U.S. Attorney Says Attack on Fraud Has Saved $100 Million in Health Care Funds

Mark J. Mandell, Esq.

If you are a health care professional, Medicare and Medicaid fraud allegations are serious. In addition to heavy fines and penalties, the government often seeks prison time to punish violators.

And that dual strategy of criminal and civil penalties, which are part of ramped-up fraud prevention efforts, has saved over $100 million in federal health care funds for the Western District of Michigan, according to U.S. Attorney Patrick Miles.

In the past few years, the attack on fraud has yielded 20 criminal convictions and health care companies paying over $5 million in fines. Mr. Miles and investigators with the U.S. Department of Health and Human Services said Michigan is experiencing issues with fraudulent activities, in part, because some firms, like home health care companies, do not have to be licensed by the state.

What officials call “mom and pop” pharmacies make up a significant portion of the spike in fraud, while physicians and other professionals have not seen an increase in fraud issues. One of the largest cases federal attorneys recently prosecuted involved six pharmacists with a Kentwood Pharmacy, where pharmacists were accused of illegally restocking and re-prescribing drugs.

The $100 million saved in Medicare and Medicaid costs is a significant amount given the area's relatively low population. In comparison, officials said, focused fraud prevention efforts in Miami, Florida have saved some $500 million in health care costs.

Mr. Miles also stated in a recent Gongwer Michigan Report that, as part of the effort, the U.S. attorney’s office has met with various health care providers, including pharmacists, physician assistants and nurse practitioners to explain what constitutes fraud and its consequences. And, he noted that those meetings, along with the ramped-up enforcement, have deterred individuals from trying to commit fraud.

Fausone Bohn, LLP Medicare and Medicaid Fraud Defense Attorneys have experience defending health care professionals, and, as former prosecutors, we understand the opposition’s mindset and strategy. Our Medicare and Medicaid fraud attorneys can help defend you against allegations of: 

• Billing for services that were never performed.
• Providing services that aren’t medically necessary.
• Upcoding of services.
• Offering and paying kickbacks to doctors or Medicare beneficiaries.
• Submitting fraudulent cost reports.
• Conspiring to commit healthcare fraud. 

Give us a call today at 248-468-4536, or visit us online at www.fb-firm.com and www.Facebook.com/FausoneBohnLLP

Veterans in State-Run Long Term Care Facilities Targeted by Legislature

Daniel J. Williams, Esq.

In August of 2014, the Michigan Court of Appeals found that the governmental immunity protections provided in M.C.L. §691.1407(1) did not apply to state-run veterans homes, where the underlying claim was sounded from the medical care or medical treatment of the moving party Estate of Andrew Ball v. Grand Rapids Home for Veterans, ___ Mich. App. ___; ___ N.W.2d ___; 2014 Mich. App. Lexis 1580; COA # 314861 (August 26, 2014).

The Court found that M.C.L. §691.1407(4), the medical care and treatment exception to the governmental immunity provided by the statute, was not implicated in Ball because the allegations arose as a result of a condition that directly resulted for the complainant’s medical condition.  The condition was his reason for treatment at the facility, and as a result, the Court found a sufficient nexus was created to allow the suit to go forward under the M.C.L. §1407(4) exception to governmental immunity.

The home in question was run by the State Department of Military and Veterans Affairs.  After the decision came down in Ball, which allowed the State to be sued as a party in cases that had a nexus to medical care and treatment, a bill was introduced by that would explicitly exclude from all liability a nursing care facility that was run by the Department of Military and Veterans Affairs.  The proposed bill would amend the language of M.C.L. §691.1407(4) to explicitly exclude those facilities from the medical care and treatment exception.  The bill is before the judiciary committee for review and a result, either passage or failure, is likely to come from the legislature this year.

The proposed amendment to the bill would except all claims stemming from the care or treatment of a veteran in a State run nursing home owned by the Department of Military and Veterans Affairs from suit by the patient against the State.  In other words, if a veteran who is placed in one of these homes is injured or wrongfully dies because of a mistake that is made by an employee of the State facility, no recovery can be had against the State for negligence or improper medical care or medical treatment.  Therefore, the only attempt at recovery would be against the individual who acted negligently and any insurance that would apply to that individual. 

