Medicaid Law
 
Amarin Pharma Inc. v. U.S. FDA

Amarin is a biopharmaceutical company incorporated in Delaware and based in New
Jersey. Compl. ¶ 24. It and four medical doctors resident in New York2 (collectively, “Amarin”)
bring this suit against the FDA, two officials with responsibility over the FDA (Dr. Stephen
Ostroff and Sylvia Matthews Burwell), and the United States (collectively, the “FDA”).3 The
FDA is t

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United States of America v. Jaime Leonard Smith

Raleigh, NC - President Of Ambulance Company Pleads Guilty To Perjury In Connection With False Health Care Claims Investigation

JAIME LEONARD SMITH, 35, of Morehead City, North Carolina, pleaded guilty to Perjury.

According to the Criminal Information, SMITH was the president of CCMT, Inc., doing business as Crystal Coast Medical Transport (CCMT). CCMT was a nonemergency ambulan

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United States of America v. Robert Manning

Houston, TX Houston Man Pleads Guilty to Conspiracy to Defraud Medicare

A Houston businessman has entered a guilty plea to engaging in a conspiracy to defraud Medicare of more than $6.6 million.

At a hearing held today before U.S. District Kenneth Ellison, Robert Manning, 60, admitted he participated in a three-year conspiracy to defraud Medicare by paying kickbacks to Medicare b

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Brissette v. Ryan

After a Superior Court trial in this legal
malpractice case, a jury found that the primary defendant,
Edward J. Ryan, Jr., was negligent in his representation of the
plaintiff, Marie D. Brissette, and awarded damages to her in the
amount of $100,000 against Ryan and his law firm, Ryan,
Boudreau, Randall, Kirkpatrick & Baker, LLP (law firm)
(collectively, defendants).2

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McCrimmon v. State

This appeal arises from the 2012 conviction in the Circuit Court for Baltimore
County of appellant Penny McCrimmon for embezzlement and misappropriation of funds
by a fiduciary and from the court’s sentence that included an order for restitution.
On March 31, 2011, the State filed a criminal information in the circuit court
charging McCrimmon with three counts: theft of pro

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Positive Progressions, Llc, a Wyoming Limited Liability Company, Northern Developmental Disability Service Providers, Inc., a Wyoming Corporation, and Nathan Cook v. Amy Landerman, F/K/A Amy Baxter

In November of 2010, Amy Landerman approached Nathan Cook about buying her business, Northern Developmental Disability Service Providers, Inc. (Northern). Mr. Cook expressed interest in buying the business. On January 24, 2011, Ms. Landerman emailed Mr. Cook and offered to sell Northern for $247,500. Mr. Cook indicated his interest in buying the business and the two agreed to meet at Northern

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Needham v. Director of the Office of Medicaid

sole beneficiary.4 MassHealth reviewed this and other financial
information for purposes of determining whether Needham met the
financial eligibility requirements for long-term care under the
Medicaid program. See 130 Code Mass. Regs. § 520.003(A)(1)
(2009) (setting an eligibility ceiling of $2,000 in countable
assets). The irrevocable trust, also valued at $412,400, w

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John Joerg, Jr. v. State Farm Mutual Automobile Insurance Co.

At common law, the collateral source rule governed both evidence and
damages. See, e.g., Gormley v. GTE Prods. Corp., 587 So. 2d 455, 457 (Fla.
1991). Historically, the damages aspect of the collateral source rule prevented the
reduction of damages by collateral sources available to the plaintiff. Id. This rule
rested on the principle that a tortfeasor should not benefit fr

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United States of America v. Sharon Ward

Cleveland, OH - Richmond Heights woman sentenced to eight years in prison for operating an $18 million healthcare fraud scheme

A Richmond Heights woman was sentenced to nearly eight years in prison for operating an $18 million home healthcare fraud scheme.

Sharon Ward, 45, was sentenced to 94 months in prison and ordered to pay $18 million in restitution after previously being fo

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Illinois League of Advocates for the Developmentally Disabled v. Illinois Department of Human Services

This lawsuit charges violations of
42 U.S.C. § 12132, a provision of Title II of the Americans
with Disabilities Act which states that “no qualified individual
with a disability shall, by reason of such disability, … be
subjected to discrimination by any [public] entity,” and of
2 No. 14-2850
Section 504 of the Rehabilitation Act, 29 U.S.C. § 794, which
has iden

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United States of America v. Wayne Vincent Wilson

Charlotte NC - Hickory, N.C. Physician Pleads Guilty To Health Care Fraud

A Hickory physician pleaded guilty to health care fraud charges for submitting to Medicare and Medicaid over $467,376 in fraudulent reimbursement claims, announced Jill Westmoreland Rose, Acting U.S. Attorney for the Western District of North Carolina. Wayne Vincent Wilson, 54, entered his guilty plea before U.S. M

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Christopher Tiplick v. State of Indiana

Synthetic cannabinoids, also known as “spice,” are compounds designed to mimic the psychoactive properties of marijuana, first reported in the United States in 2008. See Schedules of Controlled Substances: Temporary Placement of Three Synthetic Cannabinoids Into Schedule I, 78 Fed. Reg. 28,735–39 (May 16, 2013) (to be codified at 21 C.F.R. pt. 1308.11(h)(9)–(11)). Regulation of “spice

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United States of America v. Verona Spicer

Houston, TX - Clinic Manager Guilty of Health Care Fraud

The owner and operator of Elite P. Care Medical Services has been convicted of conspiracy to commit health care fraud and health care fraud in a $1 million fraud scheme. Verona Spicer, 46, pleaded guilty before U.S. District Judge Kenneth Hoyt.

