Medicaid Law
 
Cox Retirement Properites, Inc., d/b/a The Cottage Extended Care v. Charles E. Johnson, Acting Secretary of the United States Department of Health and Human Services

This is an appeal from a final decision of the Secretary of Health and Human Services (Secretary), affirming a civil money penalty against Cox Retirement Properties, Inc., d/b/a The Cottage Extended Care (the Cottage), for noncompliance with certain Medicare regulations governing skilled-nursing facilities. We have jurisdiction under 42 U.S.C. § 1320a-7a(e), and we affirm.

The Cottage is

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Five Star Quality Care - Mo., L.L.C. d/b/a Arbor View Healthcare & Rehabilitation Center v. Bonnie Sue Lawson, Public Administrator

Bonnie Sue Lawson appeals the judgment of the trial court awarding Five Star Quality Care $16,779.65 on its breach of contract claim. In her sole point on appeal, Ms. Lawson claims that the trial court erred in holding her personally liable on the contract. Ms. Lawson’s point is granted, and the judgment of the trial court is reversed.

Factual and Procedural Background

Five St

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D. Michael Campbell v. The State of Florida

D. Michael Campbell, Appellant, seeks review of an order imposing sanctions on him for pursuing baseless litigation in a class action lawsuit against the State and various agencies (collectively, “the State”). We agree with Appellant that the trial court erred in considering the State’s motion for sanctions under the circumstances of this case. Accordingly, we reverse and remand

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Blake H. Moore, M.D. v. Williamsburg Regional Hospital, et al.

In this case, a physician brings multiple state law and federal due process claims against a hospital and its officials for suspending his staff privileges based on allegations that he had sexually abused his adopted daughter. While the scope of immunity under the Health Care Quality Improvement Act, 42 U.S.C. § 11101 et seq., certainly has limits, we think the immunity attaches to defendants u

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Desalegn Sisay, et al. v. Ricky D. Smith, et al.

The plaintiffs are four taxicab companies and the five individuals who own those companies. All four companies operate in the City of Cleveland (the "City"). In this action, the plaintiffs challenge a determination by the City to award to other cab companies the exclusive right to use the outbound queue at the Cleveland Hopkins International Airport ("Hopkins"). The district court granted a prelim

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State of Alabama v. Sandoz, Inc.

The State of Alabama sued Sandoz, Inc., a subsidiary of Novartis AG for wrongfully causing the State's Medicaid program to pay too much for prescription drugs from 1991 to 2005.

Sandoz denied wrongdoing.

More...   $78400000 (02-26-2009 - AL)

William L. Jackson v. Sparks Regional Medical Center & Columbia Casualty Company

Appellant William L. Jackson, as special administrator of the Estate of Sherri Jackson, deceased, appeals the order of the Sebastian County Circuit Court granting summary judgment in favor of appellees Sparks Regional Medical Center and Columbia Casualty Company. Jackson asserts that Sparks’s motion for summary judgment was granted in error because Sparks is not entitled to the charitable-i

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Charles Archer, et al. v. Sisters of Mercy Health System, St. Louis, Inc. d/b/a Sisters of Mercy Health System d/b/a St. Joseph's Mercy Health Center

This appeal involves a medical malpractice action brought by appellants Charles and Linda Archer (“the Archers”) on behalf of their son, Mason Archer, against multiple parties, including appellee, Sisters of Mercy Health System, St. Louis Pooled Comprehensive Liability Program (“the Liability Pool”).1 The circuit judge entered an order dismissing the Liability Pool. We reve

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Transition Healthcare Associates, Inc. v. Tri-State Health Investors, LLC

Plaintiff-Appellant Transition Healthcare Associates, Inc. (Transition) appeals the district court’s grant of Defendant-Appellee Tri-State Health Investors, LLC’s (Tri-State) motion for summary judgment in this action for breach of contract, suit on account, and unjust enrichment. Transition argues that the district court erred by basing its grant of summary judgment on Transitionâ

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Estate of Marion Landers v. Michael O. Leavitt

14 In this case — a dispute about how to count to three — the plaintiffs-
15 appellants are Medicare beneficiaries who appeal from a grant of summary
16 judgment of the United States District Court for the District of Connecticut
17 (Hall, J.). Each of them spent at least three days in the hospital but was
18 discharged less than three days after having been formally

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Dean K. Brown v. Robert M. Day, in his official capacity as Director, Kansas Division of Health Policy and Finance,

Plaintiff-Appellant Dena Brown sued Defendant-Appellee Robert Day, the Director of Kansas’s Division of Health Policy and Finance (“HPF”),1 in federal court pursuant to 42 U.S.C. § 1983, after Day issued a Final Order terminating Brown’s Medicaid benefits. Brown alleged that Day’s decision, which purported to execute newly enacted Kansas law, violates federal Me

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Columbia Medical Center of Los Colinas, Inc. d/b/a Los Colinas Medical Cetner v. Athena Hogue, et al.

This is a medical malpractice case. In this appeal, it is undisputed that the hospital caused Bob Hogue’s death. The jury made that finding at trial, the hospital does not challenge it in this Court, and the dissenting justices acknowledge that the evidence supports that finding. The primary issue presented to this Court is whether sufficient evidence was admitted at trial to support the ju

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Renee Rodriguez, etc. v. Out Land of Lourdes Medical Center

Renee Rodriguez and Barbara King filed a qui tam complaint pursuant to the False Claims Act, 31 U.S.C. § 3729 et seq., against their former employer, Our Lady of Lourdes Medical Center (the “Medical Center”), a New Jersey health “Qui tam actions have 1 a long history and were used in England before the foundation of this country.” United States ex rel. Atkinson v. Pa. Sh

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Lifesphere d/b/a Maple Knoll Village v. Jack Sahind

{¶1} Defendant-appellant Jack Sahnd appeals the entry of summary judgment for plaintiff-appellee Lifesphere on its claim that Jack’s mother, Kathleen, had fraudulently transferred her home to Jack under R.C. 1336.04. We affirm.