As a result, the possibility of collection and compensation for those veterans who are injured in that way is made substantially less likely.  Given the service these men and women have given our country, such a seemingly wide ranging prohibition in cases of this nature seems rather unfair.  Simply being a veteran who resides in a Department of Military and Veterans Affairs home should not mean that the agency charged with your care should be completely immune from liability for an injury you receive, through no fault of your own.  

New Harper Lee Novel Sparks Elder Abuse Investigation

Elder abuse is a serious matter, and no one is immune to it. Not even a famous, award-winning novelist like Harper Lee, who authored To Kill a Mockingbird.

Lee, who is now 88 years old, is set to release her second novel, Go Set a Watchman, which she actually wrote over 50 years ago. While the news of a second novel set-off a buzz on social media, many Mockingbird fans expressed skepticism on the reasons behind the release.

Lee currently resides in an assisted living facility and is said to be in declining health – is it possible that she could have not knowingly consented to the release of the second novel? The New York Times recently reported that there is at least one complaint of elder abuse at Lee’s assisted living facility connected to the book’s release, and Alabama state officials are now investigating the claims.

Officials interviewed Lee in February, as well as employees of her assisted living facility and some of her friends following the unspecified complaint tied it to the publication of Go Set a Watchman.

Allegedly, Lee “appeared capable of understanding questions and provided cogent answers to investigators," according to the Times report. However, writer Marja Mills wrote a book chronicling the 18 months she spent living next to Lee. Alice Lee, Harper Lee’s elder sister, added to Mills’ transcript that Harper, “doesn’t know from one minute to the other what she’s told anybody.”

For her part, Harper Lee has yet to speak directly to reporters about the new novel or about her mental state. The closest she has come to commenting on either is in a two-word statement she gave after receiving a letter from an Alabama reporter: “Go Away!”

Fausone Bohn, LLP Michigan Elder Abuse Attorneys can help you and your family with your elder abuse claim. If you feel that your parents or grandparents have been subject to abuse, coercion, or fraud at a nursing home or an assisted living facility, give us a call today at 248-468-4536.

Read more on the issue here: https://www.yahoo.com/music/s/alabama-investigates-claim-elder-abuse-over-harper-lee-071922680.html

And in the Washington Post:

http://www.washingtonpost.com/news/morning-mix/wp/2015/03/12/report-alabama-investigating-possible-elder-abuse-in-connection-with-harper-lees-new-novel/

New Bills Would Give Blue Water Navy Vets Service-Connection for Agent Orange Diseases

We want to thank the Blue Water Navy Awareness group for sharing with us two critical pieces of legislation that were recently introduced in Congress. The pair of bills relate to Blue Water Navy Vietnam Veterans and their ability to get service-connected disability benefits for diseases associated with Agent Orange and other herbicides used during the Vietnam War.

First, HR 969 (the Blue Water Navy Vietnam Veterans Act) was introduced in February of this year and it has considerable bi-partisan support. The bill would include as part of the Republic of Vietnam its “territorial seas” for purposes of the presumption of service-connection for diseases associated with exposure by veterans to certain herbicide agents while in Vietnam.

As the bill’s sponsor, Representative Christopher Gibson (R-NY) said, this legislation, “places Navy Personnel on the same playing field as those who served on Vietnamese territory during the war – it’s the right thing to do.” We couldn’t agree more!

Rep. Gibson also noted that the bill would reduce the tremendous backlog of VA claims for veterans suffering from diseases the government links to Agent Orange.

Senator Kirsten Gillibrand (D-NY) introduced S-681 just last week in the Senate. That legislation is the Senate companion to the House bill and it would further clarify the service-connection presumption for Blue Water Navy veterans.

