Medicaid Law
 
United States of America v. Dr. Spyros Panos

Preet Bharara, the United States Attorney for the Southern District of New York, announced that DR. SPYROS PANOS, an orthopedic surgeon, was sentenced today in White Plains federal court before U.S. District Judge Nelson S. Roman to serve 54 months in prison for operating a long-running health care fraud scheme in which PANOS defrauded Medicare, the New York State Insurance Fund, and numerous priv

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United States of America v. Wanda Herdman

Wanda Herdman, 57, pleaded guilty to stealing government money. She admitted to stealing $43,158 from three needs-based federal programs. Specifically, the programs she defrauded were: the Supplemental Security Income “SSI” Program, the Supplemental Nutrition Assistance Program (more commonly known as the Food Stamp Program), and the Medicaid Program.

In Herdman’s plea,

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United States of America v. RehabCare Group Inc., RehabCare Group East Inc. and Rehab Systems of Missouri and Health Systems Inc.

Contract therapy providers RehabCare Group Inc., RehabCare Group East Inc. and Rehab Systems of Missouri and management company Health Systems Inc. have agreed to pay $30 million to resolve claims that they violated the False Claims Act by engaging in a kickback scheme related to the referral of nursing home business, the Justice Department announced today. Additionally, as part of this settlem

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United States of America v. Wanda Herdman

Wanda Herdman, 57, pleaded guilty to stealing government money. She admitted to stealing $43,158 from three needs-based federal programs. Specifically, the programs she defrauded were: the Supplemental Security Income “SSI” Program, the Supplemental Nutrition Assistance Program (more commonly known as the Food Stamp Program), and the Medicaid Program.

In Herdman’s plea,

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Nicole Dussault v. RRE Coach Lantern Holdings

[¶1] Nicole Dussault appeals from a summary judgment entered in the Superior Court (Cumberland County, Cole, J.) in favor of RRE Coach Lantern Holdings, LLC, and Resource Real Estate Management, Inc. (collectively, Coach Lantern). Dussault claims that Coach Lantern’s policy of not including in its standard lease a tenancy addendum that binds the landlord to the requirements of the federa

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Hill Country San Antonio Management Services, Inc. v. Rachel Trejo

On December 14, 2012, Appellee Rachel Trejo filed suit as Next Friend of her adult child, Rene Trejo, asserting that Hill Country Achievement Center breached the standard of care applicable to an adult day-care facility by failing to monitor or assist Rene Trejo as he exited a van after a facility outing. Hill Country originally denied the facility was a health care provider under the Texas Medica

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Sunshine Haven Nursing Operations, lLC d/b/a Sunshine Haven Lordsburg

Petitioner Sunshine Haven Nursing Operations LLC (Sunshine) operates a 67-bed nursing home in Lordsburg, New Mexico. It petitions for review of the United States Department of Health and Human Services (HHS) Departmental Appeals Board’s (DAB) decision affirming an administrative law judge’s (ALJ) decision upholding mandatory and discretionary “remedies” (penalties) impose

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Via Christi Medical Center, Inc. v. Ivan M. Reed

Ivan Reed received life-saving medical treatment at Via Christi Regional Medical Center, Inc. (Via Christi), after his car collided with a Union Pacific Railroad train. Via Christi filed a hospital lien under K.S.A. 65-406 et seq. to collect on its bill for the services provided Reed. The lien initially purported to encumber $84,744.11 of Reed's $540,000 settlement with Union Pacific; Via Christi

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April Dobyns v. Dana Hudson and USAA

April Dobyns sured Dana Hudson and USAA on a negligence theory claiming:


1. On or about December 27, 2012, an accident occurred in an around 20th and Toledo Place, Broken Arrow, Oklahoma, Tulsa County, State of Oklahoma. The minor Madison Dobyns was involved in an accident wherein said minor allegedly sustained various injuries. As a result of the accident, the injured minor and the

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Department of Revenue, o/b/o R.S.M. v. B.J.M.

The Department of Revenue, on behalf of R.S.M., appeals the final judgment of paternity and support ordering the father, B.J.M., to pay child support to the mother, R.S.M., for their child, L.W.M. Competent substantial evidence does not

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support the final judgment. Consequently, we reverse and remand for further proceedings.

In November 2010, the Department filed its peti

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Maisha I. Hamilton v. Village of Oak Lawn, Illinois

Allan Lorincz, a man in his mid‐80s retired from the University of Chicago Medical Center, where he had been a distinguished dermatologist, was dying of Parkinson’s disease in the spring of 2010 when, according to the plaintiff, Maisha Hamilton, he hired her to help him in his home with various “end‐of‐life tasks.” She was a friend of a wayward daughter of Lori

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Bambi Hamilton v. Hillcrest Healthcare System

¶1 This appeal was filed by Plaintiffs/Appellants, Bambi Hamilton, individually and as Guardian of the person and the Estate of M.H., a minor, and Matthew Hamilton to challenge the amount of the lien owed to the Appellee Oklahoma Health Care Authority. On May 31, 2013, this Court issued its Opinion reversing the Order of the district court denying the Hamiltons' request to reduce the amount of

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Terry Cline v. Oklahoma Coalition for Reproductive Justice

¶1 The Supreme Court of the United States certified two questions of Oklahoma law under the Revised Uniform Certification of Questions of Law Act, 20 O.S. 2011 §§ 1601-1611:

