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In civil lawsuits, people frequently have their depositions taken. A deposition is a question and answer session under oath between a witness and at least one attorney. When the witness is testifying on behalf of one party, either the plaintiff or the defendant, Cheap Divorce Lawyers Near Me in Parkmore the opposing party’s attorney will do most of the questioning. Usually, the lawyers for all parties are in the room, although not all of the attorneys present choose to ask questions. There is usually a court reporter present taking down what everyone says on a stenotype machine. There are many reasons for lawyers to take legal depositions.

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Here are just a few. Rules The most prominent reason someone has to give a deposition is because a lawyer is not allowed to simply call up a witness for the other side and start asking questions. In fact, Need A Good Lawyer they are not allowed to speak to them about the case when that person has been designated as a witness for another party. Instead, it must be done in a formal setting. The witness is usually subpoenaed and the lawyer that has designated that person as a witness will usually be present.Information When an attorney believes someone has information that will lead to discoverable evidence in a civil case, they are allowed to take their deposition.

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The witness is required by law to cooperate and answer fully and honestly any of the proper questions asked by the lawyers. Oftentimes, the lawyer may not know all of the important facts of the case. There may be people, objective third parties, who witnessed a car accident or that have factual information that is crucial to the case. Learning what they know about it may shed light on the case before it goes to court. This prevents one side from springing surprises on the other during trial.Intimidation On rare occasions, an attorney will take the deposition of a witness for the other side to intimidate or make the person nervous.

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This is more common in domestic dispute matters, such as child custody or divorce cases. It also happens more often to the plaintiff, Divorce Lawyer the party bringing the lawsuit. This is sometimes done to make sure the witness knows the lawyer means business. Playing hardball in a deposition is what happens when the attorney is purposefully trying to make the witness uncomfortable. This may be done to make sure they tell the truth and to find out if the person will drop the case, rather than have to go through similar questioning in court, as well if the case goes to trial.

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Litigation means a trial, right? So what does it matter if you hire a litigation attorney or a trial attorney? Can't they both perform the same functions? Not necessarily, which is why it's important to do your research before you hire an attorney to help you with a litigation lawsuit.Litigation AttorneysFirst of all, litigation does not automatically mean a trial is going to happen. The vast majority of the time, lawsuits are settled out of court without ever going to a jury. This is due to the work of the litigation attorney or litigator.Litigation attorneys handle all of the work that happens outside a courtroom. They file lawsuits, gather evidence, conduct legal research, meet with the client, file and argue motions and defend their clients. This is all done long before a lawsuit even gets close to going to a judge and jury. Litigators may even attempt mediation to achieve an out of court settlement but if a case looks like it is going to go to court, these lawyers can take depositions and prepare clients and their witnesses.Although there are differences between the two attorneys, those differences don't make one better than the other. They each serve different functions and perform different roles. Working with both types will give you the best of both worlds: an expert lawyer familiar with the ins and outs of your case and an expert presenter who can best argue your position in court if it gets that far. Many law firms have both litigators and lawyers on staff, giving you access to both types of specialists under one roof.If you prefer to have a single lawyer represent you through the entire process, be sure to ask about his or her experience in court and specifically if it has included cases covering the same legal subjects as yours. Then you'll need to decide if the attorney has the experience you need to carry your case through to the end or if you're better off starting out with a litigator and hiring a trial lawyer if and when your case gets to the courtroom.

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ATTORNEY JOHN MORGAN IS SUING THE STATE OF FLORIDA SAYING TERMINALLY ILL PATIENTS SHOULD BE ABLE TO SMOKE POT. IN NOVEMBER VOTERS APPROVED THE MEDICAL MARIJUANA BILL. Reporter: BOB JORDAN IS QUITE SKILLED AT ROLLING MARIJUANA JOINTS IN HIS HOME IN PARIS. IT'S NOT FOR HIM. IT'S FOR HIS WIFE KATHY WHO SUFFERS FROM ALS. SHE HAS TRIED VAPOR DEVICES. WHAT HAPPENS TO KATHY ISSUE STARTS GAGGING AND GETS ILL. WE HAVE TRIED EDIBLES. SHE CAN'T DO THE EDIBLES BECAUSE ONCE YOU CONSUME IT, YOU DON'T KNOW HOW STRONG IT IS. Reporter: BOB GROWS HIS OWN POT TO MAKE SURE IT IS SAFE. WITH THE CANNABIS SHE CAN TAKE ONE OR TWO PUFFS AND THAT IS ENOUGH. Reporter: ATTORNEY JOHN MORGAN WHO SPEARHEADED THE MEDICAL MARIJUANA ISSUE, CREDITS JORDAN AND HER HUSBAND TO ENCOURAGE HIM TO ACT. SO WHY DID I DO THIS? THERE ARE KATHY JORDANS OUT THERE. THERE ARE 500,000 PEOPLE OUT THERE THAT ARE SICK TODAY AND COUNTING ON THIS. Reporter: THE AMENDMENT MENTIONED SMOKING MARIJUANA AND THAT IT CAN BE SMOKED IN PUBLIC. IF SMOKING IS NOT ALLOWED IN PUBLIC, IS IT ALLOWED IN PRIVATE ? Reporter: MORGAN SAYS YES. SO DOES BOB JORDAN. THAT'S WHAT THEY VOTED FOR. IT'S ABOUT COMMON SENSE. BUT I GUESS COMMON SENSE ISN'T COMMON IN TALLAHASSEE. Reporter: BOB USES VAGUE POT FOR HIS AILMENTS.

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In civil lawsuits, people frequently have their depositions taken. A deposition is a question and answer session under oath between a witness and at least one attorney. When the witness is testifying on behalf of one party, either the plaintiff or the defendant, Malpractice Attorney Near Me in Sandton the opposing party’s attorney will do most of the questioning. Usually, the lawyers for all parties are in the room, although not all of the attorneys present choose to ask questions. There is usually a court reporter present taking down what everyone says on a stenotype machine. There are many reasons for lawyers to take legal depositions.

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Here are just a few. Rules The most prominent reason someone has to give a deposition is because a lawyer is not allowed to simply call up a witness for the other side and start asking questions. In fact, How To Find A Great Attorney they are not allowed to speak to them about the case when that person has been designated as a witness for another party. Instead, it must be done in a formal setting. The witness is usually subpoenaed and the lawyer that has designated that person as a witness will usually be present.Information When an attorney believes someone has information that will lead to discoverable evidence in a civil case, they are allowed to take their deposition.

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The witness is required by law to cooperate and answer fully and honestly any of the proper questions asked by the lawyers. Oftentimes, the lawyer may not know all of the important facts of the case. There may be people, objective third parties, who witnessed a car accident or that have factual information that is crucial to the case. Learning what they know about it may shed light on the case before it goes to court. This prevents one side from springing surprises on the other during trial.Intimidation On rare occasions, an attorney will take the deposition of a witness for the other side to intimidate or make the person nervous.

