1) In both Greber and Bay State, each case provides an analysis for potential Anti-Kickback violations, however how the court determined if the violation occurred were slightly different. In United States v. Greber, the U.S. Court of Appeals for the Third Circuit established the “one purpose” test which states, “if one purpose of the payment was to induce future referrals, the Medicare statute has been violated.” U.S. v. Greber, 760 F.2d 68, 69 (3rd Cir. 1985), cert. denied, 474 U.S. 988 (1985). The one purpose test has later been adopted by the Fifth, Ninth, and Tenth Circuits. In U.S. v. Bay State Ambulance and Hospital Rental, Inc., the First Circuit instructed the jury to apply the primary purpose test which states that the primary purpose must be improper in order to obtain a conviction under the Anti-Kickback Statute. See U.S. v. Bay State Ambulance and Hospital Rental, Inc., 874 F.2d 20, 32 (1st Cir. 1989). 2) …show more content…
Intent can be misinterpreted or the violation may be unintentional but in both Greber and Bay State, the intent to violate was clearly established. In Greber, the defendant interpreted the results and claimed that the physicians were paid for the interpretation of the results. This is a blatant act of deceit. In Bay State, the defendant Felci intentionally concealed the fact that he had a relationship with Bay State and conducted inappropriate acts including voting for the Bay State contract while serving of the board without disclosing the relationship, providing false information to the Board regarding the contract and receiving gifts and moneys during the
In the case of Alex (plaintiff) vs. Abigail (defendant), we the jury find Abigail guilty of fraud through unanimous vote. Alex presented enough evidence to support the claims of breach of contract and fraud committed by the defendant.
In Laduzinski v. Alvarez & Marsal Taxand LLC, plaintiff was looking for a job with defendant, Alvarez & Marsal Taxand LLC. Plaintiff, Laduzinski, claimed that he was lured away from his job under false pretenses since defendants hired him to get access to his contacts. Nine months later, after plaintiff had given all his contacts, the manager of the Alvarez companies fired him because there was no work for him. Laduzinski brought a claim to recover damages for fraud in the inducement.
3. Procedural History: This matter comes before the court on motions of defendants for judgment notwithstanding the verdict, for new trial pursuant to Rule 59 of the Federal Rules of Civil Procedure, and for amended judgment. We have considered defendants' motions collectively and individually and conclude that neither a new trial, judgment notwithstanding the verdict, nor amended judgment is warranted. The evidence supports the jury's verdict.
Facts: According to the case Pembaur v. City of Cincinnati (1986), an Ohio physician was being investigated for fraud. During the course of the investigation, it was necessary to interview two employees from his practice. Since the employees did not respond to a subpoena, a warrant was issued and the Sheriffs were sent out to the physician’s office where the employees also worked. Upon arrival, the Sheriffs were not allowed to enter the area where the two employees
The Crucible is set in 1600’s Salem, Massachusetts. The Massachusetts Bay Colony was the second colony established in the new world, forming in 1629. Puritans sought a new place where they could establish more religious freedom than England and could purify themselves from Catholicism. The Massachusetts Bay colony was eventually settled by a Puritan company by the name of Massachusetts Bay Company, which was a joint stock company that was given a royal charter by King Charles I. The Massachusetts Bay Colony was quickly established as a theocratic government with John Endecott as the first governor.
Reasonable doubt plays a significant role in this particular case, as it requires a standard of unsurpassable evidence in order to be able to convict the plaintiff in a criminal proceeding. This is required under the Due Process Section in the Fifth Amendment of the American Constitution, allowing a safeguard and circumvention
With the passage of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) has initiated reimbursement based off of patient satisfaction scores (Murphy, 2014). In fact, “CMS plans to base 30% of hospitals ' scores under the value-based purchasing initiative on patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey, or HCAHPS, which measures patient satisfaction” (Daly, 2011, p. 30). Consequently, a hospital’s HCAHPS score could influence 1% of a Medicare’s hospital reimbursement, which could cost between $500,000 and $850,000, depending on the organization (Murphy, 2014).
In the 17th century, Europeans were eager to colonize in the newly discovered world. Europe was willing to invest time, resources and money into expanding their power. Powerful nations such as Spain, France and Britain settled there by this time and subtly encouraged Europe to do the same. Europe sent people overseas to two sections, The Massachusetts Bay Colony and the Chesapeake Colony. At the beginning, every aspect influenced their colonies success such as social, political, economic, and geographic.
Thesis: Despite bearing some superficial similarities, the differences between the Virginia Colony and Massachusetts Bay Colony are prominent.
Some federal statutes address fraud in government health care programs, and many of these laws vary considerably (Krause 2004). Some of these laws specifically target health care fraud. Example of the laws that the government direct at inappropriate health care activities includes the “Medicare and Medicaid Anti-Kickback Statute and Ethics in Patient Referrals Act (EPRA).”
Most Americans have their favorite place to live or visit whether it be at a coastline or the mountains. The two states that are most favored by Americans are Florida and California. These are the biggest when it comes down to tourist attractions. There are many factors to consider when comparing California to Florida such as housing, weather, food, culture, and beaches.
Medicare fraud occurs when healthcare providers, suppliers, and private companies charge for services or supplies patients never receive. Additionally, abuse of the Medicare program also occurs because physicians and suppliers do not always follow best medical practices which leads to excessive costs through improper payments, or medically unnecessary services, both of which abuse the program. Conservative estimates suggest he...
Some people get stuck with a bill they must pay out of pocket after thinking that Medicare had their back when they didn’t. That’s why patients must always ask what their insurance does and doesn’t cover especially because most of the people on Medicare are old and non-working citizens that don’t have money to be paying out of pocket. The most important things that Medicare doesn’t care are most dental care, eye exams for glasses, and hearing aids. These are things that many older people which make up roughly 46 out of the 55 million of those on Medicare really need but can’t afford. But there’s also things that Medicare doesn’t cover that is implied for example cosmetic surgery, acupuncture and
The two major components of Medicare, the Hospital Insurance Program (Part A of Medicare) and the supplementary Medical Insurance program (Part B) may be exhausted by the year 2025, another sad fact of the Medicare situation at hand (“Medicare’s Future”). The burden brought about by the unfair dealings of HMO’s is having an adverse affect on the Medicare system. With the incredibly large burden brought about by the large amount of patients that Medicare is handed, it is becoming increasingly difficult to fund the system in the way that is necessary for it to function effectively. Most elderly people over the age of 65 are eligible for Medicare, but for a quite disturbing reason they are not able to reap the benefits of the taxes they have paid. Medicare is a national health plan covering 40 mi...
A general intent is the most usual modus operandi for most of the misconducts. Under the general aim, the prosecution requires proving that the offender intended to commit an act in question (Herring, 2014). They are those offenses that have no particular mens rea component in them. The defendant’s act’s results are irrelevant in a general intent crime.