Medicaid Law
 
State Farm Mutual Automobile Insurance Company v. John Joerg, Jr.

Luke Joerg was injured when his bicycle collided with a car driven by William Lazar. Joerg, a developmentally disabled adult, sued Lazar and State Farm Mutual Automobile Insurance Company, the uninsured motorist carrier. Because Lazar

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settled, the case proceeded to trial only against State Farm. Prior to trial, the trial court ruled that evidence of past medical expenses must r

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Maetta Vance v. Ball State University

In this case, we decide a question left open in Burlington Industries, Inc. v. Ellerth, 524 U. S. 742 (1998), and Faragher v. Boca Raton, 524 U. S. 775 (1998), namely, who qualifies as a “supervisor” in a case in which an employee asserts a Title VII claim for workplace harassment?

Under Title VII, an employer’s liability for such harassment may depend on the status of t

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George Wittner v. Banner Health

Ian Wittner died at the North Colorado Medical Center after being injected with the drug Haldol during a seventy-two-hour involuntary mental health hold.

His parents, Lizbeth Cardenas and George Wittner, brought this § 1983 claim against the Medical Center, the doctor, and the nurse involved in their son’s treatment. They appeal from the district court’s grant of summary ju

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Albert Ramirez v. The State of Texas

Albert Ramirez (“Ramirez” or “Appellant”) appeals a ruling of the trial court that Ramirez was not indigent for the purposes of court-appointed counsel to represent him on appeal, Case No. 08-11-00298-CR, and a trial transcript at county expense. Ramirez brings two issues: (1) error by the trial court in determining Ramirez was not indigent in spite of evidence to the contr

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United States of America v. Dr. Paul Kelly

Lansing-area resident Dr. Paul Kelly was sentenced to 18 months in prison today for his role in a $13.8 million Medicare fraud scheme.

Acting Assistant Attorney General Mythili Raman of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office; and Special Agent in Char

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Ahmad Alzubi v. Felix Rudy Arellano

Ahmad Alzubi sued Felix Rudy Arellano on an auto negligence theory claiming:

1. On or about, January 09, 2012, Defendant negligently caused a motor vehicle collision with the Plaintiff.

2. As a result, Plaintiff incurred damages which are in excess of $75,000.

3. Damages include Plaintiffs physical pain and suffering (past and future); mental pain and suffering (past and

More...   $25000 (05-31-2013 - OK)

United States of America v. ISTA Pharmaceuticals, Inc.

Pharmaceutical company ISTA Pharmaceuticals, Inc. pled guilty earlier today to conspiracy to introduce a misbranded drug into interstate commerce and conspiracy to pay illegal remuneration in violation of the Federal Anti-Kickback Statute, the Justice Department announced today. U.S. District Court Judge Richard J. Arcara accepted ISTA's guilty pleas. The guilty pleas are part of a global settle

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Federal Trade Commission v. Meggie Chapman

This appeal arises from a bench trial in which the district court found that Appellant Meggie Chapman violated the “assisting and facilitating” provision of the Telemarketing Sales Rule, 16 C.F.R. § 310.3(b).

The underlying consumer protection action was brought by the Federal Trade Commission and four states against several individual and corporate defendants who marketed an

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United States of America v. Sachin Sharma

The mastermind of a $29.1 million Medicare fraud scheme involving approximately 30 purported medical clinics pleaded guilty today in Detroit for his role in the scheme.

The guilty plea was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in

More...   $29100000 (05-03-2013 - MI)

Daniel Marrujo v. Adventist Health System/West, dba Adventist Health



Adventist Health System/West, dba Adventist Health, and its affiliated hospital White Memorial Medical Center have agreed to pay the United States and the state of California $14.1 million to settle claims that they violated the False Claims Act, the Justice Department announced today. Adventist Health is headquartered in Roseville, Calif., in the Eastern District of California, and oper

More...   $14100000 (05-04-2013 - )

Allstate Fire and Casualty Insurance Company v. Jorge Perez

Allstate Fire and Casualty Insurance Company appeals a county court order entering summary judgment in favor of Dr. Jeffrey Tedder, as assignee of Jorge

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Perez's personal injury protection (PIP) benefits under Perez's automobile insurance policy. The county court entered an order certifying the issue addressed in the final judgment as a matter of great public importance, and this

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United States of America v. Patrick J. Gelin

Following a jury trial, Defendant-Appellants Patrick J. Gelin ("Gelin") and Micheline Lamarre ("Lamarre") were each convicted under 18 U.S.C. §§ 1347 and 1349 for making fraudulent claims to, and obtaining payment from, insurance companies participating in Massachusetts' no-fault automobile insurance program. Footnote They appeal their convictions, arguing first that the district court erre

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United States of America v. MedQuest Associates, Inc.

MedQuest Associates, Inc. and three of its subsidiaries (collectively “MedQuest”) appeal an $11,110,662.71 judgment against them for filing false claims for reimbursement under Medicare Part B in this False Claims Act (FCA) qui tam action. The claims fall into two categories: (1) claims that were false because MedQuest used physician supervisors who were not approved by the local Medic

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Wos, Secetary, North Carolina Department of Health and Human Services v. E.M.A.