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This is more common in domestic dispute matters, such as child custody or divorce cases. It also happens more often to the plaintiff, Injury Attorney Near Me the party bringing the lawsuit. This is sometimes done to make sure the witness knows the lawyer means business. Playing hardball in a deposition is what happens when the attorney is purposefully trying to make the witness uncomfortable. This may be done to make sure they tell the truth and to find out if the person will drop the case, rather than have to go through similar questioning in court, as well if the case goes to trial.

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Getting custody of a child can be a very difficult experience. If you want to get custody, though, you need to make sure that you have some of the vocabulary down. There are several types of legal custody, and you need to make sure that you know what kind of custody that you need. At the very least, you need to make sure that you know the difference between legal, physical, joint and sole custody.LegalLegal custody is defined as the right and ability to make decisions for a child. These decisions might include medical, educational or even religious matters. This also means that the parent has to primary responsibility to provide for the child's general welfare. In most situations, parent share legal custody of a child even if the child only lives with one parent. There are still many cases in which a single parent or guardian maintains sole legal custody.JointJoint custody represents the most common sort of representation in most countries. In a joint custody arrangement, both parents have the right and responsibility of caring for the child. In the typical joint arrangement, parents share physical and legal custody. One parent might have the child during a larger period of time than the other, but both share financial and legal responsibilities. If the parents have equal time with the children, then the arrangement that they have is often called split custody.

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JOHN MORGAN FILED HIS LAWSUIT AGAINST THE HEALTH DEPARTMENT JUST BLOCKS FROM THE CAPITOL, WHERE LAST MONTH LAWMAKERS APPROVED THE LAW IMPLEMENTING MORGAN'S AMENDMENT 2 IT ALLOWS CANNABIS TO BE EATEN, APPLIED AS OIL, EVEN VAPED BUT NOT SMOKED. MORGAN'S LAWSUIT WOULD FORCE THE STATE TO ALLOW SMOKING. >> THE VAST MAJORITY IF NOT 100% KNEW THAT SMOKE WAS INCLUDED. SO THE FACT THAT WE ARE HERE TODAY IS REALLY UNNECESSARY BUT HERE WE GO. REPORTER: LOOKING CLOSELY AT AMENDMENT 2 THE ONLY REFERENCE TO SMOKING IT, IS IN A LINE THAT BANS SMOKING MEDICAL MARIJUANA IN ANY PUBLIC PLACE. MORGAN CLAIMS THAT MAKES IT CLEAR, VOTERS EXPECTED IT WOULD BE SMOKED AND HE SAYS LAWMAKERS TOOK AWAY THAT RIGHT. ALL THEY DID IN THE PROCESS WAS TO HURT THE PATIENTS WHO NEED IT THE MOST. REPORTER: MORGAN'S LAWSUIT CITES A 2012 STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, IN WHICH DR. MARK PLETCHER WROTE, ANALYSES OF PULMONARY FUNCTION AND LUNG DISEASE HAVE FAILED TO DETECT CLEAR ADVERSE EFFECTS OF MARIJUANA USE ON PULMONARY FUNCTION. BUT, HE ALSO WROTE, PRIOR STUDIES OF MARIJUANA SMOKERS HAVE DEMONSTRATED CONSISTENT EVIDENCE OF AIRWAY INJURY AND INFLAMMATION AS WELL AS INCREASED RESPIRATORY SYMPTOMS SIMILAR TO THAT SEEN IN TOBACC SMOKERS. FURTHER, THE AMERICAN CANCER SOCIETY POSITION ON THE POSSIBLE HARMS OF MARIJUANA, SMOKED MARIJUANA DELIVERS HARMFUL SUBSTANCES TO USERS AND THOSE CLOSE BY, INCLUDING MANY OF THE SAME SUBSTANCES FOUND IN TOBACCO SMOKE. A SPOKESWOMAN FOR THE HEALTH DEPARTMENT DECLINED TO COMMENT FURTHER UNTIL AFTER A REVIEW OF MORGAN'S LAWSUIT. COMING UP ALL NEW AT 5:00 ON WESH 2 NEWS, WE'LL HEAR FROM A LOCAL PATIENT AND A LOCAL DOCTOR.

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Here are just a few. Rules The most prominent reason someone has to give a deposition is because a lawyer is not allowed to simply call up a witness for the other side and start asking questions. In fact, Finding A Lawyer For A Will they are not allowed to speak to them about the case when that person has been designated as a witness for another party. Instead, it must be done in a formal setting. The witness is usually subpoenaed and the lawyer that has designated that person as a witness will usually be present.Information When an attorney believes someone has information that will lead to discoverable evidence in a civil case, they are allowed to take their deposition.

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The witness is required by law to cooperate and answer fully and honestly any of the proper questions asked by the lawyers. Oftentimes, the lawyer may not know all of the important facts of the case. There may be people, objective third parties, who witnessed a car accident or that have factual information that is crucial to the case. Learning what they know about it may shed light on the case before it goes to court. This prevents one side from springing surprises on the other during trial.Intimidation On rare occasions, an attorney will take the deposition of a witness for the other side to intimidate or make the person nervous.

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Family law cases require a special type of attorney to handle them. They usually involve the unhappy conclusion to a long-term relationship. The personal matters of divorce, alimony, child support and child custody require an understanding lawyer who is also a shrewd negotiator. Legal matters in the District of Columbia are unique compared to other places in the United States, because technically, DC is not a state. This federal jurisdiction requires a special license to practice and has its own special laws.

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JOHN MORGAN FILED HIS LAWSUIT AGAINST THE HEALTH DEPARTMENT JUST BLOCKS FROM THE CAPITOL, WHERE LAST MONTH LAWMAKERS APPROVED THE LAW IMPLEMENTING MORGAN'S AMENDMENT 2 IT ALLOWS CANNABIS TO BE EATEN, APPLIED AS OIL, EVEN VAPED BUT NOT SMOKED. MORGAN'S LAWSUIT WOULD FORCE THE STATE TO ALLOW SMOKING. >> THE VAST MAJORITY IF NOT 100% KNEW THAT SMOKE WAS INCLUDED. SO THE FACT THAT WE ARE HERE TODAY IS REALLY UNNECESSARY BUT HERE WE GO. REPORTER: LOOKING CLOSELY AT AMENDMENT 2 THE ONLY REFERENCE TO SMOKING IT, IS IN A LINE THAT BANS SMOKING MEDICAL MARIJUANA IN ANY PUBLIC PLACE. MORGAN CLAIMS THAT MAKES IT CLEAR, VOTERS EXPECTED IT WOULD BE SMOKED AND HE SAYS LAWMAKERS TOOK AWAY THAT RIGHT. ALL THEY DID IN THE PROCESS WAS TO HURT THE PATIENTS WHO NEED IT THE MOST. REPORTER: MORGAN'S LAWSUIT CITES A 2012 STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, IN WHICH DR. MARK PLETCHER WROTE, ANALYSES OF PULMONARY FUNCTION AND LUNG DISEASE HAVE FAILED TO DETECT CLEAR ADVERSE EFFECTS OF MARIJUANA USE ON PULMONARY FUNCTION. BUT, HE ALSO WROTE, PRIOR STUDIES OF MARIJUANA SMOKERS HAVE DEMONSTRATED CONSISTENT EVIDENCE OF AIRWAY INJURY AND INFLAMMATION AS WELL AS INCREASED RESPIRATORY SYMPTOMS SIMILAR TO THAT SEEN IN TOBACC SMOKERS. FURTHER, THE AMERICAN CANCER SOCIETY POSITION ON THE POSSIBLE HARMS OF MARIJUANA, SMOKED MARIJUANA DELIVERS HARMFUL SUBSTANCES TO USERS AND THOSE CLOSE BY, INCLUDING MANY OF THE SAME SUBSTANCES FOUND IN TOBACCO SMOKE. A SPOKESWOMAN FOR THE HEALTH DEPARTMENT DECLINED TO COMMENT FURTHER UNTIL AFTER A REVIEW OF MORGAN'S LAWSUIT. COMING UP ALL NEW AT 5:00 ON WESH 2 NEWS, WE'LL HEAR FROM A LOCAL PATIENT AND A LOCAL DOCTOR.

