Medicare Drug Theft: Report Finds Pricey HIV-Drugs Dispensed After Death

December 22, 2014 by Gregory J. Brod

Earlier this month we wrote about the theft of prescription drugs, focusing on the growing problem of medications being stolen from our nation’s seniors and why drug theft is a form of elder abuse. We urge all readers to ensure their own medications and those of loved ones are kept in a secure location. These robbery-type crimes are not the only form of prescription theft. As a Northern California Medicare fraud law firm, we are closely watching the issue of Medicare drug thefts crimes that sometimes take advantage of quirky rules and can amount to health care fraud.

Study Identifies Problem of Drugs Dispensed to Deceased Medicare Beneficiaries
In October, the inspector general for the Health and Human Services Department (“HHS”) released a report Medicare rule pursuant to which the program covers prescriptions for up to 32 days after the patient’s death. The investigators focused on a small sliver of medications and identified 158 patients whose HIV-related drugs were covered after their deaths in 2012. In one patient’s case, Medicare records show two separate medication purchases involving three pill$.jpgdrugs each that were covered after he died – charges that amounted to $7,610. Another case involved a Michigan man for whom six prescriptions from two different doctors were ordered and paid for after his death to the tune of $5,616 in Medicare costs.

Medicare’s 32-day rule provides a window for payment that is intended to accommodate some pharmacies’ billing cycles. However, and this language simply begs to be quoted directly, “[d]rugs dispensed after death cannot be used for medically indicated purposes.” Investigators suggest the problem may extend much wider than just HIV medications and likely runs throughout the Medicare Part D prescription coverage program, meaning a change could lead to significant savings for Medicare and thus for the American people. According to the report, Medicare agreed that the rule needs to be changed saying they are in preliminary talks to cut the window to “the absolute minimum given current industry billing practices and system constraints.”

Identifying & Preventing the Problem
A report from political think-tank The Heartland Institute points to two possible ways in which the drug fraud may have been carried out, theories alluded to in the official report. The first theory is that the beneficiaries were the victims of identity theft and suggests the drugs may have been resold on the black market after purchase. The second theory involves a more institutional fraud and suggests that unscrupulous, possibly fake pharmacies were responsible for the bills and that the medications were never actually dispensed.

This month, as noted in a press release from the House Ways and Means Committee, Congressmen Brady (R-TX) and McDermott (D-WA) introduced draft of a bill titled “Protecting the Integrity of Medicare Act of 2014.” The bill proposes reforms to the program’s anti-fraud programs, including measures aimed at preventing the coverage of prescriptions for deceased beneficiaries. We will follow the progress of this legislation and we favor such efforts aimed at preventing fraud before it happens.

Law Firm Recouping Money Lost to Medicare Fraud with the Help of Private Whistleblowers
We also believe it is important to attempt to recoup money lost to Medicare fraud. In many cases, the federal False Claims Act and its state equivalents is a key tool for recovering these funds. Often the recovery process begins with a brave individual coming forward to report knowledge of Medicare fraud; for example, an employee might report that a pharmacy filed fake claims for prescription medications after a beneficiary’s death. The law protects these whistleblowers from retaliation and, when the case results in money being recovered, allows them a share of the recovery in recognition of their role. If you have knowledge of Medicare fraud, our legal team can help you become part of this fight. Call to schedule a consultation.

See Related Blog Posts:
A Victim-Centered Approach to Prescription Theft
The False Claims Act and the Role of Whistleblowers in Stopping Health Care Fraud

(Image by Bill David Brooks)

The Uncertain Legal Status of Uber and Other Ride-Share Companies

December 19, 2014 by Gregory J. Brod

Perhaps the biggest phenomenon in the transportation world during 2014 has been the rise of Uber and other ride-share apps. While some have been in existence for a number of years, ride sharing companies grew exponentially this year with both riders and drivers taking advantage of technology allowing a person in need of a ride to connect with a driver for hire. Although the services have many loyal devotees, there are increasing concerns about what happens when things go wrong both in terms of car accidents and when either party has bad intentions. Our San Francisco injury law firm is closely following the related legal developments and fully prepared to represent people injured while using Uber or other ride-share services whether in a crash or as the victim of an assault.

