On August 8, 2012, a federal trial judge unsealed a whistleblower suit alleging that Mimbres Memorial Hospital (Mimbres) in New Mexico had submitted claims to Medicare and Medicaid for microbiology services in violation of requirements imposed by the Centers for Medicare & Medicaid Services (CMS) for the certification of laboratories (under the Clinical Laboratory Improvement Acts of 1988 (CLIA)). The whistleblower worked at the hospital and alleged that, because a provider’s eligibility for reimbursement for laboratory services depends on CLIA compliance, the hospital’s failure to meet CLIA requirements rendered those claims a violation of the FCA. The relator also accused Mimbres, in part, of (1) failing to conduct routine quality-control procedures on instruments to ensure that they produced accurate and verifiable results; (2) failing to conduct required monitoring and internal reviews; and (3) using outdated equipment instructions. As a result, the relator … [Read more...] about Health Care Enforcement in 2012: A Year in Review
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“This is actually more painful than a root canal because at least the dentist gives you Novocain,” Martin says, in a second, solo interview. “I don’t know Jill Simpson. I have never met Karl Rove or been in the same building with him, to my knowledge. When I ran for elective office, I got some names of consultants from Bill Canary. I couldn’t afford Bill.” … [Read more...] about The Curious Case of Alex Latifi
EXPERIENCE-BASED STRATEGY ISN’T THE BE-ALL AND END-ALL That thought, in conjunction with the series, brought me to a recent I..S. Supreme Court case regarding ineffective assistance of trial counsel. On May 14, 2018, the high court decided McCoy v. Louisiana. Robert McCoy was charged with murder. The prosecution wanted him executed because of the accusations. McCoy wanted to deny the accusations. McCoy’s attorney wanted to save his life. McCoy and his attorney couldn’t get on the same page as far as the best way to coordinate those goals. … [Read more...] about ‘Marcia Clark Investigates’ offers entertainment, but not impact
In College of Dental Surgeons of Puerto Rico v. Connecticut Gen. Life Ins. Co., 585 F. 3d 33 (1st Cir. 2009) the First Circuit grappled with this issue. The plaintiff, the College of Dental Surgeons of Puerto Rico, brought suit on behalf of its members, consisting of licensed dentists in Puerto Rico, against multiple defendants claiming that the defendants' claims handling practices were questionable, fraudulent and economically detrimental to the members. Two defendants removed the case to federal court pursuant to CAFA. The district court remanded the case on the basis that the complaint did not sufficiently define the plaintiff class. On appeal, the remand order was vacated. The First Circuit noted that the complaint plausibly alleged claims for class-wide relief and consistently alleged harm to the members as a professional group. The appellate court rejected the argument that remand was appropriate because the case could never be certified since … [Read more...] about Seeking CAFA Clarity: A Summary of Recent Case Law Addressing Challenges to Jurisdiction Under the Class Action Fairness Act
“I’m just sometimes stunned by how folks will say over and over that they love the Constitution,” he said. “Yet when it comes to something as fundamental as funding [Indian] health or salmon restoration, the money’s not there.” Within those old, beautifully lettered documents, the concept of perpetuity is rendered in poetic phrases such as “so long as the buffalo may range.” (Several treaties are on display in the “Nation to Nation”exhibit at the Smithsonian’s National Museum of the American Indian.) Yet more than antique curiosities of the frontier age, the treaties are what separate Native Americans from any other group. Native American demands for civil rights and access to quality housing, education and health care are founded not just in the moral duty to treat all people equally. The continent’s first occupants prepaid for what they are owed by ceding millions of acres. If they collected a fair rent on that … [Read more...] about What do Native Americans want from a president?