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When you are involved in any type of accident or have an injury, these things are always unplanned by their very nature. In the initial shock and confusion of the situation, you may not always really have time to think about protecting your rights or how you will be able to pay for your medical bills and time away from work. This is why it is so important to get proper legal representation when you are involved in a personal injury case: A personal injury law firm focuses exclusively on helping people in this situation, and they will be taking the burden of worry about compensation and protecting your rights off your shoulders.Why a personal injury law firm? The answer is simple: These attorneys are experts at what they do. They have spent years working with clients, negotiating with insurance companies, and going to court to fight for fair compensation for their clients. The fact is that the insurance companies have one goal in mind when it comes to negotiating settlements: They want to pay as little as possible. An insurance company who is dealing with an individual who has no legal representation at all will generally offer a far smaller settlement than they would offer if they were dealing with a personal injury law firm.One of the big advantages to hiring a law firm is that such firms do not generally require any payment at all up front. The law firm will instead agree to wait for payment ( a portion of the settlement) until the settlement is negotiated. Once the case has been settled, the personal injury lawyer will receive their percentage of the settlement as payment for their services, and the client will receive the remainder. Even when taking this percentage for legal services into account, the settlements for clients with an attorney generally are far bigger than clients who try to negotiate on their own.

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COME FORWARD JUST THIS YEAR. IN THE WATERS OF LAKE CHAMPLAIN A KEY PIECE OF EVIDENCE FOUND, THE GUN OFFICIALS SAY WAS US TO KILL 23-YEAR-OLD KEVIN DEOLIVIERA. THE WEAPON WAS REGISTERED SUSPECT 24-YEAR-OLD RICHARD MONROE'S FATHER >> JUST BECAUSE IT WAS MR. MONROE'S FATHER'S GUN SAY THAT IT WAS MR. MONROE WHO HAD THE GUN AND SHOT AND KILLED. MONROE'S CO-DEFENDANT IN A SEPARATE CASE, ZACHARY HUST, TOLD INVESTIGATORS MONROE ADMITTED THE TO SHOOTING TO HI THAT ALLEGATION LED TO MONORE'S ARREST ZACHARY HUST MAKES OR LOSES THE PROSECUTIONS CASE, WITHOUT HIM, FROM THE EVIDENCE THAT HAS BEEN SHOWN SO FAR THEY HAVE NO CASE MONROE'S ATTORNEY TOLD A FEDERAL JUDGE ON THURSDAY HUST HAS A HISTORY OF LYING TO POLICE, HAD A KEY TO MONROE'S APARTMENT WHERE THE GUN WAS AND HAD REGULAR CONTACT WITH THE VICTIM. BUT IS IT ENOUGH TO CREATE THE RESONABLE DOUBT NEEDED TO GET MONROE AQUITTED? THE DEFENSE IS DEFIANTLY GOING TO SAY THE REASON MR. HUST HAS ALL THIS INFORMATION IS BECAUSE HE IS THE PERPETRATOR, HE IS LOOKING FOR SOMEONE ELSE TO BLAME HE HAS THIS CASE RIGHT NOW, COCAINE CASE PENDING AND SO HE IS LOOKING TO GET LENIENCY AND AT THE SAME TIME HE IS LOOKING TO POINT THE BLAME AT SOMEONE ELSE, MR. MONROE AND AVOID BEING PROSECUTED FOR THE CRIME. HUST ALSO ALLEGED MONROE COMMITTED THE CRIME THE SAME DAY HE WAS GOING ONA TRIP TO CUBA WITH CHAMPLAIN COLLEGE SO HE WOULD HAVE AN ALIBY. THE QUESTION IS WILL THAT HELP PROSECUTORS OR THE DEFENSE? IT'S ONE THAT COULD GO IN ETHER DIRECTION, PARTICULARL DEPENDING UPON WHAT THEY A ABLE TO DO ON TIME OF DEATH. WITH NO OFFICIAL TIME OF DEATH.

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This is more common in domestic dispute matters, such as child custody or divorce cases. It also happens more often to the plaintiff, Business Law Attorney Near Me the party bringing the lawsuit. This is sometimes done to make sure the witness knows the lawyer means business. Playing hardball in a deposition is what happens when the attorney is purposefully trying to make the witness uncomfortable. This may be done to make sure they tell the truth and to find out if the person will drop the case, rather than have to go through similar questioning in court, as well if the case goes to trial.

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Getting custody of a child can be a very difficult experience. If you want to get custody, though, you need to make sure that you have some of the vocabulary down. There are several types of legal custody, and you need to make sure that you know what kind of custody that you need. At the very least, you need to make sure that you know the difference between legal, physical, joint and sole custody.LegalLegal custody is defined as the right and ability to make decisions for a child. These decisions might include medical, educational or even religious matters. This also means that the parent has to primary responsibility to provide for the child's general welfare. In most situations, parent share legal custody of a child even if the child only lives with one parent. There are still many cases in which a single parent or guardian maintains sole legal custody.JointJoint custody represents the most common sort of representation in most countries. In a joint custody arrangement, both parents have the right and responsibility of caring for the child. In the typical joint arrangement, parents share physical and legal custody. One parent might have the child during a larger period of time than the other, but both share financial and legal responsibilities. If the parents have equal time with the children, then the arrangement that they have is often called split custody.

