Unlawful Medicare and Medicaid Referrals Under Stark Statute

In 1989, the United States Congress enacted the Stark statute which made it illegal for physicians to make self-referrals and prevented physicians from referring Medicare or Medicaid patients for certain designated health services to any entity with which the physician has a financial interest. The purpose of this law was to remove economic incentives that may encourage some physicians to make self-referrals or to refer certain designated health services to entities in which the physician has a financial interest, instead of referrals based on a patient's health and well being.

Stark Violation Claims and Stark Violation Lawsuits

Stark violations occur when a physician (as defined by Medicare) unlawfully refers Medicare or Medicaid patients to an entity in which the physician or the physician's immediate family has a financial interest. In these situations the physician is usually making these referrals for the purpose of the physician's own financial gain and is not working in the best interest of their patients. Repeated violations of the Stark Statute can create substantial wealth for self referring doctors and can cost tax payers millions, tens of millions, or even hundreds of millions of dollars. These violations can also be hard to detect by the government and patients. For this reason it is often health care administrators, hospital administrators, benefit coordinators, accountants, and other health care professionals that are able to discover fraudulent referral practices and blow the whistle on the unlawful practice.

Violations of the Stark Statute can result in both criminal and civil penalties for the self referring doctor as well as others benefiting from the fraudulent referral practices. Whistle blowers that properly blow the whistle on these unlawful referrals can not only regain large amounts of money for the United States government, saving tax payers millions of dollars that the physician and/or the entity have taken from the federal government, but the whistle blower can also collect a percentage of this recovery as compensation for bringing a Federal False Claim Act lawsuit that reveals these fraudulent referral practices.

The History and Evolution of the Stark Statute

The Stark Statute is named after California Representative Pete Stark who authored this legislation to prevent fraudulent referral practices that compromised the health of patients, cost the government billions of dollars, and made unethical doctors rich at the expense of patients and taxpayers. Congressman Pete Stark first proposed the Federal physician anti self-referral law in 1988, and what became known as "Stark I" was enacted by the Congress in 1989. At the same time Congress overhauled Medicare's physician payment program and adopted the Resource-Based Relative Value Scale (RBRVS) which is a system used to determine how much money medical providers should be paid by Medicare. The Stark I law initially applied only to clinical laboratory services and became effective with the Medicare fee schedule on January 1, 1992. The Health Care Financing Administration proposed implementing regulations for Stark I in March of 1992, and these rules were finalized on August 14, 1995. They have been codified at 42 C.F.R. 411.350 et seq.

In 1993, Medicare and Medicaid amendments were enacted by Congress that significantly expanded the Stark law to cover a long list of designated health services in addition to clinical lab services. These amendments added the referral prohibition to additional designated health services including: inpatient and outpatient hospital services; physical therapy; occupational therapy; radiology; radiation therapy (services and supplies); durable medical equipment and supplies; parenteral and enteral nutrients (equipment and supplies); prosthetics, orthotics and prosthetic devices and supplies; outpatient prescription drugs; and home health services. These amendments, which became effective January 1, 1995, became known as "Stark II."

Medicare and Medicaid Referral Violation Law Suits
(Qui Tam Law Suits)

Through Whistle Blower Lawsuits, Qui Tam Lawsuits, and other Health Care Fraud Lawsuits, hundreds of billions of dollars have been recovered from individuals and organizations that have committed health care fraud and stolen large amounts of money from the government. For more information on Stark Statute Violations and Medicare or Medicaid Referral Violation Law Suit, please go to the following web page on Medicare and Medicaid Referral Fraud Stark Violation Law Suits.

Texas and Interstate Truck Accident Lawsuits and Insurance Claims

In handling Texas and Interstate Truck Wreck Lawsuits, it is important to realize that multiple insurance companies and risk management departments may be involved in evaluating an automobile accident claim. Both insurance companies and risk management departments have professionals whose jobs are to limit the amount that their insurance company or risk management department pays on any claim regardless of the liability facts or damages. It is therefore important to make sure that victims of a fatal or a catastrophic injury truck wreck are protected from insurance adjusters, risk managers, insurance investigators, and defense lawyers.

