Your current state is Ohio
Employer has indicated they are waiting on a decision from our third-party short-term disability company on a disability claim before the employer makes an internal decision on granting FMLA. I thought FMLA and short-term disability insurance were separate, and that I could qualify for FMLA... View More 
What are the relevant rules and regulations on starting a health insurance company in California. How can a startup which is from a foreign country set up its operations in this space. Please point me to the right set of resources. Thank you
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answered on Apr 19, 2024
Starting a health insurance company in California involves navigating a complex set of regulations and obtaining necessary approvals from the California Department of Insurance. First, you must incorporate your business in California. This involves choosing a business structure, such as a... View More
I hope this message finds you well. I represent Brighter Strides ABA, a company seeking to expand into Colorado. As we embark on this journey, we are keen on understanding the regulatory landscape for Board Certified Behavior Analysts (BCBAs) in your state.
We kindly request your assistance... View More
I had back surgery spinal stenosis in 2019. If I remember correctly I only saw him once after the surgery. He had moved to another practice. I had called several time to make an appointment at his new practice.. I was told he was not taking new patient. I told the receptionist that I was not a new... View More
For hospice fraud by Hospice as General stock corporation (means CEO).
Hospice as corporation bears vicarious liability for independent contractors, as applicable.
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answered on Apr 18, 2024
In California, a hospice operating as a general stock corporation can be held vicariously liable for the actions of its independent contractors in certain circumstances, particularly when those actions involve fraud. Here's a more detailed explanation:
1. Vicarious liability: This... View More
If Plaintiff would have to pursue Motion to Compel further discovery responses, or Motion to Compel discovery responses.
Defendant can object, based on privileges defined by evidence code. Attorney/client privilege, work product, premature, calling for legal conclusion, etc.
What... View More
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answered on Apr 18, 2024
If you have concerns about fraud, I would suggest speaking with a qualified attorney who can provide proper legal guidance for your situation. The rules around discovery, privileges, and subpoenas are complex and fact-specific.
The legally actionable material facts are: fraudulent referral to hospice by hospital with non-existent terminal disease recorded on admission to hospital, and consequent 6-months of fraudulent hospice care, presenting evident and provable basis for the CA FCA complaint .
In such situation:... View More
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answered on Apr 18, 2024
Under the California False Claims Act (CFCA), which is similar to the federal False Claims Act but specific to California, private individuals or entities can bring a qui tam action on behalf of the state against those who have allegedly defrauded the state's healthcare system. In the... View More
Section 12651 of California FCA is in relevance to misrepresentation of patient's health at hospital, with terminal non-existent diagnosis; fraudulent referral to hospice by hospital; and money fraudulently received by hospice from CA Medicare for hospice care.
What other California... View More
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answered on Apr 18, 2024
Based on the information provided, there are several other sections of the California False Claims Act (FCA) that may be relevant to the case involving misrepresentation of a patient's health, fraudulent referral to hospice, and fraudulent receipt of Medicare funds by the hospice. Here are... View More
Hospital referred patient to hospice with non-existent terminal disease, recorded on admission to hospital.
Legally actionable fraud was committee by both hospital and hospice?
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answered on Apr 18, 2024
Under California law, legally actionable fraud requires the following elements:
1. A misrepresentation of a material fact
2. Knowledge of the falsity of the misrepresentation (or reckless disregard for its truth)
3. Intent to induce reliance on the misrepresentation... View More
Hospital committed multiple frauds, that created basis for further fraudulent assessment of patient's health. Apparent, but may be used as distracting factors in regard to non-existent terminal disease.
After discharge from hospital patient was referred by unidentified hospital... View More
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answered on Apr 18, 2024
Based on the information provided, there are several potential issues that could constitute false claims and healthcare fraud under California and federal law:
1. If the hospital knowingly falsified the patient's diagnosis and health status in order to refer them to hospice care... View More
I once saw someone's post on wanting to build an application that sells courses that teaches people about their body, teaches them about diseases and prevention, (if treatment is included, it involves only natural and harmless medicines like water, fruit, exercises, e.t.c)
A person can... View More
Seminal cases. Fraudulent referral from hospital to hospice.
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answered on Apr 17, 2024
To find court cases related to hospice fraud and fraudulent referrals from hospitals to hospices in California, you can search several sources:
1. PACER (Public Access to Court Electronic Records): This is an electronic public access service that allows users to obtain case and docket... 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
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
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
answered on Apr 17, 2024
Tell them on the phone that if you don't have the money in 48 hours you will report them to Medicare, and the state board of quality medical control.
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 need to appeal to a medical negligence case. The court held that the doctor was negligent because he did not provide reasonable advice to the plaintiff to ensure that the wound was properly taken care of and failed to ensure that the appropriate and reasonable advice was given to him. Also, when... 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
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
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