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Advice from business attorneys in MichiganThe relationship between an attorney and a client is a unique one based on facts and information a client may not let many other people be privy to in normal circumstances. A client has a privileged relationship with his or her lawyer, meaning the information shared between them remains confidential and that both parties can choose which elements of the information shall be kept private and which may be disclosed in public.While attorney-client privilege is universally understood, certain types of lawyers are imposed with exceptions to this privilege based on their practice focus within the law. Transactional attorneys have a different type of attorney-client privilege than most lawyers and the extent of the confidentiality privilege to which they are entitled depends upon the nature of the services they provide to a business and the primary purpose of their services. What affects the confidentiality privilege of transactional attorneys?The type of services provided by a transactional lawyer to a company ranges depending on the company's needs. Services may range from being advisory and consultatory in nature, as in business planning and analyzing, to strict legal representation, as in business dispute litigation.If a business attorney is analyzing or advising on business strategy, managing transactions, or providing business consultations on maximizing assets without providing legal representation for a business, he or she is not entitled to attorney-client privilege. As such, he or she is not required to keep information shared by the client confidential.If a transactional attorney is managing or negotiating a business transaction in which legal issues are involved, he or she is serving as a legal representative for the company. He or she is consequently permitted to employ the confidentiality privilege.Why attorney-client privilege mattersThe confidentiality privilege between a lawyer and their client may not seem significant when your company hires a business law attorney to aid in business transactions, help close deals, and learn options for maximizing company assets. However, if a business dispute should happen to arise during or after a business transaction in which your lawyer was involved and he or she did not provide legal representation in his or her services, the information previously shared with the lawyer is not protected by this privilege and can be shared with the other entity involved in the business dispute. If the other side in the dispute attempts to learn the strategies and interactions of your company through an attorney who is not entitled to attorney-client privilege, this lack of confidentiality can serve as a threat to your business. Under business law, certain aspects of your case are not protected by attorney-client privilege.

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Hospice fraud in South Carolina and the United States is an increasing problem as the number of hospice patients has exploded over the past few years. From 2004 to 2008, the number of patients receiving hospice care in the United States grew almost 40% to nearly 1.5 million, and of the 2.5 million people who died in 2008, nearly one million were hospice patients. The overwhelming majority of people receiving hospice care receive federal benefits from the federal government through the Medicare or Medicaid programs. The health care providers who provide hospice services traditionally enroll in the Medicare and Medicaid programs in order to qualify to receive payments under these government programs for services rendered to Medicare and Medicaid eligible patients.While most hospice health care organizations provide appropriate and ethical treatment for their hospice patients, because hospice eligibility under Medicare and Medicaid involves clinical judgments which may result in the payments of large sums of money from the federal government, there are tremendous opportunities for fraudulent practices and false billing claims by unscrupulous hospice care providers. As recent federal hospice fraud enforcement actions have demonstrated, the number of health care companies and individuals who are willing to try to defraud the Medicare and Medicaid hospice benefits programs is on the rise.A recent example of hospice fraud involving a South Carolina hospice is Southern Care, Inc., a hospice company that in 2009 paid $24.7 million to settle an FCA case. The defendant operated hospices in 14 other states, too, including Alabama, Georgia, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Ohio, Pennsylvania, Texas, Virginia and Wisconsin. The alleged frauds were that patients were not eligible for hospice, to wit, were not terminally ill, lack of documentation of terminal illnesses, and that the company marketed to potential patients with the promise of free medications, supplies, and the provision of home health aides. Southern Care also entered into a 5-year Corporate Integrity Agreement with the OIG as part of the settlement. The qui tam relators received almost $5 million.Understanding the Consequences of Hospice Fraud and Whistleblower ActionsU.S. and South Carolina consumers, including hospice patients and their family members, and health care employees who are employed in the hospice industry, as well as their SC lawyers and attorneys, should familiarize themselves with the basics of the hospice care industry, hospice eligibility under the Medicare and Medicaid programs, and hospice fraud schemes that have developed across the country. Consumers need to protect themselves from unethical hospice providers, and hospice employees need to guard against knowingly or unwittingly participating in health care fraud against the federal government because they may subject themselves to administrative sanctions, including lengthy exclusions from working in an organization which receives federal funds, enormous civil monetary penalties and fines, and criminal sanctions, including incarceration. When a hospice employee discovers fraudulent conduct involving Medicare or Medicaid billings or claims, the employee should not participate in such behavior, and it is imperative that the unlawful conduct be reported to law enforcement and/or regulatory authorities. Not only does reporting such fraudulent Medicare or Medicaid practices shield the hospice employee from exposure to the foregoing administrative, civil and criminal sanctions, but hospice fraud whistleblowers may benefit financially under the reward provisions of the federal False Claims Act, 31 U.S.C. §§ 3729-3732, by bringing false claims suits, also known as qui tam or whistleblower suits, against their employers on behalf of the United States.Types of Hospice Care ServicesHospice care is a type of health care service for patients who are terminally ill. Hospices also provide support services for the families of terminally ill patients. This care includes physical care and counseling. Hospice care is normally provided by a public agency or private company approved by Medicare and Medicaid. Hospice care is available for all age groups, including children, adults, and the elderly who are in the final stages of life. The purpose of hospice is to provide care for the terminally ill patient and his or her family and not to cure the terminal illness.If a patient qualifies for hospice care, the patient can receive medical and support services, including nursing care, medical social services, doctor services, counseling, homemaker services, and other types of services. The hospice patient will have a team of doctors, nurses, home health aides, social workers, counselors and trained volunteers to help the patient and his or her family members cope with the symptoms and consequences of the terminal illness. While many hospice patients and their families can receive hospice care in the comfort of their home, if the hospice patient's condition deteriorates, the patient can be transferred to a hospice facility, hospital, or nursing home to receive hospice care.Hospice Care StatisticsThe number of days that a patient receives hospice care is often referenced as the "length of stay" or "length of service." The length of service is dependent on a number of different factors, including but not limited to, the type and stage of the disease, the quality of and access to health care providers before the hospice referral, and the timing of the hospice referral. In 2008, the median length of stay for hospice patients was about 21 days, the average length of stay was about 69 days, almost 35% of hospice patients died or were discharged within 7 days of the hospice referral, and only about 12% of hospice patients survived longer than 180 days.Most hospice care patients receive hospice care in private homes (40%). Other locations where hospice services are provided are nursing homes (22%), residential facilities (6%), hospice inpatient facilities (21%), and acute care hospitals (10%). Hospice patients are generally the elderly, and hospice age group percentages are 34 years or less (1%), 35 - 64 years (16%), 65 - 74 years (16%), 75 - 84 years (29%), and over 85 years (38%). As for the terminal illness resulting in a hospice referral, cancer is the diagnosis for almost 40% of hospice patients, followed by debility unspecified (15%), heart disease (12%), dementia (11%), lung disease (8%), stroke (4%) and kidney disease (3%). Medicare pays the great majority of hospice care expenses (84%), followed by private insurance (8%), Medicaid (5%), charity care (1%) and self pay (1%).As of 2008, there were approximately 4,700 locations which were providing hospice care in the United States, which represented about a 50% increase over ten years. There were about 3,700 companies and organizations which were providing hospice services in the United States. About half of the hospice care providers in the United States are for-profit organizations, and about half are non-profit organizations. General Overview of the Medicare and Medicaid ProgramsIn 1965, Congress established the Medicare Program to provide health insurance for the elderly and disabled. Payments from the Medicare Program arise from the Medicare Trust fund, which is funded by government contributions and through payroll deductions from American workers. The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is the federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid.In 2007, CMS reorganized its ten geography-based field offices to a Consortia structure based on the agency's key lines of business: Medicare health plans, Medicare financial management, Medicare fee for service operations, Medicaid and children's health, survey & certification and quality improvement. The CMS consortia consist of the following:The FCA anti-retaliation provision protects the hospice whistleblower from retaliation from the hospice when the employee (or a contractor) "is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment" for taking action to try to stop the fraudulent activity. 31 U.S.C. § 3730(h). A hospice employee's relief includes reinstatement, 2 times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination or retaliation, including litigation costs and reasonable attorneys' fees.A SC hospice fraud FCA whistleblower would initially file a disclosure statement, complaint and supporting documents with the U.S. Attorney's Office in Columbia, South Carolina, and the US Attorney General. After the disclosures are filed, a federal court complaint can be filed. The SC division where the frauds occurred, the relator's residence, and the defendant residence, will determine which division the case will be assigned. There are eleven federal court divisions in South Carolina. Once the case has been filed, the government has 60 days to decide whether or not to intervene. During this time, federal government investigators located in South Carolina will investigate the claims. If the case involved Medicaid, SC Medicaid fraud unit investigators will likely become involved as well. If the government intervenes in the case, the U.S. Attorney for South Carolina is usually the lead attorney. If the government does not intervene, the relator's SC attorney will prosecute the case. In South Carolina, expect a qui tam case to take one to two years to get to trial.Tips on Recognizing Hospice Fraud SchemesThe HHS Office of Inspector General (OIG) has issued Special Fraud Alerts for fraudulent and abusive practices of hospices. U.S. and South Carolina hospices, patients, hospice employees and whistleblowers, their attorneys and lawyers, should be familiar with these hospice fraud practices. Tips on recognizing hospice frauds in South Carolina and the U.S. are:• A hospice offering free goods or goods at below market value to induce a nursing home to refer patients to the hospice. • False representations in a hospice's Medicare/Medicaid enrollment form. • A hospice paying "room and board" payments to the nursing home in amounts in excess of what the nursing home would have received directly from Medicaid had the patient not been enrolled in the hospice. • False statements in a hospice's claim form (CMS Forms 1450, UB-04 or UB-92). • A hospice falsely billing for services that were not reasonable or necessary for the palliation of the symptoms of a terminally ill patient. • A hospice paying amounts to the nursing home for "additional" services that Medicaid considered included in its room and board payment to the hospice. • A hospice paying above fair market value for "additional" non-core services which Medicaid does not consider to be included in its room and board payments to the nursing home. • A hospice referring patients to a nursing home to induce the nursing home to refer its patients to the hospice. •A hospice providing free (or below fair market value) care to nursing home patients, for whom the nursing home is receiving Medicare payment under the skilled nursing facility benefit, with the expectation that after the patient exhausts the skilled nursing facility benefit, the patient will receive hospice services from that hospice. • A hospice providing staff at its expense to the nursing home to perform duties that otherwise would be performed by the nursing home. • Incomplete or no written Plan of Care was established or reviewed at specific intervals. • Plan of Care did not include an assessment of needs. • Fraudulent statements in a hospice's cost report to the government. • Notice of Election was not obtained or was fraudulently obtained. • RN supervisory visits were not made for home health aide services. • Certification or Re-certification of terminal illness was not obtained or was fraudulently obtained. • No Plan of care was included for bereavement services. • Fraudulent billing for upcoded levels of hospice care. • Hospice did not conduct a self-assessment of quality and care provided. • Clinical records were not maintained for every patient. • Interdisciplinary group did not review and update the plan of care for each patient.Recent Hospice Fraud Enforcement CasesThe DOJ and U.S. Attorney's Offices have been active in enforcing hospice fraud cases.In 2009, Kaiser Foundation Hospitals settled an FCA lawsuit by paying $1.8 million to the federal government. The defendant allegedly failed to obtain written certifications of terminal illness for a number of its patients.In 2006, Odyssey Healthcare, a national hospice provider, paid $12.9 million to settle a qui tam suit for false claims under the FCA. The hospice fraud allegations were generally that Odyssey billed Medicare for providing hospice care to patients when they were not terminally ill and ineligible for Medicare hospice benefits. A Corporate Integrity Agreement was also a part of the settlement. The hospice fraud qui tam relator received $2.3 million for blowing the whistle on the defendant.In 2005, Faith Hospice, Inc., settled claims an FCA claim for $600,000. The hospice fraud allegations were generally that Faith Hospice billed Medicare for providing hospice care to patients more than half of whom were not terminally ill.In 2005, Home Hospice of North Texas settled an FCA claim for $500,000 regarding allegations of fraudulently billing Medicare for ineligible hospice patients.In 2000, Michigan osteopath Donald Dreyfuss, who pleaded guilty to criminal fraud charges, including violation of the AKS for receiving illegal kickbacks from a hospice for recommending the hospice to the staff of his nursing home, settled an FCA suit for $2 million.ConclusionHospice fraud is a growing problem in South Carolina and throughout the United States. South Carolina hospice patients, hospice employees, and their SC lawyers and attorneys, should be familiar with the basics of the hospice care industry, hospice eligibility under the Medicare and Medicaid programs, and typical hospice fraud schemes. Hospice organizations should take steps to ensure full compliance with Medicare/Medicaid hospice billing requirements to avoid hospice fraud allegations and FCA litigation.© 2010 Joseph P. Griffith, Jr.