Interstate Truck Accident Lawsuits and Insurance Claims

Interstate Trucking Companies are governed by the U.S. Department of Transportation and must carry liability insurance for accidents that their drivers may cause that result in bodily injury or death. These insurance policies make sure that people who are injured or the families of those killed by negligent interstate truck drivers can be compensated up to the policy limits for damages that have been suffered. These damages can include wrongful death damages, medical expenses, physical impairment, pain & suffering, disfigurement, and lost wages. Evidence of these damages is usually required for large recoveries including obtaining policy limits on an interstate truck accident claim.

Texas Truck Accident Lawsuits and Insurance Claims

Texas requires minimum liability coverage for commercial vehicles not regulated by the U.S. Department of Transportation. In handling Texas Commercial Truck Collision Claims, it is important to investigate all known insurance on each automobile, driver, and vehicle owner involved in the collision to maximize the recovery that is made for the injured person or the family of the deceased. In locating insurance and all potential sources of recovery, it is important to review all potential parties that be liable for the accident to determine their insurance and or their ability to pay a large verdict.

Texas and Interstate Truck Accident Lawyer and Information

For more information on Texas Commercial Truck Accident Lawsuits or Interstate Truck Accident Lawsuits, please go to the following Fatal and Serious Injury Truck Collision Web Page.

Military Medical Malpractice Claims and Lawsuits

With the sharp rise in the number of our service personnel in the Army, Air Force, Navy, and Marines that have served the United States in the Iraq War and Afghanistan War has come an increase in the number of veterans and families of military personnel that rely on the military for medical services. At the same time the demand for quality military medical services has increased the budget and ability of the United States government to pay for these services for our country's service personnel and veterans has decreased. These factors have stressed many military hospitals and military medical service professionals to create environments where military medical malpractice is becoming more common.

Military Medical Malpractice Lawsuits & Military Doctor Negligence Claims

As a Texas medical malpractice lawyer Jason Coomer handles Federal medical malpractice lawsuits, Military medical malpractice lawsuits, VA medical malpractice lawsuits, Texas medical malpractice lawsuits, army doctor negligence claims, and federal medical malpractice claims including emergency room errors, post-surgical infections, birth injury, wrongful amputation, unwarranted testing of experimental drugs on patients, and other kinds of inadequate or unethical treatment birth injuries, drug interactions, medication errors, misdiagnoses (failure to diagnose cancer, spine injuries, heart problems or disease), surgical errors (bariatric surgery errors, spine surgery errors, heart surgery errors, simple surgery errors), Cerebral Palsy, Erb’s Palsy, monitoring errors, and errors resulting in hypoxia.

Common Causes of Military Medical Malpractice Lawsuits and Negligent VA, Army, and Navy Doctors

Unfortunately, medical mistakes often happen when military doctors and nurses get too busy, are understaffed by hospital administrators, are under the influence of drugs or alcohol, are not well organized, are under poor hospital administration, or are just not paying attention. As Veterans Administration Hospital, Navy Hospital, Army Hospital, and other Military Hospital medical budgets decrease, healing people becomes more difficult and is less of a priority than saving money sometimes creating cost cutting measures and poor hospital administration policies that cause under supported military doctors, military nurses, and military medical professionals to commit more medical mistakes. Overworked military doctors, residents, and nurses are much more likely to make mistakes than well rested health care professionals.

Medical mistakes also happen more often when no one is watching. It is extremely important when you are in the hospital to have someone that is with you and to help watch out for your well being. This is especially true if you have an allergy to certain types of medicines, are going to be unconscious or under antistesia, or on strong pain killers. In such, situations it is typically a good idea to have a person that you trust to be your health care advocate with a valid HIPPA Authorization, Medical Power of Attorney, and Power of Attorney. Communication with your health care professionals and your health care advocate is also important and can greatly limit medical mistakes.