{¶2} Kathleen was 80+ when, in January 2005, she gave her house to her son Jack Sahnd. About seven months later, Kathleen moved to Maple Knoll, a geriat

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June D. Scamardo v. Sparks Regional Medical Center

June Scamardo appeals the order of the Sebastian County Circuit Court granting summary judgment in favor of Sparks Regional Medical Center (Sparks). On appeal, Scamardo argues that the circuit court erred in refusing to apply the law of the case doctrine to preclude the motion for summary judgment filed by Sparks. Scamardo also contends that the trial court erred in holding that Sparks was entitle

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Rebecca Bolanos, a Minor, etc. v. Superior Court of the State of California for the county of Los Angeles

These proceedings involve amendments enacted in 2007 to statutes that govern claims for reimbursements made by the California Department of Health Services for funds expended on behalf of injured parties by the state’s Medi-Cal program. The background of the Medi-Cal program has been described in Shewry v. Arnold (2004) 125 Cal.App.4th 186, 193.1 The amendments in question came in response

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Lorri Bielanski v. County of Kane, Illinois, Kane Child Advocacy Center, Kane County Child Advocacy Advisory Board, et al.

Lorri Bielanski, at the age of fifteen, was falsely accused of sexually abusing a six-yearold neighbor. Eventually acquitted of all charges, she sued a number of public officials and entities for violating her constitutional rights during the investigation and prosecution of the alleged crime. The district court dismissed her complaint in its entirety. We affirm.

I.

On review of this

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S.A. Vakilian v. Wesley Shaw, et al.

After criminal charges for Medicaid fraud were dismissed against the late Mohammad Vakilian, M.D., the administrator of his estate, S.A. Vakilian, (decedent and administrator collectively, “Vakilian”) sued Wesley Shaw (“Shaw”), an investigator in the Michigan Attorney General’s Office, and Richard Koenigsknecht (“Koenigsknecht”), an Assistant Attorney Gen

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Grady Jordan v. The Western Pennsylvania Hospital, d/b/a West Penn Hospital

The Department of Public Welfare (the Department) appeals an order of the Court of Common Pleas of Allegheny County (trial court) that overruled the Department’s objections to the trial court’s approval of a settlement of a tort action brought by the parents of Grady Jordan, a minor, on his behalf, seeking damages for injuries he suffered as a result of alleged medical malpractice at

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Rhode Island Hospital v. Michael O. Leavitt

Congress established the Medicare program in 1966 to provide health insurance to the elderly and disabled. See 42 U.S.C. § 1395 et seq. Part A of that program covers, inter alia, expenses related to inpatient hospitalization. The amount Medicare pays for these services is generally determined under the prospective payment system (PPS). See Robert Wood Johnson Univ. Hosp. v. Thompson, 297 F.3d 2

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IMS Health, Inc. and Verispan, LLC v. Kelly A. Ayotte, New Hampshire Attorney General

The spiraling cost of brand-name prescription drugs is a matter of great concern to government at every level. New Hampshire has attempted to curb this escalating problem by enacting innovative legislation. Certain affected companies have challenged New Hampshire's legislative response, and that challenge raises important constitutional questions that lie at the intersection of free speech and cyb

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Mission Hospital Regional Medical Center, et al. v. Sandra Shewry, etc.

We enter here into the arcane world of Medicaid law to answer a fundamental question: does a federal statute imposing notice and comment requirements apply to actions taken or mandated by a state legislature? In 2004, the California Legislature, as part of adopting a state budget after the Constitutional budget deadline had expired, proposed and enacted over only a three-day period a freeze on the

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Rita Tristani v. Estelle Richman, in Her Official Capacity as Secretary of the Commonwealth of Pennsylvania Department of Public Welfare

Estelle B. Richman, Secretary of the Commonwealth of Pennsylvania, Department of Public Welfare (the Department), appeals the order of the District Court for the Middle District of Pennsylvania, enjoining the Department from denying Medicaid benefits to Robert A. James. The central issue to the appeal is whether an annuity, purchased by James’s wife Josephine, may be treated by the Departme

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PROTECTION AND ADVOCACY SYSTEM, JANE DOES 1-3 and JOHN DOE 1, v. CITY OF ALBUQUERQUE

{1} In this case, we consider whether City of Albuquerque Ordinance C/S O-06-21, the Assisted Outpatient Treatment Ordinance (the Ordinance), is preempted by state law. First, though, we must consider whether Plaintiffs, Jane Does 1 through 3, John Doe 1, and Protection and Advocacy System (P&A), have standing to challenge the Ordinance. We agree with the district court that Plaintiffs have s

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State of Missouri v. Schering-Plough Corp. d/b/a Warrick Pharmaceuticals Corp.

The State of Missouri sued Warrick Pharmaceuticals Corporation, Schering-Plough Corporation and others on a Medicaid fraud claiming that the drug companies inflated reported prices for Medicaid reimbursement, costing the state about $15 million over 11 years.

Defendants denied wrongdoing.

More...   $7000000 (10-31-2008 - MO)

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