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In some part of our lives, there will come a time when we will need attorney services. We may need their professional services when we buy a property, close a business deal, adopt a child, file for divorce, or when we need someone to defend us in courts. And throughout the time that we deal with our attorneys to finalize any procedure where we need legal advice, we tend to discuss many things. We may discuss about the steps that needs to be done, what legal actions need to be taken, etc. But, there is one thing that, both us as the client and the attorney, may not discuss per se or may not discuss at all. This is the attorney services fees. Yes, despite the fact that professional fees for attorney services are important; these are mostly not being discussed. The most valid reason for this is that it seems awkward to talk about them. Besides, it usually feels uncomfortable to talk about them; especially if the services involve dealing with sensitive cases. But, as the one hiring an attorney, you need to know more about attorney services fees so that it won’t be uncomfortable for you to talk about it. Know the Correct Attorney Services Fees As you will be the one to hire and therefore pay for the services, knowing the current market rate for such services would be important. Usually, legal or attorney services fees varies according to where the services are being performed. Here are the three most important things that you have to consider when deciding what amount should be fair enough as fees for your attorney; 1. Decide on how much money you can afford to pay. As the client, you know how much you can afford. And you should tell your attorney that. In most cases, if you can’t afford to pay a lot, you can opt for public attorneys. They usually have low rates for their services. But just the same, you need to determine how much money you have and if you can pay the attorney’s regular rates. 2. The kind of services needed. You should also know whether you will need an expert attorney in a certain field. Most fees are based on the level of expertise needed in a legal service or how much work is involved. 3. The usual rate for the type of service. Appraising how much money you will need as payment for attorney services will usually depend on the type of service rendered. Hence, it is important that you’d be able to distinguish what type of services you need. It is also important that you know the current rate for the type of service that you need. When deciding about the attorney services fees, it is also vital that you plan on what type of fee arrangement you will offer. Actually, this is also a factor when deciding how to pay your attorneys. Now, you will need to decide whether you will pay him/her a flat rate, hourly rate or contingency fee. The latter will mean that you will pay your attorney a certain percentage on any amount that you will get should you win a case; for example, settlement fee for divorce or child custody. You will have to discuss on how much you will possibly get and what percentage should be the payment. If you are going to pay a flat rate, on the other hand, the attorney will determine how much is the total fee that you will have to pay. Other expenses such as photocopying, etc are computed with the flat rate fee. Now, hourly rate shall be computed based on the hours spent by your attorney on the case or proceedings.

