Medicaid Law
 
State Of New Mexico v. Surratt

On August 31, 2010, following an investigation by the New Mexico State
19 Police, Defendant Danny Surratt was charged in Lea County Magistrate Court with
2
1 several counts stemming from allegations of inappropriate sexual conduct with his
2 two minor stepgranddaughters. Defendant served for many years as a law
3 enforcement officer in Lea County and was a deputy sheriff at the... More...
   $0 (12-11-2015 - NM)

Humana Medical Plan, Inc. vs. Mary Reale, et al.

Humana, the appellant in this case, administers Medicare benefits to enrollees
in its Medicare Advantage plans pursuant to a contract with the Centers for Medicare
and Medical Services. At all relevant times, Mary Reale, the appellee, was enrolled
in a Humana Medicare Advantage plan (Humana Gold Plus H1036-054C). In
January 2009, Mrs. Reale sustained injuries resulting from a... More...
   $0 (12-08-2015 - FL)

Lutheran Services Florida, Inc. v. Dept. of Children & Families

Lutheran Services Florida, Inc. (LSF), is the court-appointed guardian for the person and property of the ward Larry Peron. Mr. Peron resides in a nursing home facility as a beneficiary of the Medicaid Institutional Care Program (ICP). As part of that program, Mr. Peron pays a portion of his income to the facility as his patient
responsibility payment and Medicaid ICP pays the balance of th... More...
   $0 (12-08-2015 - FL)

Stacy R. Dellit v. Joshua M. Tracy

The parties, who never married, are the parents of two minor children born in 2006 and 2008. Father and Mother remained together for a period of time after both children were born, but eventually separated in 2009. As a result, Father filed a petition to establish custody and visitation. The parties came to an agreement and filed a stipulated order establishing custody and visitation, which was... More...   $0 (12-07-2015 - WY)

United States of America v. Wanda C. Shorter

Hammond, IN - Wanda C. Shorter Found Guilty By Jury Trial

Wanda C. Shorter, 43, of Elkhart, Indiana, was found guilty after a four-day jury trial of all four counts charged by indictment in a health care billing fraud/aggravated identity theft case.

According to documents in this case, Empowerment Non-Emergency Medical Transportation, Inc. (hereafter "Empowerment") was an enrolle... More...
   $0 (12-04-2015 - IN)

Stacy R. Dellit v. Joshua M. Tracy

The parties, who never married, are the parents of two minor children born in 2006 and 2008. Father and Mother remained together for a period of time after both children were born, but eventually separated in 2009. As a result, Father filed a petition to establish custody and visitation. The parties came to an agreement and filed a stipulated order establishing custody and visitation, which was... More...   $0 (12-04-2015 - WY)

Canonsburg General Hospital v. Sylvia Mathews Burwell

Through the Centers for Medicare and Medicaid Services (CMS), the Secretary provides for the reimbursement of the reasonable costs of healthcare services for Medicare beneficiaries. See 42 U.S.C. § 1395f(b)(1)(A). Two aspects of the reimbursement scheme are relevant here. The first is the system for managing the costs of reimbursement. Healthcare providers submit requests for reimbursement for ... More...   $0 (12-04-2015 - DC)

Bluestem Telephone Co. v. Kansas Corporation Comm'n

The Telecommunications Act of 1996 (1996 Act) was passed by Congress in order to further deregulate the telecommunications industry. 47 U.S.C. § 151 et seq. (2012); see Citizens' Utility Ratepayer Bd. v. Kansas Corporation Comm'n, 264 Kan. 363, 369, 956 P.2d 685 (1998). The 1996 Act was intended to serve the dual purposes of ensuring "universal service" to both low income consumers and consumers i... More...   $0 (12-03-2015 - KS)

United State of America v. Melissa Prentice-Erickson

Omaha, NE - Nebraska Therapist Sentenced in Health Care Fraud Case

A Lincoln-area woman must repay more than $192,000 to the state of Nebraska and serve 12 weekends in jail over the next year after pleading guilty to committing health care fraud. Melissa Prentice-Erickson must also serve six months under house arrest and a 5 year term of probation, under a sentence handed down this after... More...
   $0 (12-02-2015 - NE)