If you feel you or need a Military medical malpractice lawyer because you or a loved one has been seriously injured by medical negligence or someone close to you has died as a result of medical negligence or a doctor mistake, it is important to investigate the claim and make sure that it does not happen again.

Communication Prevents Many Medical Mistakes

Military Doctors, Army Doctors, Navy Doctors, Air Force Doctors, and Veterans Administration Hospitals typically provide quality medical care, but sometimes mistakes are made. It is always a good idea to have someone that you trust look out after you when you are in the hospital. This person can communicate important information regarding your condition and watch out for you when you are in the hospital. It is important to make sure that you or your medical advocate communicate with health care professionals to limit the mistakes that are made.

However, even with proper communication medical mistakes can be made. If a mistake is made, it is important to report the mistake and if the mistake causes serious injury or death it is important to investigate a potential federal medical malpractice claim and potential lawsuits. This is because medical mistakes that no one knows about will not be noticed and will not result in future better medical care. Medical mistakes that are reported will help other patients and are an essential part of the feedback needed to improve our health care delivery system.

For more information on Military Medical Malpractice Claims and Preventing Military Medical Malpractice, go to the following web page on Military Medical Malpractice Lawsuits or seek an attorney's advice on setting up a health care advocate for loved ones going into a hospital.

Texas Commercial Truck Accident Lawsuits and Company Vehicle Lawsuits

According to the National Center for Statistics and Analysis, thousands of motorists are killed each year by commercial vehicles including large trucks, specialized vans, modified company trucks, specialized company SUVs, and company cars. These commercial vehicles are too often driven by under trained, inexperienced, and/or over worked drivers that are under pressure to drive fast as well as keep maintenance costs down. These factors combined with distractions in the vehicles including cell phones, GPS devices, computers, paper work, radio communications, and other employees can cause fatal automobile accidents.

Whether a company driver is driving a large commercial vehicle such as a bus, passenger van, 18-wheeler, dump truck, propane truck, garbage truck, construction truck, semi-trucks, tractor-trailer, utility truck, hauling truck, or semi, or smaller commercial vehicles such as an SUV, passenger vehicle, limo, or taxi cab, it is important that the driver be trained to operate the commercial vehicle they are driving and have their driving record reviewed. Unfortunately, some businesses neither train their drivers nor do a proper investigation to determine if the drivers to which they are entrusting their commercial vehicles have a history of reckless driving, have caused several accidents, have DWI accidents in their past, have a history of driving drunk or under the influence of drugs, or have no experience driving the vehicles that they are given. These failures can lead to negligent entrustment that causes an accident, wreck, or collision resulting in serious injuries, catastrophic injuries, or even death.

Texas Truck Accident Lawyer and Commercial Vehicle Accident Lawsuits

Truck and other commercial vehicle accidents can result in fatal passenger accidents, catastrophic injuries, and significant damages to families. It is therefore important for businesses to make sure that their company vehicles, especially, large commercial vehicles are driven by experienced and well trained drivers that do not have histories of reckless and unsafe driving, DWI accidents, fatal accidents, drinking & driving, or driving under the influence.

For more information on Texas Commercial Truck Accident Lawsuits or Texas Company Vehicle Accident Lawsuits, please go to the following web page on Texas Commercial Vehicle Accident Lawsuits.

Investment Fraud, Negligence, and Ponzi Schemes

Ponzi Schemes are fraudulent investment scams that pay returns to investors from their own money or money paid by subsequent investors rather than from any actual profit earned. Their name comes from Charles Ponzi, who duped thousands of people into investing in a postage stamp speculation scheme back in the 1920s. Ponzi thought he could take advantage of differences between U.S. and foreign currencies used to buy and sell international mail coupons. Ponzi told investors that he could provide a 40% return in just 90 days compared with 5% for bank savings accounts. Ponzi was deluged with funds from investors, taking in $1 million during one three-hour period. Though a few early investors were paid off to make the scheme look legitimate, an investigation found that Ponzi had only purchased about $30 worth of the international mail coupons. Now the term "Ponzi Scheme" applies to investment scheme that "rob-Peter-to-pay-Paul", money from new investors is used to pay off earlier investors until the whole scheme collapses.

