Medicaid Law
 
Julie Mahony v. Universal Pediatric Services

Julie Mahony appeals the district court’s1 grant of summary judgment dismissing claims of wrongful termination against her former employer, Universal Pediatric Services, Inc. (“UPSI”); S. Tucker Anderson, its president and chief executive officer; and Connie Freeman, its principal owner. Mahony appeals only the dismissal of the claim that she was wrongfully terminated in violati

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James D. MacDonald v. City Hospital, Inc.

Once again, this Court is asked to consider the constitutionality, vel non, of W. Va. Code § 55-7B-8 which places a limit or “cap” on compensatory damages for noneconomic loss awarded in a medical professional liability action. On two prior occasions, in the cases of Robinson v. Charleston Area Medical Center, Inc., 186 W. Va. 720, 414 S.E.2d 877 (1991) and Verba v. Ghaphery, 210 W.

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Rita L. Tristani v.Estelle Richman

In 1965, Congress amended the Social Security Act to create a program for states to assist the poor with their medical expenses. Through this program, known as Medicaid, the fifty states pay medical expenses on behalf of qualified beneficiaries. For more than thirty years, in circumstances where third parties are liable for such medical expenses, the Pennsylvania Department of Public Welfare (DPW)

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United States of America ex rel. Charles Wilkins v. United Health Group, Inc.

This matter comes on before this Court on an appeal from an order the District Court entered on May 13, 2010, granting the motion of appellees United Health Group, AmeriChoice, and AmeriChoice-New Jersey (collectively “appellees”) under Federal Rule of Civil Procedure 12(b)(6) to dismiss Charles Wilkins‟ and Daryl Willis‟ (collectively “appellants”) qui tam acti

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David Kaspari v. Carol K. Olson

[¶1] The Department of Human Services appealed from a judgment reversing the Department's calculations of David and Sarah Kaspari's monthly recipient liabilities for their nursing home costs. The Department argues the district court erred in construing Medicaid regulations to allow the Kasparis to reduce their monthly recipient liabilities for nursing home care by their payments for mortgage in

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Robert Probert v. Family Centered Services of Alaska, Inc.

Defendants Family Centered Services of Alaska (“FCSA”) and its officers filed this interlocutory appeal challenging the district court’s conclusion that FCSA’s Therapeutic Family Homes (“Homes”) are covered by the Fair Labor Standards Act (“FLSA”) and are subject to its overtime provisions. We conclude that the Homes are not covered by that statute

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Norma Sano v. Jimmy J. Greenlee

In two issues, Appellant Norma Sano appeals the trial court’s designation of Appellee Jimmy J. Greenlee as joint managing conservator with the exclusive right to establish their child’s primary residence in its divorce decree. We affirm.

II. Factual and Procedural Background

After three years of litigation, the trial court granted the parties’ divorce

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Donald Harrell v. Kris Hochderffer

Appellants Donald Harrell and Shirley Temesgen appeal the trial court's denial of their motion for summary judgment and grant of partial summary judgment in favor of appellee Kris Hochderffer, in his capacity as trustee of the Clark Family Trust. The underlying dispute involves a personal-injury settlement received by the appellants' mother, Jessie Mae Clark, and stepfather, Rudie Clark, and a tru

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Donald Harrell and Shirley Temegsen v. Kris Hochderffer

Appellants Donald Harrell and Shirley Temesgen appeal the trial court's denial of their motion for summary judgment and grant of partial summary judgment in favor of appellee Kris Hochderffer, in his capacity as trustee of the Clark Family Trust. The underlying dispute involves a personal-injury settlement received by the appellants' mother, Jessie Mae Clark, and stepfather, Rudie Clark, and a tru

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Richard Chudacoff, M.D. v. University Medical Center of Southern Nevada

Richard Chudacoff, M.D. (“Chudacoff”) appeals the grant of summary judgment (the “November Order”) in his civil rights action arising from the suspension of his medical staff privileges at the University Medical Center of Southern Nevada (“UMC”), a county hospital organized under the laws of Nevada, as well as the denial of his motion for leave to file a third a

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Lula Lounds v. State of Oklahoma, ex rel. Department of Veterans Affairs

Defendant, State of Oklahoma ex rel. Oklahoma Department of Veterans Affairs (State or ODVA), appeals a judgment in favor of Plaintiff, Lula Lounds, the daughter and personal representative of the estate of her father, David Shelton (Decedent). For the reasons set forth below, we affirm as modified herein.

BACKGROUND FACTS

2 In November 2007, Plaintiff filed this action against O

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United States of America Ex Rel. Susan Hutcheson and Philip Brown

In this qui tam action brought under the False Claims Act (FCA), 31 U.S.C. § 3729 et seq., relator Susan Hutcheson appeals from a Rule 12(b)(6) dismissal of her claims against Blackstone Medical, Inc. (Blackstone).

Hutcheson argues that Blackstone "knowingly" "cause[d]" hospitals and physicians to submit materially "false or fraudulent" claims to Medicare, Medicaid, and TRICARE in viol

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Patricia K. Hoendermis v. Advanced Physicial Therapy, Inc.