Common Carrier” or Just Another Driver? cell.jpg
Uber and other rideshare apps may save passengers money but customers may not have the same legal protections they have in a traditional taxi. As the California Civil Jury Instructions explain, “common carriers” are companies that are in the business of transporting the general public or their property. This is important because common carriers owe enhanced duties and “must use the highest care and the vigilance of a very cautious person. They must do all that human care, vigilance, and foresight reasonably can do under the circumstances to avoid harm to passengers [or property]” (California Civil Jury Instructions 902). In contrast, a typical driver only owes a duty of ordinary care, a much lower standard. The enhanced duties make it easier to recover in a personal injury lawsuit if a car accident occurs. It is well-established that taxis and buses fall into the category of common carriers. While at least some courts have found ride-share companies fall into this category, others have yet to rule on the issue and the companies strongly contest the label.

Accusations of Assault Involving Ride-Share Drivers
In addition to the risk of car accidents, there have been allegations of assault and rape by ride-share drivers. On Wednesday, Uber’s head of global safety authored a blog post promising to focus on safety while defending the company’s record. ABC News reports the post comes amid increasing concerns the California-based company, valued at a whopping $40 billion, does not adequately screen drivers for past criminal convictions. The post does not mention a lawsuit filed last week by California prosecutors that alleges Uber exaggerates its screening process which does not, unlike regulated San Francisco taxi companies, require fingerprinting. It does, however, reference a case in India involving a driver accused of raping a customer. While there are few details provided, the post does allude to new screening processes and a team that will respond to safety reports. District Attorney George Gascon said he could not comment on specifics but said San Francisco encourages any changes that make rides safer.

Protecting Ride-Share Passengers in California
As an injury law firm, we are dedicated to protecting people hurt by others’ negligence. While the law is different, we are ready to fight for anyone injured while using ride-share services or otherwise. Do not accept a company’s refusal to compensate you, regardless of any contractual provisions that purport to limit responsibility. We are prepared to use injury law, common carrier principles, employment law, and other areas of the law to ensure you are compensated. In addition to helping those hurt in a car accident involving a ride-share company, we are also prepared to victims of assault and/or rape by a ride-share driver. Call to arrange a no-cost consultation with our skilled San Francisco rideshare injury attorney.

See Related Blog Posts:
Limo Fire Tragedy and California Common Carrier Law
San Francisco Lawyer Comments on Taxi Accident Law After Pedestrian Dies in Cab Collision

(Photo by Carissa Rodgers)

The Impact of Alcohol: Santa Rosa Injury Lawyer Examines the True Meaning of BAC

December 18, 2014 by Gregory J. Brod

duikeys.jpgIn most news stories (and blog posts) about drunk driving accidents there is at least one reference to blood alcohol concentration (“BAC”). Most readers have probably heard that the legal limit in all states is 0.08%, but it can be hard to understand what BAC really means. Today, our Santa Rosa DUI injury law firm looks at what BAC means from a driving skills standpoint.

From “Buzzed” to Legally Drunk…
In a dedicated drinking and driving fact sheet, the National Council on Alcoholism and Drug Dependence (NCADD) looks at how alcohol impacts a driver even before reaching the 0.08 mark. It is worth noting that these are generalized based on an average person and some people may experience a greater impact from the same BAC.

  • 0.02 -- A person begins to relax and experience a shift in mood. While this sounds innocuous (and despite seeming to be coordinated), there is a loss in judgment, a decline in visual processing, and a drop in the ability to perform multiple tasks at the same time, all of which can make the difference between a close-call and a crash.

  • 0.05 -- Psychomotor (muscular activity linked to mental activity) performance drops sharply. Visual perception decreases; eyes move slower and the ability to track moving objects is reduced. Reaction times slow and it is harder to respond to emergencies.

  • 0.08 -- Effects increase as muscle coordination and perception are reduced. Skills essential to driving like judgment, danger-detection, reasoning, self-control, and general information processing ability are inhibited.