Breach of Fiduciary Duty, Conflicts, and Failure of Checks and Balances

With the Madoff and Stanford Group Investment Fraud Allegations has come other allegations that stock brokers, lawyers, accountants, fund managers, investment firms, auditors, and other companies and people that should have recognized fraud have committed negligence, fraud, breach of fiduciary duty, conflicts of interest, and other violations of law that may make them liable for investors' losses. Many investors are beginning to realize that their may be a way to recoup some or most of the money that they lost from their retirement funds, life savings, or other investment.

For more information on large investment fraud news and allegations or seeking compensation for a breach of fiduciary duty, conflict of interest, or failure of checks and balances, please go to the following web page on Investment Fraud, Ponzi Schemes, Conflicts of Interest, Negligence, and Breach of Fiduciary Duty Claims.

Gadolinium Contract Dye and Nephrogenic System Fibrosis Lawsuits

Gadolinium is a rare earth metal that can be put into dyes and injected into the blood stream to enhance MRI and MRA images. Unfortunately, the use of Gadolinium contrast dyes in people can cause nephrogenic systemic fibrosis (NSF) in patients with kidney problems. Nephrogenic Systemic Fibrosis is a debilitating and potentially fatal disease for which there is no known cure. It is believed that even though some pharmaceutical companies knew about the painful, debilitating, and life-threatening side effects of Gadolinium contrast dyes as early as April 2006, they hid the potential problems caused by the use of Gadolinium in dyes. Though they sold more products, the continued use of dyes with Gadolinium has likely unnecessarily injured and killed many people.

Gadolinium Contract Dye and Nephrogenic System Fibrosis

Persons with kidney problems should avoid any dyes with Gadolinium and should be aware of this potential danger if they are having an MRI or MRA done. Nephrogenic systemic fibrosis (NSF) or Nephrogenic fibrosing dermopathy is a rare and serious syndrome that involves fibrosis of skin, joints, eyes, and internal organs. Scientific research has recently discovered an association between nephrogenic system fibrosis with exposure to gadolinium in patients with severe kidney failure.

In NSF, patients develop large areas of hardened skin with fibrotic nodules and plaques. Flexion contractures with an accompanying limitation of range of motion can also occur. NSF resembles scleromyxedema at the histologic (microscopic) level; it shows a proliferation of dermal fibroblasts and dendritic cells, thickened collagen bundles, increased elastic fibers, and deposits of mucin.

People that have had MRIs and are having unexplained symptoms including skin hardening, fibrotic nodules, strange lesions, deep pain, joint pain, and inability to walk or use of their joints, should contact their doctors to determine if they have Nephrogenic systemic fibrosis (NSF), Nephrogenic fibrosing dermopathy, or renal insufficiency.

For more information on Nephrogenic Systemic Fibrosis or a potential Nephrogenic Systemic Fibrosis law suit, feel free to go to the following web page Nephrogenic System Fibrosis and MRI Contrast Dye Lawsuits.

TARP Fraud Lawsuits, Theft of Government Funds, and Bailout Fraud Lawsuits

The Troubled Asset Relief Program (TARP) is a $700 Billion Government Bail Out of the troubled United States Banking and Credit System. It was designed to unfreeze the credit market and enable the government to purchase residential and commercial mortgage assets, including whole loans and securities. Unfortunately, after it was announced numerous Corporate interests began scheming on how to get as much of the Bail Out money as possible and use the money not for its intended purpose, but to enrich the corporations and CEOs that were able to fraudulently get a portion of the money.