You can check out the Blue Water Navy Awareness Blog here: http://bluewaternavyawarenss.blogspot.com/

And we join the group in their call for you and your neighbors to contact your representatives and senators and urge them to support this legislation. It is very encouraging that these bills have bi-partisan sponsors and support, but similar legislation in the past has fallen victim to the dreadfully slow legislative process and died while in committee – where these two bills currently remain.

Michigan State Police Will Be First Law Enforcement Agency to Use a Drone Statewide

Paul Bohn, Esq.

We wrote a little while back about the latest trend of recreational drone usage. While the Federal Aviation Administration (FAA) has tried to slow the increasing use of these UAVs (Unmanned Aerial Vehicles) with regulatory measures, drones are probably coming to a neighborhood near you whether you like it or not.

And now, the Michigan State Police have become the first law enforcement agency in the country with permission to use a drone statewide. The State Police purchased the drone back in September 2013 and have been working with the FAA to come into safety and training compliance.

The drones will be utilized in search and rescue missions, and crime scene and accident investigations.

While this approval signifies progress for drone advocates, the news has prompted privacy concerns.

Legislation was introduced last session to regulate the police use of drones, but nothing ever came of the bill. Privacy proponents are hopeful that similar legislation will be introduced again and passed.

“There are legitimate uses but it's important that we rein in big brother," said former state Rep. Tom McMillin. “I really wanted to make sure there is reporting on how it's being used. If they are recording things that they shouldn't, that stuff should be destroyed. We don't just want them flying around watching people."

Check out our last blog on drones and the legal complications with their popularity here: http://fbfirm.blogspot.com/2015/02/dronies-trending-upward-in-air-and-on.html

Read more on this story in the Detroit Free Press:

http://www.freep.com/story/news/local/michigan/2015/03/09/drone-michigan-state-police-faa/24659777/

VA Health Care Investigations Left in the Dark

The Department of Veterans Affairs picked up another notch on their belt of scandals and mishaps earlier this month. USA Today recently reported that the VA has not publicly released the findings of 140 health care investigations going back to 2006.

And so more problems for our veterans continued to fester without proper oversight, leaving those who have served our country out to dry.

It is unknown how many of the investigations uncovered serious or dangerous problems as the reports have not been read or analyzed yet, but all of them concerned VA medical care provided to veterans or complaints of clinical misconduct.

The VA inspector general said they could not provide specifics for the apparent lack of transparency, as the inspector general has not analyzed the reports in full.

Catherine Gromek, the VA inspector general, advised requesting the reports under the Freedom of Information Act. USA Today submitted a request in January for 23 reports. Her office has maintained that officials are "working diligently" to fulfill the request.

The inspector general’s office noted that, in general, reports may not be released if allegations are unsubstantiated and disclosing them could damage someone's reputation, when there is a pending lawsuit or when subjects of investigations are no longer working at the VA.

Officials from the inspector general's office did review 26 reports withheld from the public since January 2014 and found less than half — 46% — involved unsubstantiated allegations. They said in 42% of the cases, inspectors determined VA officials had already addressed their concerns so a public report was unnecessary. One was the subject of a pending lawsuit.

However, these statistics and reasons for lack of transparency do not satisfy the many veterans and their families who continue to suffer through poor care, long waits, and a bevy of other issues at VA medical centers. And they should not satisfy the public either.

Read USA Today’s full report on the issue here:

http://www.usatoday.com/story/news/politics/2015/03/08/probes-of-veterans-health-care-often-not-released-to-public/24525109/

At Legal Help For Veterans, PLLC, we focus exclusively on veterans’ rights. If you are a veteran looking to get the benefits that you deserve, call us today at 1-800-693-4800. We handle a variety of claims, including PTSD, TBI, and other service-connected injuries. www.LegalHelpForVeterans.com

Increased Police Patrols Looking for Drunk Drivers this St. Patrick’s Day

Mark Mandell, Esq.

St. Patrick’s Day is just around the corner and is undoubtedly one of the biggest drinking days of the year. Be assured that police and state troopers will be on high alert March 17 throughout the day and night, making sure that everyone gets to their St. Patty’s Festivities safely.