Spicer admitted that she hired a physician to sign patient medical documents at

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United States of America v. Amira Mantoura

New Haven, CT - Stamford Podiatrist Pleads Guilty to Submitting False Medicare Claims, Also Pays 288K in Civil Settlement

AMIRA MANTOURA, 53, of Greenwich, waived her right to indictment and pleaded guilty to one count of making a false statement to the Medicare program. In pleading guilty, MANTOURA, a Stamford-based podiatrist, admitted that she submitted false claims to Medicare, Medic

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Council on Dev. Disabilities, Inc. v. Cabinet for Health & Family Servs.

The Appellant, the Council on Developmental Disabilities, Inc., is a
Kentucky nonprofit corporation that advocates for "children and adults with
mental retardation and their families and other interested persons in the
community." It receives funding from several sources, including Metro United
Way and the Louisville/Jefferson County Metro Government.
In January 2010, the

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United States of America v. Lynwood Patrick, Jr.

Bridgeport, CT - Lynwood Patrick, Jr., 40, of East Hartford, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to three years of probation, the first six months of which PATRICK must serve in home confinement, for submitting a fraudulent application for a personal mortgage modification.

According to court documents and statements made in court, from approximately O

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EDDIE HOFFMAN v. 21ST CENTURY NORTH AMERICA INSURANCE COMPANY AND CAROLYN ELZY

Eddie Hoffman was injured in October 2010, when his vehicle was rear
ended by a vehicle driven by Carolyn Elzy. The accident occurred at or near the
intersection of Old Hammond Highway and Sharp Road in Baton Rouge,
Louisiana. Mr. Hoffman filed suit against Ms. Elzy and her insurer, 21st Century
North America Insurance Company (“Century”), for damages allegedly resulting <

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Marquez v. Dept. of Health Care Services

We begin with an overview of California’s Medi-Cal program for context, and then discuss the parties’ factual and legal contentions in this litigation. A. California’s Medi-Cal Program
Medi-Cal is California’s program under the joint federal-state program known as Medicaid. (Welf. & Inst. Code, § 14000 et seq.) Medicaid provides federal financial assistance to participating states

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United States of America v. Tiffany Saunders Carraway

Baltimore, MD - Baltimore Woman Pleads Guilty to Food Stamp and Medicaid Fraud

Received Over $95,000 in Fraudulent Food Stamp and Medicaid Benefits

Tiffany Saunders Carraway, age 34, of Baltimore, pleaded guilty to theft of government property arising from a scheme to falsify her income and living arrangements to illegally obtain food stamp and Medicaid benefits.

The gui

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Specialty Select Care Center of San Antonio LLC d/b/a Casa Rio Healthcare and Rehabilitation v. Jose Flores, as next friend of Julie Flores

This is an appeal of a trial court’s order denying a motion to compel arbitration filed by Specialty Select Care Center of San Antonio, LLC d/b/a Casa Rio Healthcare and Rehabilitation. After the parties’ briefs were filed, this court abated this appeal pending the Texas Supreme Court’s decisions in three appeals from this court. See Williamsburg Care Co. L.P. v. Acosta, 406 S.W.3d 711 (Tex.

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United States of America v. Stephen J. Schneider and Linda K. Schneider

Wichita, KS - Prison Terms Don’t Change For Former Haysville Doctor and Wife

A federal judge resentenced a former Haysville physician and his wife without changing the amount of time they must spend in prison for illegally distributing prescription pain killers to patients who overdosed on them, U.S. Attorney Barry Grissom said.

Stephen J. Schneider, 62, currently in federal c

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United States of America v. Victor Lee Gonzalez

McAllen, TX - Area Ambulance Company Owner Pleads Guilty in Health Care Fraud Scheme

The owner of Vic’s Texas Transport, Inc. (dba Victory EMS) has been convicted of health care fraud and aggravated identity theft, announced United States Attorney Kenneth Magidson. Victor Lee Gonzalez, 28, of Mission, entered his guilty plea before Chief U.S. District Judge Ricardo Hinojosa.

As

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United States of America v. Paula J. Butterfield

Charleston, WV - Trivillian's Pharmacy sentenced for federal healthcare and drug crimes

Former Owner Paula Butterfield Sentenced to One Year and One Day in Federal Prison

United States Attorney Booth Goodwin announced that Trivillian’s Pharmacy, a long-standing Kanawha City retail and compounding pharmacy, was sentenced today in federal court in Charleston to three years of pro

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United States of America v. Willie Chester Mitchell

McAllen, TX - Durable Medical Equipment Company Owner Pleads Guilty to Health Care Fraud

The owner of Illusion Medical Equipment and Illusion Medical Equipment II LLC in McAllen has been convicted of health care fraud and aggravated identity theft, announced United States Attorney Kenneth Magidson. Willie Chester Mitchell, 33, of McAllen, entered his guilty plea today before Chief U.S. Di

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Hi-Desert Medical Center v. Douglas

The federal Medicaid program provides financial assistance to states that offer medical treatment to needy persons. (Mission Hospital Regional Medical Center v. Shewry (2008) 168 Cal.App.4th 460, 469–470 (Mission I).) “California participates in the federal Medicaid program through the Medi-Cal program,” and the Department is the state agency authorized to administer the Medi-Cal program.

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