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The following are six main points that highlight the functions of a lawyer.1) Representation of clients in court - especially when charges are leveled against the client by a third party such as the state or another person concerning crimes or criminal actions allegedly taken by the client. Otherwise, the lawyers draw up papers against an offender who is believed to have violated the rights of the client, and stands for the client in court.2) Drafting of papers and doing legal research on behalf of the client - such as in the writing of briefs and research into relevant facts concerning a particular case. Most of the hard work is done by the lawyer, while the clients merely need to show their face.5) Executing the last wishes of the deceased - such as a written will stating their precise desires in black and white, a trust, etc. The lawyer helps to see to it that these wishes are carried out to the letter.6) Prosecution of criminal suspects in court - this is applicable if the lawyer is working for an arm of government, say the Police Department, the Department of Justice, or the District Attorney's Office.

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COME FORWARD JUST THIS YEAR. IN THE WATERS OF LAKE CHAMPLAIN A KEY PIECE OF EVIDENCE FOUND, THE GUN OFFICIALS SAY WAS US TO KILL 23-YEAR-OLD KEVIN DEOLIVIERA. THE WEAPON WAS REGISTERED SUSPECT 24-YEAR-OLD RICHARD MONROE'S FATHER >> JUST BECAUSE IT WAS MR. MONROE'S FATHER'S GUN SAY THAT IT WAS MR. MONROE WHO HAD THE GUN AND SHOT AND KILLED. MONROE'S CO-DEFENDANT IN A SEPARATE CASE, ZACHARY HUST, TOLD INVESTIGATORS MONROE ADMITTED THE TO SHOOTING TO HI THAT ALLEGATION LED TO MONORE'S ARREST ZACHARY HUST MAKES OR LOSES THE PROSECUTIONS CASE, WITHOUT HIM, FROM THE EVIDENCE THAT HAS BEEN SHOWN SO FAR THEY HAVE NO CASE MONROE'S ATTORNEY TOLD A FEDERAL JUDGE ON THURSDAY HUST HAS A HISTORY OF LYING TO POLICE, HAD A KEY TO MONROE'S APARTMENT WHERE THE GUN WAS AND HAD REGULAR CONTACT WITH THE VICTIM. BUT IS IT ENOUGH TO CREATE THE RESONABLE DOUBT NEEDED TO GET MONROE AQUITTED? THE DEFENSE IS DEFIANTLY GOING TO SAY THE REASON MR. HUST HAS ALL THIS INFORMATION IS BECAUSE HE IS THE PERPETRATOR, HE IS LOOKING FOR SOMEONE ELSE TO BLAME HE HAS THIS CASE RIGHT NOW, COCAINE CASE PENDING AND SO HE IS LOOKING TO GET LENIENCY AND AT THE SAME TIME HE IS LOOKING TO POINT THE BLAME AT SOMEONE ELSE, MR. MONROE AND AVOID BEING PROSECUTED FOR THE CRIME. HUST ALSO ALLEGED MONROE COMMITTED THE CRIME THE SAME DAY HE WAS GOING ONA TRIP TO CUBA WITH CHAMPLAIN COLLEGE SO HE WOULD HAVE AN ALIBY. THE QUESTION IS WILL THAT HELP PROSECUTORS OR THE DEFENSE? IT'S ONE THAT COULD GO IN ETHER DIRECTION, PARTICULARL DEPENDING UPON WHAT THEY A ABLE TO DO ON TIME OF DEATH. WITH NO OFFICIAL TIME OF DEATH.

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BI GONS BY BUY GONS. >> IT'S A DANGEROUS WORLD RIGHT NOW CAB WAB KARI WE'VE GOT RUSSIAN EXPANSIONISM A MESS IN THE MIDDLE EAST IN SYRIA, LIBYA. NORTH KORTH KOREA THE ISSUE. MANY THOUGHT OF THE G20 A OPPORTUNITY PERHAPS FOR AMERICA AND DONALD TRUMP TO RECLAIM THE MANTLE OF LEADERSHIP IN THE WORLD THAT HAS BEEN DETERIORATING OVER THE MONTHS BECAUSE DONALD TRUMP HAS NOT REAFFIRMED THE COMMITMENT UNTIL YESTERDAY AGAIN PROPERLY TO ARTICLE 5 OF NATO. HE HAS NOT TAKEN THE LEADERSHIP ROLES NECESSARY IN A LOT OF THESE PLACES. IT DIDN'T HAPPEN. THAT DIDN'T HAPPEN AT THE G20. IN FACT IF ANYTHING THE LEADERS ON SATURDAY WILL LEAVE THE G20 WITH THE WORLD MORE SPLINTERED PLACE THAN IT WAS WHEN THE MEETING STARTED. WHAT IS THE -- PLACE OF THE UNITED STATES IN THE WORLD RIGHT NOW. >> IT'S REALLY DISHEARTENING FOR THOSE IN THE NATIONAL SECURITY AND FOREIGN POLICY COMMUNITY TO SEE HOW THE PRESIDENT IN SUCH A SHORT TIME HAS DAMAGED THE UNITED STATES'S REPUTATION THROUGHOUT THE WORLD. AND THERE IS A REASON THAT DOZENS OF NATIONAL SECURITY AND FOREIGN POLICY EXPERTS AND FORMER OFFICIALS WERE CONCERNED ABOUT KRUFRP BECOMING PRESIDENT ON THE CAMPAIGN AND THERE IS NOTHING HE HAS DONE SINCE HE'S BEEN PRESIDENT THAT CHANGED THAT ASSESSMENT. BUT JUST GOING BACK FOR A SECOND TO WHAT PETER WAS DESCRIBING BEFORE WITH RESPECT TO THE INTELLIGENCE COMMUNITY. WHAT REALLY MATTERS IS THE AGENCY THAT IS WERE INVOLVED IN MAKING THE DETERMINATION, AND THE AGENCY THAT IS HAVE THE RELEVANT RESPONSIBILITY FOR LOOKING AT MAJOR COUNTERINTELLIGENCE ISSUES ARE THE AGENCY THAT IS WERE INVOLVED IN MAKING THAT ASSESSMENT. AND IT'S NOT JUST THE AGENCIES. IT'S THE DIRECTOR OF NATIONAL INTELLIGENCE WHO SITS ATOP ALL OF THE INTELLIGENCE COMMUNITY. IT'S THE FORMER DIRECTOR OF NATIONAL INTELLIGENCE AND PRESIDENT TRUMP'S CURRENT DIRECTOR OF NATIONAL INTELLIGENCE WHO SUPPORTS THE ASSESSMENT THAT THAT THERE WAS RUSSIAN INFLUENCE ON THE CAMPAIGN. THE FORMER FBI DIRECTOR, THE BIPARTISAN CHAIR AND VICE SIR CHAIR OF THE SENATE INTELLIGENCE COMMITTEE, BASICALLY EVERYBODY IN A POSITION OF AUTHORITY TO UNDERSTAND IN INTELLIGENCE.

