Get free answers to your Health Care Law legal questions from lawyers in your area.
How to look up information associated with hospice accreditation (specifically doctors on the list) if hospice is accredited by ACHC?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Apr 20, 2024
To look up information about a hospice accredited by the Accreditation Commission for Health Care (ACHC), you can start by visiting the ACHC's official website. There, you will find resources and tools to help verify accreditation status. It's also useful to contact the ACHC directly... View More 
How to obtain information about doctors associated with hospice license, if CMS certification number is known?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Apr 20, 2024
To find out information about doctors associated with a hospice that has a CMS certification number in California, you can start by visiting the Centers for Medicare & Medicaid Services (CMS) website. This site provides access to various data, including details about certified hospice care... 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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
For hospice fraud by Hospice as General stock corporation (means CEO).
Hospice as corporation bears vicarious liability for independent contractors, as applicable.
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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 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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
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?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
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
Lawyers, want to be a Justia Connect Pro too? Learn more ›
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
She threatened me that, she will transfer it to collections and my OBGYN will not deliver me. I want to know what are my rights on this situation as the contract doesn’t have a clause for termination and I was abused and humiliated twice by this manager. I want to know how much out of the balance... View More
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Mar 28, 2024
In California, patients have the right to be treated with respect and to receive care without discrimination or harassment. If you've experienced threatening behavior from an office manager, it's important to document the incidents and communicate your concerns in writing to your... View More
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Mar 27, 2024
The situation regarding gun rights after voluntary admission to a hospital for depression can be complex. If your admission was voluntary and you weren't held for treatment after being deemed a danger to yourself or others by a court, your right to possess firearms might not be immediately... View More
Please provide reference to reliable sources for filing False Claims Act in Healthcare case, in California Superior Court.
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Mar 26, 2024
To initiate a False Claims Act case in the healthcare sector within the California Superior Court, it's crucial to understand that these cases typically involve the whistleblower (qui tam plaintiff) alleging that false claims have been made to obtain money from state healthcare programs. Such... View More
While Medicare is Federal program, there is California Medicare division; and California Superior Court has jurisdiction over California Medicare False Claims Act cases.
Cases have to be filed under seal, in chambers. Any references to practical guides are sought, as starting point for... View More
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Mar 26, 2024
Under California law, filing a claim under the California False Claims Act regarding Medicare fraud involves specific procedures. Cases must be filed under seal directly to the judge's chambers. This is designed to prevent the defendant from being alerted before the government has had a chance... View More
Is a self-paying client not allowed to work with a private practicing Registered Dietitian in the state of California if they do not have a referral from an authorized health provider?
Lawyers, want to be a Justia Connect Pro too? Learn more ›
answered on Mar 22, 2024
Under California law, specifically Business and Professions Code Section 2585, there's a clear set of regulations regarding who can represent themselves as a registered dietitian or a dietetic technician, registered. The law stipulates that individuals must meet certain educational,... View More
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
