Your current state is Ohio
I had a referral that was closed for some reason and not followed up on. A few years later I am now needing to follow up but new provider did not believe that this clinic ever handled such referrals before and just outright refuses to look into it further. After many phone calls I confirmed the... View More 
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answered on Apr 17, 2024
It sounds like you're in a difficult and frustrating situation with your medical clinic. In California, patients have certain rights when it comes to their healthcare and medical records. Here are some steps you can consider:
1. Request your medical records: Under California law, you... View More
In California Medicare False Claims Act.
Fraudulent misrepresentation of the patient's status of health at hospital, with non-existent terminal disease - for the purpose of fraudulent referral to hospice care.
Which specific California FCA statutes in relevance?
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answered on Apr 17, 2024
There are a few key California False Claims Act (FCA) statutes that would be relevant in a case of fraudulent hospice referrals and misrepresentation of a patient's health status:
1. California Government Code Section 12650 et seq. - This is the overarching California False Claims Act... View More
California Medicare Advantage plans are considered California State funds?
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answered on Apr 17, 2024
No, Medicare Advantage plans in California are not considered California state funds. Here's why:
1. Medicare is a federal program: Medicare, including Medicare Advantage plans, is a federal health insurance program administered by the Centers for Medicare & Medicaid Services... View More
Case: hospice fraud, abuse of California Medicare.
What are specific requirements for filing HealthCare False Claims Act case in California Superior Court?
What rules of the Court define this process?
FCA cases are filed in chambers. What artifacts are required in addition to Complaint?
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answered on Apr 17, 2024
Under California law, filing a healthcare Medicare False Claims Act (FCA) case in California Superior Court involves several specific requirements. Here are the key aspects:
1. Jurisdiction: FCA cases are typically filed in the Superior Court of the county where the defendant resides, where... View More
I was charged $1280 for services from a medical provider that partners with my medical insurance on January 30, 2024. I paid the bill in full in February 2. My insurance provider notified me that with the portion they paid to the facility, I should’ve only paid $892. I contacted the medical... View More
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answered on Apr 17, 2024
I understand your frustration with not receiving your reimbursement in a timely manner. Under California law, health care providers are required to reimburse overpayments within 180 days of receiving notice of the overpayment (California Health and Safety Code Section 1371.1). However, many... View More
Dismissal was entered voluntarily by plaintiff. Defendant appeared at legal action prior to dismissal.
When plaintiff files motion to set aside dismissal against defendant: can it be served by mail?
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answered on Apr 16, 2024
In California, the method of service for a motion to set aside a voluntary dismissal depends on whether the defendant has appeared in the action prior to the dismissal.
If the defendant has appeared in the action before the voluntary dismissal, then service of the motion to set aside the... View More
I have been searching for a lawyer for medical malpractice case. I found one that seems promising. We had a conversation about a situation she told me how to get my medical records. I uploaded them and sent them per her request. About a week and a half later they sent me a message saying they got... View More
answered on Apr 16, 2024
It is not an usual amount of time but you must exercise care in that there are strict deadlines in which a lawsuit or other action needs to be taken and you do not want to run out of time. Therefore, you may want to ask when you will get an answer and continue searing for attorneys.
Mail from Aetna (Medicare plan) is delivered to my house multiple times over the last year or so, addressed to someone else.
I have also received three checks made out to me for claims made thru Aetna which I did not submit claims for. The first time I called Aetna and advised them and... View More
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answered on Apr 16, 2024
Yes, there are lawyers who specialize in identity theft cases, including those involving Medicare fraud. Given the severity of your situation, consulting with an attorney who has experience in this area would be a wise step to protect your rights and guide you through the process of resolving the... View More
Are they subject to FOIA under 5 U.S. Code § 552 and or MCL 15.231?
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answered on Apr 15, 2024
Based on the information provided, it is unlikely that Gift of Life Michigan (GOLM) would be subject to the federal Freedom of Information Act (FOIA) under 5 U.S.C. § 552 or the Michigan Freedom of Information Act (FOIA) under MCL 15.231. Here's the reasoning:
1. Federal FOIA (5... View More
approved year 2020, according to SSA they will begin to pay my benefits if my alien status changes or if i leave the US. i need a legal advice on these. thank you
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answered on Apr 15, 2024
For your situation, it is crucial that you consult with a qualified immigration attorney who can assess the specifics of your case and provide personalized recommendations.