Not only is drunk driving extremely dangerous, but there are hefty consequences associated with drunk driving. A person is considered “over the limit” if they are operating a vehicle with a BAC of .08 or greater. There are enhanced penalties for “Super Drunk Driving” if an individual’s BAC is 0.17 or higher.

The severity of the penalties depends on what number offense it is and the level of intoxication. The penalties include the following:

• If BAC is below .17 and it is a first offense the penalties includes up to a $500 fine and Up to 93 days in jail;
• If BAC is above .17 and it is a first offense the penalties includes up to a $700 fine and 180 days in jail;
• If it is a second offense within 7 years the penalties include one or more of the following: a $200 to $1000 fine and/or 5 days to 1 year in jail;
• If it is a third offense within a lifetime the offense is considered a felony and the penalties include one or more of the following: a $500 to $5000 fine, 1 to 5 years imprisonment and/or probation with 30 days to 1 year in jail;
• Additionally, convicted drunk drivers are subject to a $1,000 penalty for two consecutive years under the Driver Responsibility Act, for a total of $2,000 in additional costs.

You should contact an experienced Michigan drunk driving attorney if you find yourself facing charges. There are a number of strategies that could be used to lessen the consequences, help you keep your license or get it reinstated more quickly, depending on your individual circumstances. Fausone Bohn’s Michigan criminal defense and drunk driving attorneys have experience navigating a variety of cases.

There are a number of safer alternatives to drunk driving, including designating a sober driver, calling a friend, taking a cab or getting an Uber. Be sure to put safety first this St. Patty’s Day.

If you are charged with drunk driving, or have questions about drunk driving laws in Michigan, contact experienced criminal defense attorney Mark Mandell at 248-468-4536 or online at www.fb-firm.com.

Fausone Bohn, LLP has assisted clients pulled over for drunk driving and other driving infractions throughout southeast Michigan, including Detroit, Ann Arbor, Northville, Novi, Livonia, Canton, Farmington, and Royal Oak.

Alaska Becomes Third State to Legalize Marihuana, Could Michigan Be Next?

Mark Mandell, Esq.

Alaska will be the third state to legalize marihuana, due to a recent voter-passed initiative. As of 2015, marihuana has been decriminalized, and the recreational pot business will be up-and-running by 2016.

Could Michigan be the next state to jump on the “Pineapple Express”? There are already some rumblings of a 2016 ballot proposal.

The current laws and local ordinances governing marihuana and medicinal marihuana have become quite the patchwork in Michigan. Lawyers, law enforcement, and citizens alike are hoping the Michigan Supreme Court will soon provide some clarity to these laws.

Today, depending on where you live in Michigan, if you have a Medical Marihuana Registry Card, how you’re transporting that marihuana, and whether you get pulled over by a state trooper or a local police officer, you could face a range of consequences.

With conflicting decisions coming out of the circuit courts on whether the Michigan Medical Marihuana Act has any value when it comes to possessing marihuana, it is hoped that the Michigan Supreme Court will clarify whether people can use a medical marihuana defense if they face criminal charges.

If you were pulled over and had marihuana in your car and need legal help, you could have a defense to avoid potential penalties. Our attorneys have the experience to navigate Michigan’s complex medical marihuana laws and protect your rights or lessen the fines or penalties you could be facing.

Read more on the legalization of weed in Alaska on CNN: http://www.cnn.com/2015/02/24/us/alaska-marijuana/index.html

You can read more on the Michigan Marihuana issue on MLive: http://www.mlive.com/news/grandrapids/index.ssf/2015/02/marijuana_leaves_legal_experts.html

Fausone Bohn, LLP Metro Detroit defense attorneys have the experience you need to protect your rights in medical marihuana defense cases. If you need a local lawyer who can help with your marihuana defense case, give Fausone Bohn, LLP a call at (248) 468-4536 or visit us online at www.fb-firm.com.

Fausone Bohn, LLP serves clients throughout southeastern Michigan including the cities of Detroit, Ann Arbor, Northville, Farmington, Brighton, South Lyon, Livonia, Canton and Novi.