Other Bail Out Fraud Lawsuits and Qui Tam Lawsuits

The Bail Outs of AIG, Fannie Mae, and Freddie Mac also may lead to potential qui tam claims as approximately $300 Billion in government funds are being used to save these private and quasi public entities. The federal takeover of Fannie Mae and Freddie Mac places a conservatorship on government sponsored enterprises Fannie Mae and Freddie Mac by the US Treasury in September 2008.

American International Group, Inc. (AIG) has also been the recipient of a large government bail out. Like the TARP money, the AIG bail out needs to used for its intended purpose and not to enrich the wealth of a few that find ways to steal bail out money for themselves. Whether you are for or against these large bail outs, we would all agree that it is important that none of this money be fraudulently taken and used to enrich a few individuals.

Economic Incentives for Whistleblowers Lawsuits, Government Fraud Lawsuits, and Qui Tam Lawsuits

Whistleblower Law Suits or Qui Tam Lawsuits, allow whistleblowers to seek compensation on the government's behalf from companies and people that have defrauded taxpayers out of government money.

When a government imposes a penalty, for the doing or not doing an act, and gives that penalty in part to whistleblowers that will sue for the same, and the other part of the recovery goes to the government, and makes it recoverable by action, such actions are called "qui tam actions", the plaintiff is suing on their own behalf as well for the government and taxpayers.

Qui tam provisions of the False Claims Act are based on the theory that one of the least expensive and most effective means of preventing frauds on taxpayers and the government is to make the perpetrators of government fraud liable to actions by private persons acting under the strong stimulus of personal ill will or the hope of gain.

The strong public policy behind creating an economic gain for whistleblowers is that the government would be significantly less likely to learn of the allegations of fraud, but for persons in certain positions with specialized knowledge of fraud that has been committed. Congress has made it clear that creating this economic incentive is beneficial not only for the government, taxpayers, and the realtor, but is an efficient method of regulating government to prevent fraud and fraudulent schemes.

The central purpose of the qui tam provisions of the False Claims Act is to set up incentives to supplement government regulation and enforcement by encouraging whistleblowers with specialized knowledge of fraud going on in the government to blow the whistle on the crime.

The whistleblower's share of recovery is a maximum of 30 percent and the government's prior knowledge of fraud now does not necessarily bar a whistleblower from collecting lost revenue. If the government takes over the lawsuit, the relator can "continue as a party to the action." The defendant is also required to pay for the relator's attorney fees. The whistleblower is also protected from retaliatory actions by his or her employer. As a result a 1986 amendment to the False Claims Act, qui tam lawsuits have increased dramatically. Though the amendment was first made for corrupt defense contractors, the amendment has uncovered billions of dollars in health care fraud and will probably apply to fraudulently obtained TARP and Bail Out Funds.

TARP Financial Fraud Lawsuits, Theft of Government Funds, and Bailout Lawsuits

Through Whistleblower Lawsuits, Qui Tam Lawsuits, and other Government Fraud Lawsuits, hundreds of billions of dollars have been recovered from fraudulent government contractors that have stolen large amounts of money from the government and taxpayers.

It is extremely important that Whistleblowers continue to expose fraudulent billing practices and unnecessary treatments that cost billions of dollars. For more information on TARP Fraud Lawsuits, Bailout Fraud Lawsuits, Government Fraud Lawsuits, and other Qui Tam Fraud Lawsuits, please go to the following TARP Bailout Fraud Web Page.

Texas Intentional Torts and Crime Victims Rights

Under Texas Law victims of intentional torts such as sexual assault, molestation, rape, offensive touching, assault & battery, hazing, and intentional infliction of emotional harm can seek compensation from the criminals and perpetrators that have committed these intentional torts against them as well as sometimes from other parties that allowed the sexual assault, molestation, rape, or other intentional torts to occur.

An intentional tort arises when a person intends to commit a wrongful act such as sexual assault, physical assault, murder, theft, or molestation which results in serious injury, death, or significant damages. From a legal perspective, it can often be difficult to obtain compensation from a person who commits an intentional tort unless that person is wealthy. This is because most insurance policies do not cover intentional wrongful acts such as murder, sexual assault, rape, molestation, or theft. Further, most criminal and sexual predators do not have money or resources to pay compensation to their victims.

