of prominent surgeon who double-booked operations

By Jonathan Saltzman GLOBE STAFF OCTOBER 05, 2017

Federal prosecutors are investigating the billing practices of one of the nation’s highest-paid surgeons after a Spotlight Team report detailed that Dr. David B. Samadi ran two surgeries simultaneously on hundreds of occasions — a routine that colleagues said many patients did not know about.

Samadi, the chief of urology at Lenox Hill Hospital in Manhattan and a medical expert on Fox News, already is the focus of a state inquiry into how he handles his enormous caseload of prostate surgeries. Current and former Lenox Hill medical personnel say he typically relied on unsupervised residents who were still learning how to do surgery.

Now, the US attorney’s office in Manhattan is looking at Samadi, too. Federal law prohibits surgeons at teaching hospitals from billing Medicare for two simultaneous operations unless the doctor was present for all “critical parts.”

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Reuben Guttman, a Washington, D.C., lawyer who has represented clients in federal cases alleging health-care fraud, said it was extraordinary for a prosecutor to disclose an open investigation.

The e-mail to the Globe, he said, was a “clear signal that the matter of concurrent surgeries is extremely material to the payment of Medicare and Medicaid funds.”

. . . .

read the full article here.

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Whistle-blower files suit over alleged double-booked surgeries

By Jonathan Saltzman and Todd Wallack – GLOBE STAFF JUNE 07, 2017

Orthopedic surgeons at Massachusetts General Hospital repeatedly kept patients waiting under anesthesia longer — sometimes more than an hour longer — than was medically necessary or safe, as they juggled two or even three simultaneous operations, according to a federal lawsuit that alleges frequent billing fraud at the prestigious hospital.

Dr. Lisa Wollman, a former anesthesiologist at Mass. General, alleges in the lawsuit that at least five surgeons endangered patients by regularly performing simultaneous surgeries. Wollman charges that the doctors also defrauded the government by submitting bills for surgeries in which they were not in the operating room for critical portions of procedures, leaving the work to unsupervised trainees.

Wollman said she witnessed surgeons performing simultaneous operations repeatedly from 2010 to 2015, when she left MGH for New England Baptist Hospital. She said hospital policy gave the doctors financial incentives to do more procedures, and they never told patients they would be going back and forth between operating rooms.

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Wollman’s lead attorney, Reuben Guttman of Washington, D.C., argues that the doctors violated rules for two government health insurance programs, Medicare and Medicaid, which require surgeons to be present for all “critical portions” of an operation in order to get paid. If surgeons weren’t present and billed the insurers without making their role clear, it could constitute billing fraud, though the rule has seldom been enforced.

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Guttman, Wollman’s attorney, said it was premature to talk about the damages if Mass. General is found to have improperly billed Medicaid and Medicare, but the costs could be considerable. The law calls for treble damages and Mass. General could face an additional penalty of at least $5,000 for each instance of improper billing, Guttman said. If Wollman prevails, he added, she could potentially receive 25 percent to 30 percent of any money recovered under the False Claims Act.

Read Full Article here.