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In civil lawsuits, people frequently have their depositions taken. A deposition is a question and answer session under oath between a witness and at least one attorney. When the witness is testifying on behalf of one party, either the plaintiff or the defendant, Best Disability Attorney Near Me in Bryanston the opposing party’s attorney will do most of the questioning. Usually, the lawyers for all parties are in the room, although not all of the attorneys present choose to ask questions. There is usually a court reporter present taking down what everyone says on a stenotype machine. There are many reasons for lawyers to take legal depositions.

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Here are just a few. Rules The most prominent reason someone has to give a deposition is because a lawyer is not allowed to simply call up a witness for the other side and start asking questions. In fact, Find A Criminal Lawyer they are not allowed to speak to them about the case when that person has been designated as a witness for another party. Instead, it must be done in a formal setting. The witness is usually subpoenaed and the lawyer that has designated that person as a witness will usually be present.Information When an attorney believes someone has information that will lead to discoverable evidence in a civil case, they are allowed to take their deposition.

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The witness is required by law to cooperate and answer fully and honestly any of the proper questions asked by the lawyers. Oftentimes, the lawyer may not know all of the important facts of the case. There may be people, objective third parties, who witnessed a car accident or that have factual information that is crucial to the case. Learning what they know about it may shed light on the case before it goes to court. This prevents one side from springing surprises on the other during trial.Intimidation On rare occasions, an attorney will take the deposition of a witness for the other side to intimidate or make the person nervous.

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This is more common in domestic dispute matters, such as child custody or divorce cases. It also happens more often to the plaintiff, Christian Family Lawyers Near Me the party bringing the lawsuit. This is sometimes done to make sure the witness knows the lawyer means business. Playing hardball in a deposition is what happens when the attorney is purposefully trying to make the witness uncomfortable. This may be done to make sure they tell the truth and to find out if the person will drop the case, rather than have to go through similar questioning in court, as well if the case goes to trial.