Bluestem Telephone Co. v. Kansas Corporation Comm'n

The Telecommunications Act of 1996 (1996 Act) was passed by Congress in order to further deregulate the telecommunications industry. 47 U.S.C. § 151 et seq. (2012); see Citizens' Utility Ratepayer Bd. v. Kansas Corporation Comm'n, 264 Kan. 363, 369, 956 P.2d 685 (1998). The 1996 Act was intended to serve the dual purposes of ensuring "universal service" to both low income consumers and consumers i... More...   $0 (11-30-2015 - KS)

NEW ORLEANS REGIONAL PHYSICIAN HOSPITAL ORGANIZATION, INC v. USA

Plaintiff, New Orleans Regional Physician Hospital Organization, Inc., d/b/a Peoples Health Network (PHN or plaintiff), has filed a motion for reconsideration of a portion of the court’s August 21, 2015 Opinion and Order.1 Pl.’s Mot., Sept. 18, 2015, ECF No. 121-1; see generally New Orleans Reg’l Physician Hosp. Org., Inc. v. United States (New Orleans), 122 Fed. Cl. 807 (2015). Plaintiff mainta... More...   $0 (11-27-2015 - DC)

United States of America v. Jocelyn Pyles-Elo, M.D.

Houston, TX - Jury Convicts Former City of Houston Doctor of Health Care Fraud

A jury has returned a guilty verdict against a former staff physician for the City of Houston of 14 counts of health care fraud in a $1 million health care fraud scheme, announced U.S. Attorney Kenneth Magidson. Jocelyn Pyles-Elo, M.D., 58, was convicted following a 3 ½ day trial in Houston.

The jury h... More...
   $0 (11-20-2015 - TX)

United States of America v. Novartis Pharmaceuticals Corp.

New York, NY - Manhattan U.S. Attorney Announces $370 Million Civil Fraud Settlement Against Novartis Pharmaceuticals For Kickback Scheme Involving High-Priced Prescription Drugs, Along With $20 Million Forfeiture Of Proceeds From The Scheme - Novartis Admits to and Accepts Responsibility for Facts Regarding Its Distribution of Exjade and Myfortic

Preet Bharara, the United States Attorney... More...
   $370000000 (11-20-2015 - NY)

In the Interest of J.F., J.L., and J.N., Children

DeDe’s1 drug use, petty thefts, and incarcerations eventually resulted in the termination of her parental rights to her five children.2 In this case, she appeals the trial court’s order terminating her parental rights to J.F., J.L., and J.N. She contends that the evidence is legally and factually insufficient to support the trial court’s findings that she (1) knowingly placed or knowingly allowed ... More...   $0 (11-19-2015 - TX)

United States of America v. Florence Bikundi and Michael Bikundi

Washington, D.C. - Owners of Home Health Care Agency Found Guilty Of Taking Part in $80 Million Medicaid Fraud

Defendants Used Money to Finance a Lavish Lifestyle

Florence Bikundi, and her husband, Michael Bikundi, the owners of Global Healthcare, Inc., a home care agency, have been found guilty by a jury of health care fraud, money laundering, and other charges stemming from a s... More...
   $0 (11-18-2015 - NY)

United States of America v. HCA Holdings, Inc. f/d/b/a HCA, Inc. f/d/b/a HCA – Hospital Corporation of America f/d/b/a Hospital Corporation of America and Parallon Business Solutions, LLC, West Florida Regional Medical Center, Inc. d/b/a West Florida Hospital; HCA Health Services of Florida, Inc. d/b/a Regional Medical Center Bayonet Point; HCA Health Services of Florida, Inc. d/b/a Oak Hill Hospital; and New Port Richey Hospital, Inc. d/b/a Medical Center of Trinity (“HCA”).