Whether H.B. No. 1970, Section 1, Chapter 216, O.S.L. 2011 prohibits: (1) the use of misoprostol to induce abortions, including the use of misoprostol in conjunction with mifepristone according to a protocol

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William Romine v. St. Joseph Health System d/b/a Saint Joseph-Mt. Sterling

Plaintiff-Appellant, William Romine, appeals the district court’s grant of Defendant-Appellee’s motion for summary judgment. As a result of an unsatisfactory experience in Defendant’s emergency room, Romine brought this action pursuant to the Emergency Medical Treatment and Active Labor Act (“EMTALA”), 42 U.S.C. §1395dd. The district court granted Defendantâ€

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Carole L. Hughes v. John B. McCarthy, Medicaid Director

Plaintiffs Carole and Harry Hughes (collectively, the Hugheses), a nursing home resident and her community spouse, appeal the district court’s grant of summary judgment in favor of the director of the Ohio Department of Job and Family Services (ODJFS or the Ohio agency),1 holding that the Ohio agency properly penalized Mrs. Hughes based on Mr. Hughes’s purchase of an annuity for hims

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Newspaper Holdings, Inc., Integracare of Texas, LLC, and Charlotte Patterson v. Crazy Hotel Assisted Living, LTD, Crazy Hotel Assisted Living GP, LLC, Leisure Life Senior Apartment Housing II, LTD, and Charles V. Miller, Jr.

This defamation case arises from a series of articles published in the Mineral Wells Index (the Index), a newspaper owned by Newspaper Holdings, Inc. (NHI).

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The articles reported regulatory compliance problems and official investigations into the Crazy Water Retirement Hotel, a local Mineral Wells assisted living facility, and examined the conduct of Charles Miller, president of th

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Donald Gale v. Omnicare, Inc

Donald Gale sued Omnicare, Inc. on a qui tam theory claiming that Omnicare illegally paid kickbacks to nursing homes in return for more patient referrals for prescription drugs.

Omnicare denied wrongdoing.

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Court Docket Entries for October, 2013:

10/01/2013 130 Opinion and Order signed by Judge James S. Gwin on 10/1/13. The Cour

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National Collegiate Athletic Associaiton v. Governor of the State of New Jersey

Betting on sports is an activity that has unarguably increased in popularity over the last several decades. Seeking to address instances of illegal sports wagering within its borders and to improve its economy, the State of New Jersey has sought to license gambling on certain professional and amateur sporting events. A conglomerate of sports leagues, displeased at the prospect of State-licensed ga

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Michael Quinn III v. Magna Health Care, Inc.

Michael Quinn III, Michael Quinn, Jr. and Kimberly G. Quinn sued Magna Health Care, Inc., Magna Home Health Center, Inc. and Leonard Agbasi on negligence and breach of contract theories claiming:

1. The Plaintiffs Michael Guinn III, Michael Guinn II, and Kimberly Guinn are currently citizens and residents of Tulsa County, State of Oklahoma.

2. The Plaintiff Michael Guinn III. is

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United States of America v. Yolanda Nowlin

Yolanda Nowlin, 42, has been convicted of conspiracy to commit health care fraud, four counts of health care fraud, conspiracy to commit kickback fraud and aiding and abetting Social Security fraud, United States Attorney Kenneth Magidson announced today. The verdicts were returned late yesterday afternoon following seven days of trial and less than three hours of deliberations.

Nowlin, of

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Julio Ramos, M.D. v. Kewanee Hospital

¶ 1 Plaintiff, Julio Ramos, M.D., filed a three-count second amended complaint against defendant, Kewanee Hospital (the hospital), seeking injunctive relief, a declaration that the hospital improperly summarily suspended his privileges, and damages arising from the summary suspension. Plaintiff voluntarily dismissed his second amended complaint, then filed the current action six weeks later. Fo

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United States of America v. Q2Administrators, LLC

Relator Thomas M. Zizic, M.D. (“Zizic”) filed this qui tam1

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1 The term “qui tam” is an abbreviation of the phrase “‘qui tam pro domino rege quam pro se ipso in hac parte sequitur,’ which means ‘who pursues this action on our Lord the King’s behalf as well as his own.’” United States ex rel. Atkinson v

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Carol A. Douglas v. Cox Retirement Properties, Inc.

¶1 On April 2, 2009, Richard Douglas was admitted to the Defendant's rehabilitative care center for extended care. Douglas remained at the facility for approximately 21 days and was discharged on April 23, 2009. He died a short time later on May 12, 2009. The decedent's estate filed a wrongful death action in Tulsa County against the Defendant, alleging Douglas died as a result of the facility'

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Kodigbo Odelugo v. The State of Texas

Appellant, Kodigbo Odelugo, without an agreed punishment recommendation from the State, pleaded guilty to the offense of engaging in

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organized criminal activity, namely aggregate theft of over $200,000,1 and the trial court assessed his punishment at confinement for fifteen years. In three issues, appellant contends that he received ineffective assistance of counsel and the tri

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New Jersey Primary Care Association, Inc. v. State of New Jersey Department of Human Services

Under the federal Medicaid statute, 42 U.S.C. § 1396 et seq., states participating in Medicaid and implementing a managed care environment are obligated to make, at least every fourth month, supplemental payments (known as ―wraparound payments‖) to federally-qualified health centers (―FQHCs‖) in an amount equal to the difference between a predetermined rate set by th

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