Defended a DME supplier in an extensive federal criminal/civil health care fraud investigation involving the alleged submission of false claims (FCA) to the federal and state health care programs by upcoding, improperly using billing modifiers, and other allegedly fraudulent billing practices. The matter was resolved with civil payback and client avoided criminal penalties.

Three Ohio AIDS patients filed a lawsuit against the director of the Ohio Department of Health (ODH) to prevent enforcement of proposed rules that would arbitrarily deny funding for potentially life-saving medications to Ohio residents infected with HIV or suffering from AIDS-related symptoms. Defendants claimed that ODH failed to follow statutory rule-making process and the proposed rules were unenforceable. Court agreed that public interest would be served by protecting the right of a public hearing, and issued preliminary injunction preventing ODH from implementing new rules pending resolution of the lawsuit.

Our attorneys represented a major pharmaceutical distributor in a qui tam case involving the alleged failure to pay Medicaid rebates for repackaged drugs. All of the relator’s claims were dismissed.

I have acted as preventative counsel for various hospital and medical practice groups with regard to labor and employment matters, including the review of employee handbooks, policies and advice concerning discipline and discharge of employees.

The Plaintff sued our client, the owner of a nursing home, for $100,000 for negligence related to a slip and fall.  The claim was dismissed on summary judgment.

We serve as outside counsel to a health care consulting firm. Our role has included advising on succession planning, commercial contract matters and a variety of intellectual property issues.

Dinsmore served as lead counsel representing the sellers of a closely-held health care enterprise in the multi-million dollar asset sale of multiple nursing homes.

Successful handling and resolution of short-term and long-term disability denial of benefits claims under ERISA. Representative cases:

• Storer v. Prudential Insurance Co. of America, et al.
  • Early resolution of case after successful mediation.
• Wheeler v. Prudential Insurance Co. of America, et al.
  • Obtained decision in favor of long-term disability benefits plan leading to resolution on appeal.

Mr. O'Neil and Ms. Bentz represented a hospital before the West Virginia Health Care Cost Review Authority, the Office of Judges, the Circuit Court of Marion County, and the West Virginia Supreme Court of Appeals in the successful prosecution of the hospital's application for a certificate of need to develop a $285,000,000 replacement hospital.

We obtained a jury verdict for the defense, which was affirmed on appeal, in a suit for hospital negligence in excess of $1,000,000.

Successfully argued for and obtained dismissal of medical malpractice lawsuit stemming from alleged physical, verbal, and mental abuse of psychiatric patient.

Ms. Rice represented a hospital in a class action filed by four uninsured patients who alleged that a hospital's charging of uninsured patients at full charges, while charging Medicare, Medicaid, and insured patients at less than full charges, was unlawful.

I have provided representation with respect to collection efforts for a large hospital pertaining to patient services for various state agencies such as regional jails and the West Virginia Department of Health and Human Services.  Through the initiation of collection suits and negotiations, we have collected in excess of $500,000 of unpaid charges for a large state-wide hospital group.

Our firm represented the Defendants, Samaritan Hospital and an employed physician, in a lawsuit seeking in excess of $2 million for medical malpractice. The case resulted in a jury verdict for the defense.