Physicians Misjudge a Terminal Patient’s Life Span: Is It Fraud?

Can physicians always tell when a patient has less than 6 months to live? And if they misjudge, is that fraud?

A registered nurse and three nonclinicians filed a federal False Claims Act (FCA) lawsuit against Care Alternatives, a for-profit hospice in Cranford, New Jersey, claiming the hospice illegally admitted at least 16 patients who were not in their last 6 months of life and so did not qualify for Medicare hospice coverage.



The whistleblowers’ medical expert, Robert Jayes, MD, testified that the patients’ medical records did not back up the hospice medical director’s prognosis of imminent death and thus did not support a certification of need for hospice care. The hospice’s medical expert disagreed, testifying that a physician could reasonably have determined that the life expectancy of each of those patients was 6 months or less. The whistleblowers were all former staffers.

A federal district judge held that a

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Hoverboard-Riding Dentist, Found Guilty of Fraud, Is Sentenced to 12 Years

Seth Lookhart, a dentist in Alaska, pulled a tooth out of a sedated woman’s mouth while balancing on a hoverboard, one video showed. He rolled down the hallway, pulled his gloves off and threw his hands in the air, another showed.

Mr. Lookhart then sent the videos to people outside the practice, prosecutors said, and the footage became part of a wide-ranging case against the dentist on charges of fraud, embezzlement and unlawful dental acts.

On Monday, Judge Michael Wolverton of Anchorage Superior Court sentenced Mr. Lookhart to 20 years in prison, with eight years suspended, and to 10 years of probation, a statement from Alaska’s Department of Law said this week. Mr. Lookhart had been charged in 2017 with felony offenses of medical assistance fraud, theft in the second degree and a scheme to defraud.

Other charges included misdemeanor offenses for medical assistance fraud and unlawful dental acts, the

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