The federal Medicaid statute’s anti-lien provision, 42 U. S. C. §1396p(a)(1), pre-empts a State’s effort to take any portion of a Medicaid beneficiary’s tort judgment or settlement not “designated aspayments for medical care,” Arkansas Dept. of Health and Human Servs. v. Ahlborn, 547 U. S. 268, 284. A North Carolina statute requires that up to one-third of any d

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Brian C. Howard M.D. v. Sulzer Orthopedics, Inc.

¶1 The United States Court of Appeals for the Tenth Circuit (Tenth Circuit) certified a single question of first impression to this Court under the Revised Uniform Certification of Questions of Law Act, 20 O.S. 2011 §1601, et seq. We are not asked whether the negligence claim is preempted by federal law as the Tenth Circuit has resolved that preemption analysis has no place in the cause. Rat

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Maria Ramirez v. Oklahoma Health Care Authority

Maria Ramirez sued the Oklahoma Health Care Authority claiming:

1) Maria Rarnirez (“Ramirez”) is now and at all times relevant to this action has been a resident of Tulsa County, Oklahoma.

2) The OHCA is an Oklahoma governmental agency that administers Oklahoma’s Medicaid program throughout the State of Oklahoma including Tulsa County, Oklahoma.

3) The

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Sharon Thurber v. Aetna Life Insurance Company

3 Sharon Thurber worked at Quest Diagnostics (“Quest”) as
4 a client services representative from 1993 through August
5 15, 2007. As a full-time Quest employee, Thurber was
6 enrolled in Quest’s Employee Retirement Income Security Act
7 (ERISA) disability benefits plan, administered by Aetna Life
8 Insurance Company (“Aetna”). Under the plan, Thur

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La Vida Llena v. Karen L. Montoya

{1} Appellant Karen Montoya, Bernalillo County Assessor (the Assessor), appeals from the district court’s order reversing the Bernalillo County Valuation Protest Board’s (the Board) determination that Appellee La Vida Llena is not entitled to a charitable exemption from property tax. On appeal, we consider whether the property tax exemption for a continuing care facility that donates

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Henry Pashby v. Albert Delia

In 2010, the North Carolina General Assembly voted to impose stricter eligibility requirements for in-home personal care services (PCS), an optional Medicaid program that assists disabled adults with daily tasks such as eating and bathing. Appellees—thirteen North Carolina residents who lost access to in-home PCS due to the statutory change (collectively "the PCS Recipients")—brought

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Rodney McMillan v. City of New York

8 One of the central goals of the Americans with Disabilities
9 Act of 1990 (“ADA”), 42 U.S.C. § 12101 et seq., is to ensure that,
10 if reasonably practicable, individuals are able to obtain and
11 maintain employment without regard to whether they have a
12 disability. To accomplish this goal, the ADA requires that
13 employers provide reasonable accommodations

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Robert Scott Howell v. Sandra Liliana Howell

This is an appeal from a divorce and child-custody jury trial. By eleven issues— which we consolidate into five—appellant Robert Scott Howell contends that the trial court erred by: (1) making an improper comment on the evidence; (2) overruling several of his evidentiary objections; (3) overruling his expert challenge; and (4) overruling his motion for judgment notwithstanding the ve

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United States v. Momence Meadows Nursing Center, Inc.

United States sued Momence Meadows Nursing Center, Inc. under the False Claims Act and the Illinois Whistleblower Reward and Protection Act for fraudulent billing of worthless services and false certification that the nursing home was in compliance with federal and state patient care regulations. Former employees of the defendant nursing home claimed that it defrauded Medicare and Medicaid by pro

More...   $28100000 (02-26-2013 - IL)

A.G.Q. v. Agency for Persons With Disabilities

A.G.Q. is a child with severe developmental disabilities who is on the waiting list for the Medicaid waiver program, which allows waivers from compliance with certain statutes and regulations for persons with developmental disabilities who are provided services in the home. See Russell v. Agency for Persons With Disabilities, 929 So. 2d 601 (Fla. 1st DCA 2006). The agency denied his application to

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William D. Evans v. HCA Health Services of Oklahoma, Inc. d/b/a OU Medical Center

William D. Evans v. HCA Health Services of Oklahoma, Inc. d/b/a OU Medical Center, Rixie Mae Albrecht, M.D., Kristi Prejeant, M.D. and Meredith Workman, M.D. on medical negligence (medical malpractice) theories claiming:

1. On the June 9, 2008, Marilyn Fay Evans presented to OU Medical Center to undergo a colonoscopy and it was discovered she had a mass in her recto-sigmoid colon. She was

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Victor J. Shattuck v. Donna Mae Peck

¶ 1. BURGESS, J. Defendant Donna Mae Peck appeals from a superior court judgment granting plaintiff Victor J. Shattuck a writ of possession for the parties’ former residence in Cavendish and denying defendant’s counterclaim for an equitable interest in the Cavendish property and another former residence in Springfield. We affirm.

¶ 2. The fact

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