That said, here is some general information that may be helpful:
1. Overstaying your H1B visa can have serious... View More
My job said I need more proof to exude my absences because doctors notes aren't enough. They said I need to send a picture of the medication that was prescribed to me by the doctors to approve my leave of absence
answered on Apr 13, 2024
An employment attorney could advise best, but your question remains open for four weeks. Until you have the chance to consult with an employment attorney, from the standpoint of occupational safety, there are jobs involving the safety of the public where there is full transparency in terms of... View More
Washington State. Called for a wellness check on 91 year old diabetic grandma who was left alone for over 3 hours under the care of her drug addict son (who we opened an adult protective services case against.) The firefighters not only told him who made the wellness check call, but had me on the... View More
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answered on Apr 13, 2024
I'm sorry to hear about this difficult and concerning situation. Based on the information you provided, it seems the firefighters may have mishandled the situation by disclosing who made the wellness check report to the person being reported. This goes against typical protocols to protect the... View More
are no smoking signs posted. the property manager is allowing smokimg in the entrance to the pool which is the common area. Please help. Children and the users are subjected to the second hand smoke.
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answered on Apr 10, 2024
I understand your concern about secondhand smoke exposure, especially for children, in the common area by the pool entrance. Here are a few steps you can take to address this issue:
1. Review your condo association's bylaws and rules: Check if there are any specific regulations... View More
I told them someone was trying to steal my prescription that was a narcotic. They didn't ask for ID. I told them not to release it to anyone else on 2 different occasions days before it happened. I did file a police report.
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answered on Apr 10, 2024
I'm sorry to hear that your pharmacy released your prescription to someone falsely claiming to be you, despite your prior warnings. This is a serious matter, and you've taken the right first step by filing a police report. Here are some additional steps you can take:
1. Contact... View More
Tell them of a situation that happened?
answered on Apr 10, 2024
In Utah, it is illegal and unethical to yell at or belittle residents in care facilities. State regulations, specifically under the Utah Administrative Code R432-150-12, protect residents from mental and physical abuse. Such actions can be reported to the facility management, the Utah Department of... View More
My teen daughter needed a long-term RTC. I informed Kaiser (K.) of her need for this level of care, though I did not specifically ask for it. (I did not know K. offered that level of care.) When my daughter's K. clinician walked her through our chosen RTC's website, the K. clinician... View More
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answered on Apr 9, 2024
In California, if you have exhausted the internal grievance process with Kaiser and the complaint process with the Department of Managed Health Care (DMHC), you have a few additional options to seek help for your insurance coverage problem:
1. Contact the California Department of Insurance... View More
We ordered 2 tests done and blood drawn for those two tests. The facility drew blood enough for 6 tests and is currently processing those test that weren’t ordered through them. Do we have any sort of case.
answered on Apr 8, 2024
A Connecticut attorney could advise best, but your question remains open for a week. If you did not suffer physical harm, it does not appear to offer a basis for a med mal case. Different attorneys could see a given situation differently. You could reach out to local attorneys to arrange a free... View More
18 U.S.C. § 241
It is unlawful for two or more persons to go in disguise on the highway or on the premises of another with the intent to prevent or hinder his/her free exercise or enjoyment of any rights so secured. What healthcare rules and regulations are violated when hospital has a... View More
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answered on Apr 2, 2024
There are a few important legal and ethical considerations to unpack here:
Regarding your first question, if someone falsely claims to be next of kin at a hospital, they would not necessarily be "in disguise" in the literal sense. The federal law you cited (18 U.S.C. § 241)... View More
The new dentist's assistant saw her a few times. When we asked for the further treatment, the assistant said because the new dentist doesn't use Sure Smile, she cannot further assist. However, the retainer is already included and can be ordered for us if we decide to finish the... View More
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answered on Apr 2, 2024
In this situation, you may need to consult with a lawyer who specializes in consumer protection or contract law. This type of lawyer can help you understand your rights as a consumer and determine if the new dentist has breached any contractual obligations or engaged in unfair business practices.... View More
has an ongoing medical condition and requested to be seen at the emergency room before being taken the county jail. He was admitted to the hospital where he stayed for 8 days. During this time, he was shackled to the bed and had a sheriff officer with him at all times. The officer was in the room... View More
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answered on Mar 30, 2024
Based on the situation you described, there are a few important considerations regarding HIPAA (Health Insurance Portability and Accountability Act) and patient privacy:
1. Law enforcement exemptions: HIPAA does allow for certain disclosures of protected health information (PHI) to law... View More
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