However, sometimes the injuries from a serious crime including sexual molestation or sexual assault result from the wrongful acts of more than one party. An example of this would be when a private school, church, community center, or daycare center has a duty to provide proper supervision of its premises and staff to make sure that the children in their care are safe from harm. If the church, private school, community center, or daycare center hires or allows a person that has a history of molestation or sexual assault to be around children, they may have violated their duty to protect children and negligently allowed a sexual assault or molestation to occur. Similarly, if a homeowner is taking care of someone else's child and allows someone with a history of sexual or violence with children, there may be a potential claim under homeowner's insurance, if the homeowner negligently allows the sexual predator to be alone with the child. Further, if the church, private school, community center, or daycare center allows strangers to access the premises or does not adequately screen or supervise its employees, and a child is molested as a result of the private school's, church's or daycare center's lack of care, the negligent conduct may support a legal cause of action for negligence.

Common intentional torts include sexual molestation, sexual assault, rape, battery, and child abuse. Many of these intentional torts will support a sexual molestation lawsuit or sexual assault lawsuit if the criminal is wealthy or if other parties are negligent in allowing the sexual predator to be alone with children in their care.

Many victims of crimes do not realize that there may be civil actions that can be filed against criminals in addition to criminal charges. In cases where reckless conduct such as when a drunk driver kills someone in a fatal accident, when security officers or bouncers known for violence seriously injure or kill someone, or a rich criminal commits an intentional act such as murder or rape, there are civil laws in Texas that allow the victim or the victim's family to seek compensation.

Texas Drowning Accident Lawsuits and Defective Swimming Pools

Unfortunately, drowning is the second leading cause of death among children under 14 years of age and is a real danger for young children that are not properly supervised when participating in water sports or live near unsafe or unsecured pools. Consumer Safety Groups and Organizations including the Consumer Product Safety Commission (CPSC) have become aware of many dangers with defectively designed and roped pools and have issued several safety warnings about the importance of pool safety.

There have also been several stories in the news where defective swimming pool drains have caused serious injuries to small children as well as trapped small children under water. These defective pool drain and spa drain accidents have caused several children to have been serious injured or killed due to having body parts entrapped by the drain of a swimming pool, wading pool, or spa. Under normal conditions, pipes leading from a pool's drain, or into the pool's pumps, draw water from the pool creating suction. If something blocks the normal function of a pool drain, the amount of suction can increase as the pump draws water past the obstruction. This increased suction can entrap a small child or person, causing the person to be held underwater, which often leads to brain damage because of lack of oxygen or hypoxia. In extreme situations, defective drains in wading pools have caused a child sitting on the drain outlet to be disemboweled by extreme suction.

For more information on Texas Drowning Accident Lawsuits and Defective Swimming Pool Claims, go to the following Texas Drowning Accident Lawsuits and Defective Swimming Pool webpage.

Healthcare Fraud Law Suits (Qui Tam Claims & Medicare Fraud Claims)

Law enforcement authorities estimate that health-care fraud costs taxpayers between $60 billion and $100 billion each year. Through Qui Tam Claims and Health Care Fraud Lawsuits, billions of dollars have been recovered from individuals and organizations that have committed health care fraud and stolen large amounts of money from United States Tax Payers.

There are lawful ways that whistleblowers and American Heroes can act as a "Relator" and file Qui Tam Claims and Whistleblower Lawsuits to recover millions or billions of dollars that have been stolen from the United States.

In a recent Qui Tam settlement False Claims Act qui tam or whistleblower lawsuits were settled resulting in a $1.7 Billion recover. Of this settlement, whistleblowers will receive a combined share of approximately $150 million.

For more information on Qui Tam Claims and Whistleblower Lawsuits feel free to go to the following web pages on Health Care Fraud Claims, Defense Contractor Fraud Claims, and Government Contractor Fraud Claims.