Columbia, SC - HCA Settles Allegations of Billing for Unnecessary Lab Tests and Double Billing for Fetal Testing for $2,000,000

United States Attorney Bill Nettles announced today that the United States Attorney's Office for the District of South Carolina with the State of Florida, settled claims of health care fraud with HCA Holdings, Inc. f/d/b/a HCA, Inc. f/d/b/a HCA – Hospital Corpor... More...
   $0 (11-17-2015 - SC)

Amarin Pharma Inc. v. U.S. FDA

Amarin is a biopharmaceutical company incorporated in Delaware and based in New
Jersey. Compl. ¶ 24. It and four medical doctors resident in New York2 (collectively, “Amarin”)
bring this suit against the FDA, two officials with responsibility over the FDA (Dr. Stephen
Ostroff and Sylvia Matthews Burwell), and the United States (collectively, the “FDA”).3 The
FDA is the federa... More...
   $0 (11-15-2015 - NY)

United States of America v. Jaime Leonard Smith

Raleigh, NC - President Of Ambulance Company Pleads Guilty To Perjury In Connection With False Health Care Claims Investigation

JAIME LEONARD SMITH, 35, of Morehead City, North Carolina, pleaded guilty to Perjury.

According to the Criminal Information, SMITH was the president of CCMT, Inc., doing business as Crystal Coast Medical Transport (CCMT). CCMT was a nonemergency ambulan... More...
   $0 (11-05-2015 - NC)

Brissette v. Ryan

After a Superior Court trial in this legal
malpractice case, a jury found that the primary defendant,
Edward J. Ryan, Jr., was negligent in his representation of the
plaintiff, Marie D. Brissette, and awarded damages to her in the
amount of $100,000 against Ryan and his law firm, Ryan,
Boudreau, Randall, Kirkpatrick & Baker, LLP (law firm)
(collectively, defendants).2 ... More...
   $0 (10-31-2015 - MA)

United States of America v. Robert Manning

Houston, TX Houston Man Pleads Guilty to Conspiracy to Defraud Medicare

A Houston businessman has entered a guilty plea to engaging in a conspiracy to defraud Medicare of more than $6.6 million.

At a hearing held today before U.S. District Kenneth Ellison, Robert Manning, 60, admitted he participated in a three-year conspiracy to defraud Medicare by paying kickbacks to Medicare b... More...
   $0 (10-29-2015 - TX)

McCrimmon v. State

This appeal arises from the 2012 conviction in the Circuit Court for Baltimore
County of appellant Penny McCrimmon for embezzlement and misappropriation of funds
by a fiduciary and from the court’s sentence that included an order for restitution.
On March 31, 2011, the State filed a criminal information in the circuit court
charging McCrimmon with three counts: theft of prope... More...
   $0 (10-27-2015 - MD)

Positive Progressions, Llc, a Wyoming Limited Liability Company, Northern Developmental Disability Service Providers, Inc., a Wyoming Corporation, and Nathan Cook v. Amy Landerman, F/K/A Amy Baxter

In November of 2010, Amy Landerman approached Nathan Cook about buying her business, Northern Developmental Disability Service Providers, Inc. (Northern). Mr. Cook expressed interest in buying the business. On January 24, 2011, Ms. Landerman emailed Mr. Cook and offered to sell Northern for $247,500. Mr. Cook indicated his interest in buying the business and the two agreed to meet at Northern’... More...   $0 (10-23-2015 - )

Needham v. Director of the Office of Medicaid

sole beneficiary.4 MassHealth reviewed this and other financial
information for purposes of determining whether Needham met the
financial eligibility requirements for long-term care under the
Medicaid program. See 130 Code Mass. Regs. § 520.003(A)(1)
(2009) (setting an eligibility ceiling of $2,000 in countable
assets). The irrevocable trust, also valued at $412,400, wa... More...
   $0 (10-20-2015 - MA)

John Joerg, Jr. v. State Farm Mutual Automobile Insurance Co.

At common law, the collateral source rule governed both evidence and
damages. See, e.g., Gormley v. GTE Prods. Corp., 587 So. 2d 455, 457 (Fla.
1991). Historically, the damages aspect of the collateral source rule prevented the
reduction of damages by collateral sources available to the plaintiff. Id. This rule
rested on the principle that a tortfeasor should not benefit fr... More...
   $0 (10-18-2015 - FL)

United States of America v. Sharon Ward

Cleveland, OH - Richmond Heights woman sentenced to eight years in prison for operating an $18 million healthcare fraud scheme

A Richmond Heights woman was sentenced to nearly eight years in prison for operating an $18 million home healthcare fraud scheme.

Sharon Ward, 45, was sentenced to 94 months in prison and ordered to pay $18 million in restitution after previously being fo... More...
   $0 (10-18-2015 - )

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