Healthcare Risk Management – June 1, 2025

Predictions for 2034 Include Nuclear Verdicts, Increased AI Use

Key trends in the healthcare industry will continue in the coming decade and exacerbate risk management challenges, according to an assessment by The Doctors Company, part of TDC Group, a malpractice insurer based in Napa, CA. Nuclear verdicts will continue to be a threat to healthcare organizations, and risk managers will have to contend with multiple trends that will require time and resources.

Sorensen Ruling a Win for Anti-Kickback Defendant

In a rare win for a defendant convicted of violating the Anti-Kickback Statute, the U.S. Court of Appeals for the Seventh Circuit took the rare step of overturning the defendant’s conviction in United States v. Sorensen.

Culture Change Can Be Crucial to Patient Safety

Risk managers often hear that patient safety initiatives and other improvement efforts must have support from the top if they are to succeed, but the real key is having an organizational culture that facilitates those goals, according to a leader in culture change.

Nurse Case Managers Can Cut Workers’ Comp Costs

Risk managers should consider using nurse case managers for workers’ compensation cases, even though there can be an additional cost.

Continuing Concern Over Liability from AI in Healthcare

Risk management concerns were raised as soon as healthcare providers started using artificial intelligence, and the fears are keeping pace with the increasing presence of the technology.

OCR Imposes $1.5 Million Civil Monetary Penalty

The Office of Civil Rights recently announced a $1.5 million civil money penalty (CMP) for HIPAA violations against Warby Parker, the online retailer of prescription and non-prescription eyewear. The case highlights the need for a prompt and effective response after a breach.

EHR Faults Affect Some Specialties More

A survey of rehab therapy leaders from private practices, hospitals, and contract therapy organizations indicates that the known deficiencies in electronic health records may affect some specialties more than others.

Florida Jury Awards $45 Million After Healthcare System Found Reckless

In July 2020, a 55-year-old experienced a severe heart attack requiring immediate intervention. Rather than directing emergency responders to a nearby hospital equipped to treat the condition, a healthcare system admitted the patient to one of its smaller hospitals and delayed care by transferring him to a larger, in-network facility farther away. The transfer was marred by 90 minutes of delay. When the patient finally arrived, efforts to stabilize him failed, and he died shortly after. The patient’s family alleged that the healthcare system’s internal policies placed business interests ahead of the patient’s survival, a claim that clearly resonated with the jury. Although the defendant invoked Florida’s Good Samaritan Act to argue for immunity under the “reckless disregard” standard, the jury found that the delays constituted reckless conduct.

Court Holds That Failure to Order Tests May Shift Burden of Proof to Defense

On Feb. 28, 2025, a California appellate court ordered the trial court below to vacate its ruling denying a plaintiff’s request for a special jury instruction. The trial court had denied the plaintiff’s request for a jury instruction shifting the burden of proof on causation to the defendant in the plaintiff’s medical malpractice action because of the absence of evidence that the plaintiff would otherwise need to prove the case. However, the appellate court felt that was unfair to the plaintiff and disapproved.

Manage Third-Party Vendor Relationships Carefully

Third-party vendors pose a significant risk to a healthcare organization’s HIPAA compliance program, but those risks can be mitigated by diligently following best practices.

HIPAA Resuming Audits; Know What to Expect

The Office of Civil Rights recently resumed audits for HIPAA compliance, meaning some covered entities will be visited for a thorough check that could have serious ramifications. Knowing what to expect can reduce the risk and stress.