Advanced Physical Therapy (APT) terminated the employment of Patricia Hoendermis (“Patti”), the clinic’s practice administrator, for an inability to communicate with her co-workers and supervisor. Hoendermis sued APT for wrongful termination and failure to provide overtime compensation. The superior court granted APT summary judgment on both claims. Hoendermis appeals. We revers

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Nabil Bissada v. Arkansas Children's Hospital

Nabil K. Bissada, M.D., appeals the district court’s1 grant of summary judgment to Arkansas Children’s Hospital (ACH), Samuel Smith, Jonathan Bates, Robert D.B. Jaquiss, Timothy Martin, Michelle Moss, Bonnie Taylor, Robert Lyle, Sandra Taylor, Debra Barrow, Patti Higginbotham, and John and Jane Does 1-10 (collectively, appellees). Dr. Bissada, a pediatric urologist, alleged appellees

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United States of America v. Peter G. Rogan

The United States has a judgment for more than $60 million against Peter Rogan,who defrauded the Medicare and Medicaid programs. See United States v. Rogan, 517 F.3d 449 (7th Cir. 2008). Rogan, who has fled the country, concealed his wealth in an attempt to frustrate his many creditors. See, e.g., Dexia Crédit Local v. Rogan, 629 F.3d 612 (7th Cir. 2010). By tracing Rogan’s assets, the

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Jessica Cohon v. State of New Mexico

Plaintiff-Appellant Jessica Cohon sought funding through New Mexico’s Mi Via Waiver program,1 a Medicaid program offered by New Mexico that offers a home and community-based alternative to institutional care for qualifying individuals. Cohon qualified for the Mi Via Waiver program and submitted budget requests which were granted in part and denied in part. She unsuccessfully filed an admini

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Russell Allen Nordyke v. Mary V. King

We must decide whether the Second Amendment prohibits a local government from banning gun shows on its property.

I

A

Russell and Sallie Nordyke operate a business that promotes gun shows throughout California. A typical gun show involves the display and sale of thousands of firearms, generally ranging from pistols to rifles. Since 1991, the Nordykes have promoted numerous show

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Gertrud Moreno v. Texas A&M University-Kingsville

Appellant Gertrud Moreno challenges the plea to the jurisdiction and summary judgment granted in favor of appellee Texas A&M University-Kingsville (TAMUK) on Moreno's claim for retaliatory discharge under the Texas Whistleblowers Act. See Tex. Gov't Code Ann. § 554.002 (West 2004). By two issues, Moreno argues that the trial court erred in granting TAMUK's: (1) motion for summary judgment be

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Hilda Solis v. Laurelbrook Sanitarium and School, Inc.

Acting on a tip from a concerned citizen, the Wage and Hour Division of the U.S. Department of Labor commenced an investigation into potential child labor violations committed by Laurelbrook Sanitarium and School, Inc. (“Laurelbrook”). After concluding that Laurelbrook had violated the child labor provisions of the Fair Labor Standards Act of 1938, 29 U.S.C. §§ 201-219 (“FL

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Dr. Penny M. Wilkie v. United States Department of Health and Human Services

Dr. Penny M. Wilkie filed suit against the United States Department of Health and Human Services ("the Department"), alleging, inter alia, that the Department violated her rights under Title VII of the Civil Rights Act of 1964. Specifically, Dr. Wilkie asserted that the Department violated her rights to (1) be free of sexual harassment and gender discrimination; (2) be free of a hostile work envir

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Hong Pham v. Michael P. Starkowski, Commissioner of Social Services

This appeal arises from a class action lawsuit filed by the plaintiff, Hong Pham, individually and on behalf of all others similarly situated, against the defendant, Michael P. Starkowski, the commissioner of social services, challenging the constitutionality of Public Acts, Spec. Sess., September, 2009, No. 09-5, §§ 551 and 642 (Spec. Sess. P.A. 09-5), which effectively terminated certain s

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Anna C. Moore v. Clyde L. Reese, III

Plaintiff Anna “Callie” Moore (“Moore”) sued Defendant Clyde Reese, Commissioner of Georgia’s Department of Community Health (“DCH”),1 for allegedly violating the Medicaid Act (“the Act”) by reducing Moore’s Medicaidfunded private duty nursing care from 94 to 84 hours per week. The district court granted Moore’s motion for partia

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U.S. Renal Care, Inc. v. Laura Jaafar

This case stems from a dispute regarding Appellant U.S. Renal Care’s (Renal Care) purchase of Rencare, Ltd., formerly owned by Appellees Laura Jaafar, Lisa Lewis, and their father, Bob Ehl (collectively Sellers). Jaafar and Lewis sued Renal Care for breach of contract, violation of prompt payment statutes, and attorney’s fees, among other claims. Renal Care counterclaimed for breac

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Daniel Branson v. Sharp Healthcare, Inc.

The beneficiary of medical services under the California Medical Assistance Program (Medi-Cal) is required to reimburse the Department of Health Care Services (the Department) for the costs of medical care from a recovery obtained in a tort action against a third party liable for the beneficiary's injuries. The Department's claim, however, "is limited to that portion of a settlement, judgment, or

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Southwest Fiduciary, Inc. v. Arizona Health Cost Containment System Administration

¶1 In these consolidated cases we address a question the Supreme Court left open in Arkansas Department of Health and Human Services v. Ahlborn, 547 U.S. 268 (2006), concerning the lien rights of a state Medicaid plan after it has paid medical expenses for a victim who subsequently settles with a tortfeasor for less than the full amount of her overall damages. We conclude that the state plan ma

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