In this case, Plaintiffs’ stated goal is to ensure that economically disadvantaged children throughout the State of Michigan obtain adequate medical care. The court can safely say that the endeavor is commendable. Having a virtuous goal in sight, however, does not endow a court with the power to hear a case, nor create a cause of action where none exists. In this case, neither jurisdic

This dispute is before us for the third, and we trust last, time. See Bethesda Lutheran Homes & Services, Inc. v. Leean, 122 F.3d 443 (7th Cir. 1997), 154 F.3d 716 (7th Cir. 1998). In the first round, Bethesda, a private residential institution in Wisconsin for the mentally retarded, along with several current and would-be residents, brought suit under 42 U.S.C. sec. 1983 against a number

Medicaid Act. Assuming plaintiff, who qualified for a phalloplasty under the medically needy classification of Medicaid, had an enforceable federal right to reasonable standards for determination of the extent and scope of services that a state will provide under the Medicaid Act, the Iowa Department of Human Services regulation excluding sex reassignment surgery was not unreasonable, arbitrary or

Class Action - Plaintiffs Orthopaedic Hospital and the California Association of Hospitals and Health Systems claimed that Defendant Director of the California Department of Health Services violated section 1396a(a)(30)(A) of the federal Medicaid Act, 42 U.S.C. § 1396a-1396v by setting reimbursement rates for hospital providers of outpatient services without proper consideration of the effect of

Qui Tam Action - Plaintiff alleged that Columbia HCA Healthcare Corporation, now known as HCA - The Healthcare Company, and its subsidiaries Columbia Homecare Group, Inc. and Columbia Management Companies, Inc. of defrauding the government health care programs by inflating charges to the government and paying kickbacks to doctors so they would refer Medicare and Medicaid patients to their faciliti

Wal-Mart challenged the two-tiered reimbursement program established by the Arkansas Department of Human Services under which chain pharmacies, including Wal-Mart and Walgreen, received 6.8 % less revenue than independently owned pharmacies for filling prescriptions for the same drugs for Medicaid patents. Wal-Mart alleged that the defendant failed to consider the appropriate criteria which it cl

Civil Rights - 42 U.S.C. 1983 - Disabled - Sexual and Psychological Abuse - Three developmentally disabled men (all with an IQ of less than 60) were repeatedly raped, beaten and tortured in a state-licensed adult family care home. Damon Beckman (age, 26 -- IQ approximately 60) was tortured between September 1994 and July 1996. Eric Busch (age, 26 -- IQ approximately 40) was tortured between July

Lottery Tickets - This as an action to determine the true owner of winning lottery tickets. It came out in court that the winning lottery numbers had been derived from the medicaid card of plaintiff's mother and the testimony of various nonparty witnesses substantially corroborated plaintiff's version of the relevant events.

Daisey L. Johnson sued Life Insurance Company of Georgia ("Life of Georgia"), alleging that it had engaged in intentional and reckless fraud and fraudulent suppression by selling her a Medicare supplement insurance policy that was worthless to her because she was eligible for Medicaid.

On September 9, 1986, while a resident at Capital District Psychiatric Center in the City of Albany, Arnold O. fell through a second-story plate glass window and fractured his spine, rendering him a paraplegic. A claim against the State was thereafter filed on his behalf alleging negligent design of the building. Certain of Arnold O.'s medical and hospital costs were paid by Medicaid and, in Febru

Medicaid Coverage - In August of 1996, Charles Dillingham was admitted to a nursing care facility after suffering a stroke. Mr. Dillingham was 86 years of age. In September 1996, Mr. Dillingham transferred assets worth $126,735.76 to his son, David Dillingham, the petitioner. In November 1996, petitioner applied to the Buncombe County Department of Social Services for Medicaid coverage for his fat

Medical Malpractice - Adenoidectomy - Medicaid - An infant child, who was a Medicaid recipient, died after the hospital where the surgery was to be performed denied care to the child after the Medicaid review board disapproved coverage for the adenoidectomy procedure. The mother of the child brought a medical malpractice action against the hospital, facility, and the physician at the facility who

Automobile Accident - Medicaid - Utah Code Annotated: 26-19-4.5 - McNeil was a passenger in an automobile which was involved in an accident. He sustained severe brain injuries with permanent effects and profound neurological deficits. At the time of the accident, he was sixteen years of age and resided with his seventy-six-year-old grandmother and legal guardian, Lilian McNeil, who had raised hi

Rose Mary and Michael Candia brought a medical malpractice claim on behalf of their dauther Lisa Ann Candia and themselves. The malpractice claim was settled for $700,000, approved by an order filed on April 24, 1996, inter alia, that $28,112.94, the amount of a lien claimed by the State of New Jersey based upon Medicaid benefits provided to Lisa Ann was to be held in an interest bearing accou

Medical malpractice - wrongful birth. Plaintiff sough medical care from defendant when she learned that one of the two twin fetuses she was carrying died. She decided to have an abortion and the dead fetus was aborted. When she returned to her OB/GYN, she learned that she was still carrying the other fetus which was delivered prematurely by Cesarean -section shortly thereafter. The baby we

Declaratory judgment action by trustee of supplemental needs trust established by a Medicaid recipient seeking a determination that medical assistance liens filed by the Minnesota Department of Human Services against recipient's causes of action accruing as a result of an accident were unenforcable. Norwest was the trustee of two supplemental needs trusts created pursuant to the provisions of 42

Three False Claims Act (qui tam) action claims. Robert J. Merena filed the first of the claims against SmithKline on November 12, 1993 in the Eastern District of Pennsylvania. All three complaints alleged that SmithKline, which operates a nationwide system of clinical laboratories, adopted myriad complicated procedures for the purpose of defrauding state and federal healthcare programs, in

Action by the State of Washington to recover $2.2 billion in Medicaid funds spent on tobacco-related illnesses in the last three decades, and damages and penalities.

Qui tam - False Claims Act - whistleblower action initiated by Mr. Kready against the University of Texas for submitting false bills to Medicare, Medicaid and other federal programs without possessing sufficient documentary evidence to support those claims. Kready's complaint alleged that the Unversity of Texas Medical School at San Antonio submitted claims between January 1990 and December, 1995

Twenty-three counts of medicaid fraud and conspiracy to commit mail fraud.