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Hospice fraud in South Carolina and the United States is an increasing problem as the number of hospice patients has exploded over the past few years. From 2004 to 2008, the number of patients receiving hospice care in the United States grew almost 40% to nearly 1.5 million, and of the 2.5 million people who died in 2008, nearly one million were hospice patients. The overwhelming majority of people receiving hospice care receive federal benefits from the federal government through the Medicare or Medicaid programs. The health care providers who provide hospice services traditionally enroll in the Medicare and Medicaid programs in order to qualify to receive payments under these government programs for services rendered to Medicare and Medicaid eligible patients.While most hospice health care organizations provide appropriate and ethical treatment for their hospice patients, because hospice eligibility under Medicare and Medicaid involves clinical judgments which may result in the payments of large sums of money from the federal government, there are tremendous opportunities for fraudulent practices and false billing claims by unscrupulous hospice care providers. As recent federal hospice fraud enforcement actions have demonstrated, the number of health care companies and individuals who are willing to try to defraud the Medicare and Medicaid hospice benefits programs is on the rise.A recent example of hospice fraud involving a South Carolina hospice is Southern Care, Inc., a hospice company that in 2009 paid $24.7 million to settle an FCA case. The defendant operated hospices in 14 other states, too, including Alabama, Georgia, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Ohio, Pennsylvania, Texas, Virginia and Wisconsin. The alleged frauds were that patients were not eligible for hospice, to wit, were not terminally ill, lack of documentation of terminal illnesses, and that the company marketed to potential patients with the promise of free medications, supplies, and the provision of home health aides. Southern Care also entered into a 5-year Corporate Integrity Agreement with the OIG as part of the settlement. The qui tam relators received almost $5 million.Understanding the Consequences of Hospice Fraud and Whistleblower ActionsU.S. and South Carolina consumers, including hospice patients and their family members, and health care employees who are employed in the hospice industry, as well as their SC lawyers and attorneys, should familiarize themselves with the basics of the hospice care industry, hospice eligibility under the Medicare and Medicaid programs, and hospice fraud schemes that have developed across the country. Consumers need to protect themselves from unethical hospice providers, and hospice employees need to guard against knowingly or unwittingly participating in health care fraud against the federal government because they may subject themselves to administrative sanctions, including lengthy exclusions from working in an organization which receives federal funds, enormous civil monetary penalties and fines, and criminal sanctions, including incarceration. When a hospice employee discovers fraudulent conduct involving Medicare or Medicaid billings or claims, the employee should not participate in such behavior, and it is imperative that the unlawful conduct be reported to law enforcement and/or regulatory authorities. Not only does reporting such fraudulent Medicare or Medicaid practices shield the hospice employee from exposure to the foregoing administrative, civil and criminal sanctions, but hospice fraud whistleblowers may benefit financially under the reward provisions of the federal False Claims Act, 31 U.S.C. §§ 3729-3732, by bringing false claims suits, also known as qui tam or whistleblower suits, against their employers on behalf of the United States.Types of Hospice Care ServicesHospice care is a type of health care service for patients who are terminally ill. Hospices also provide support services for the families of terminally ill patients. This care includes physical care and counseling. Hospice care is normally provided by a public agency or private company approved by Medicare and Medicaid. Hospice care is available for all age groups, including children, adults, and the elderly who are in the final stages of life. The purpose of hospice is to provide care for the terminally ill patient and his or her family and not to cure the terminal illness.If a patient qualifies for hospice care, the patient can receive medical and support services, including nursing care, medical social services, doctor services, counseling, homemaker services, and other types of services. The hospice patient will have a team of doctors, nurses, home health aides, social workers, counselors and trained volunteers to help the patient and his or her family members cope with the symptoms and consequences of the terminal illness. While many hospice patients and their families can receive hospice care in the comfort of their home, if the hospice patient's condition deteriorates, the patient can be transferred to a hospice facility, hospital, or nursing home to receive hospice care.Hospice Care StatisticsThe number of days that a patient receives hospice care is often referenced as the "length of stay" or "length of service." The length of service is dependent on a number of different factors, including but not limited to, the type and stage of the disease, the quality of and access to health care providers before the hospice referral, and the timing of the hospice referral. In 2008, the median length of stay for hospice patients was about 21 days, the average length of stay was about 69 days, almost 35% of hospice patients died or were discharged within 7 days of the hospice referral, and only about 12% of hospice patients survived longer than 180 days.Most hospice care patients receive hospice care in private homes (40%). Other locations where hospice services are provided are nursing homes (22%), residential facilities (6%), hospice inpatient facilities (21%), and acute care hospitals (10%). Hospice patients are generally the elderly, and hospice age group percentages are 34 years or less (1%), 35 - 64 years (16%), 65 - 74 years (16%), 75 - 84 years (29%), and over 85 years (38%). As for the terminal illness resulting in a hospice referral, cancer is the diagnosis for almost 40% of hospice patients, followed by debility unspecified (15%), heart disease (12%), dementia (11%), lung disease (8%), stroke (4%) and kidney disease (3%). Medicare pays the great majority of hospice care expenses (84%), followed by private insurance (8%), Medicaid (5%), charity care (1%) and self pay (1%).As of 2008, there were approximately 4,700 locations which were providing hospice care in the United States, which represented about a 50% increase over ten years. There were about 3,700 companies and organizations which were providing hospice services in the United States. About half of the hospice care providers in the United States are for-profit organizations, and about half are non-profit organizations. General Overview of the Medicare and Medicaid ProgramsIn 1965, Congress established the Medicare Program to provide health insurance for the elderly and disabled. Payments from the Medicare Program arise from the Medicare Trust fund, which is funded by government contributions and through payroll deductions from American workers. The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is the federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid.In 2007, CMS reorganized its ten geography-based field offices to a Consortia structure based on the agency's key lines of business: Medicare health plans, Medicare financial management, Medicare fee for service operations, Medicaid and children's health, survey & certification and quality improvement. The CMS consortia consist of the following:The FCA anti-retaliation provision protects the hospice whistleblower from retaliation from the hospice when the employee (or a contractor) "is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment" for taking action to try to stop the fraudulent activity. 31 U.S.C. § 3730(h). A hospice employee's relief includes reinstatement, 2 times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination or retaliation, including litigation costs and reasonable attorneys' fees.A SC hospice fraud FCA whistleblower would initially file a disclosure statement, complaint and supporting documents with the U.S. Attorney's Office in Columbia, South Carolina, and the US Attorney General. After the disclosures are filed, a federal court complaint can be filed. The SC division where the frauds occurred, the relator's residence, and the defendant residence, will determine which division the case will be assigned. There are eleven federal court divisions in South Carolina. Once the case has been filed, the government has 60 days to decide whether or not to intervene. During this time, federal government investigators located in South Carolina will investigate the claims. If the case involved Medicaid, SC Medicaid fraud unit investigators will likely become involved as well. If the government intervenes in the case, the U.S. Attorney for South Carolina is usually the lead attorney. If the government does not intervene, the relator's SC attorney will prosecute the case. In South Carolina, expect a qui tam case to take one to two years to get to trial.Tips on Recognizing Hospice Fraud SchemesThe HHS Office of Inspector General (OIG) has issued Special Fraud Alerts for fraudulent and abusive practices of hospices. U.S. and South Carolina hospices, patients, hospice employees and whistleblowers, their attorneys and lawyers, should be familiar with these hospice fraud practices. Tips on recognizing hospice frauds in South Carolina and the U.S. are:• A hospice offering free goods or goods at below market value to induce a nursing home to refer patients to the hospice. • False representations in a hospice's Medicare/Medicaid enrollment form. • A hospice paying "room and board" payments to the nursing home in amounts in excess of what the nursing home would have received directly from Medicaid had the patient not been enrolled in the hospice. • False statements in a hospice's claim form (CMS Forms 1450, UB-04 or UB-92). • A hospice falsely billing for services that were not reasonable or necessary for the palliation of the symptoms of a terminally ill patient. • A hospice paying amounts to the nursing home for "additional" services that Medicaid considered included in its room and board payment to the hospice. • A hospice paying above fair market value for "additional" non-core services which Medicaid does not consider to be included in its room and board payments to the nursing home. • A hospice referring patients to a nursing home to induce the nursing home to refer its patients to the hospice. •A hospice providing free (or below fair market value) care to nursing home patients, for whom the nursing home is receiving Medicare payment under the skilled nursing facility benefit, with the expectation that after the patient exhausts the skilled nursing facility benefit, the patient will receive hospice services from that hospice. • A hospice providing staff at its expense to the nursing home to perform duties that otherwise would be performed by the nursing home. • Incomplete or no written Plan of Care was established or reviewed at specific intervals. • Plan of Care did not include an assessment of needs. • Fraudulent statements in a hospice's cost report to the government. • Notice of Election was not obtained or was fraudulently obtained. • RN supervisory visits were not made for home health aide services. • Certification or Re-certification of terminal illness was not obtained or was fraudulently obtained. • No Plan of care was included for bereavement services. • Fraudulent billing for upcoded levels of hospice care. • Hospice did not conduct a self-assessment of quality and care provided. • Clinical records were not maintained for every patient. • Interdisciplinary group did not review and update the plan of care for each patient.Recent Hospice Fraud Enforcement CasesThe DOJ and U.S. Attorney's Offices have been active in enforcing hospice fraud cases.In 2009, Kaiser Foundation Hospitals settled an FCA lawsuit by paying $1.8 million to the federal government. The defendant allegedly failed to obtain written certifications of terminal illness for a number of its patients.In 2006, Odyssey Healthcare, a national hospice provider, paid $12.9 million to settle a qui tam suit for false claims under the FCA. The hospice fraud allegations were generally that Odyssey billed Medicare for providing hospice care to patients when they were not terminally ill and ineligible for Medicare hospice benefits. A Corporate Integrity Agreement was also a part of the settlement. The hospice fraud qui tam relator received $2.3 million for blowing the whistle on the defendant.In 2005, Faith Hospice, Inc., settled claims an FCA claim for $600,000. The hospice fraud allegations were generally that Faith Hospice billed Medicare for providing hospice care to patients more than half of whom were not terminally ill.In 2005, Home Hospice of North Texas settled an FCA claim for $500,000 regarding allegations of fraudulently billing Medicare for ineligible hospice patients.In 2000, Michigan osteopath Donald Dreyfuss, who pleaded guilty to criminal fraud charges, including violation of the AKS for receiving illegal kickbacks from a hospice for recommending the hospice to the staff of his nursing home, settled an FCA suit for $2 million.ConclusionHospice fraud is a growing problem in South Carolina and throughout the United States. South Carolina hospice patients, hospice employees, and their SC lawyers and attorneys, should be familiar with the basics of the hospice care industry, hospice eligibility under the Medicare and Medicaid programs, and typical hospice fraud schemes. Hospice organizations should take steps to ensure full compliance with Medicare/Medicaid hospice billing requirements to avoid hospice fraud allegations and FCA litigation.© 2010 Joseph P. Griffith, Jr.

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