…And Higher BAC Levels
Of course, continuing to drink past the legal limit means even greater impact. According to the Press Democrat, preliminary tests on a driver arrested in Cloverdale recently put his BAC at 0.24, nearly three times the legal limit. Police had to block the Ukiah man’s path with a patrol car in order to get him to stop and it is only luck that prevented a much more tragic outcome.

A resource page produced by nonprofit B.R.A.D. 21 (founded in memory of a young man who died from acute alcohol poisoning) provides insight into what happens at higher BAC levels such as detected in the Cloverdale case. In brief, higher levels impact the drinker as follows:

  • 0.10-0.125 – Significant motor coordination impairment. Balance, vision/hearing, and reaction times are diminished. Judgment is also significantly impaired.
  • 0.13-0.15 – Gross impairment of motor skills, major loss of balance, lack of bodily control. Severe impact on judgment and perception.
  • 0.16-0.19 – In simple terms, “sloppy drunk.”
  • 0.20 – Nausea and vomiting may occur. The drinker feels increasingly dazed and disoriented. Many people need help just to stand.
  • 0.25 - Severe impairment of all mental, physical, and sensory activity. Increased risk of serious injury from falls. Subject may pass out and die from choking on his/her own vomit.
  • 0.35 - Akin to surgical anesthesia, coma can occur.
  • 0.40 and up- Death from respiratory distress becomes a distinct possibility.

To put it lightly, alcohol and driving do not mix. As a recent campaign noted, “buzzed driving is drunk driving.” The only safe BAC for driving is 0.

A Message Worth Repeating
We talk a lot about drinking and driving in these pages. There are two reasons why we risk sounding like a broken record: 1) If we can prevent even one death or serious injury, it’s worth it; 2) We want families to know that when the very worst happens they are not alone and someone is ready to help. Notably, a civil case may exist based in part on alcohol consumption even if the responsible driver was UNDER the legal limit.

If you have been injured or lost a loved one in a DUI crash in Sonoma County or elsewhere in Northern California, we are here to help. Call anytime. Our team will fight for you. We cannot reverse time but we can get you the monetary compensation you need in the wake of a terrible car crash. We promise to treat you with respect and to never forget it is an honor to represent you.

See Related Blog Posts:
Understanding Blood Alcohol Content in the Aftermath of a Fatal Single-Car Crash in Berkley
Repeat Drunk Drivers: An Epidemic Endangering All of Us
(Image by James Palinsad)

Commercial Truck Accidents and Legal Liability: Who’s Responsible When Trucks Cause Injuries?

December 16, 2014 by Gregory J. Brod

Responsibility. It is one of the most important values we can pass on to our children. As children grow into young adults, it becomes increasingly clear that responsibility is at once a simple concept and a quite complex one. If you didn’t stop a friend from driving drunk and the friend causes a crash, are you responsible? If your boss tells you to deliver the pizza within ten minutes and you speed to get there, are you responsible, is your boss, or are you both? In today’s post, our San Francisco injury law firm looks at one small segment of this issue from one particular vantage point: truck accidents and legal responsibility.

Semi-Truck Involved in Five Car Pileup
Authorities are trying to determine what caused a multi-vehicle accident in San Francisco this past Saturday afternoon. Per the San Francisco Chronicle, the unidentified driver of a semi-truck suffered life threatening injuries after colliding with one vehicle and crashing into three parked cars before hitting a building located at 21st and Guerero. A second person was also injured in the incident. The Chronicle reports that photographs on social media sites show the truck bore a Safeway logo.

Legal Responsibility for Injuries Caused by Trucks
bigrig.jpgWinning an accident claim or obtaining a favorable settlement requires the injured party identify the responsible party, show fault, and demonstrate how the accident impacted the victim (i.e. prove damages). When a commercial truck causes an accident, there are a number of parties who may be deemed responsible including but not limited to: The driver; The company that owns the truck; The company that employs the driver; The company (and/or individual people) that loaded the vehicle; The manufacturer of the truck or any components; and Any company involved in maintaining the truck. Legal liability may be shared among several of these players and they may join forces (and legal teams) to fight the plaintiff or may point fingers amongst themselves leaving the plaintiff and the judge/jury to figure out who is responsible. In some cases, liability and responsibility for the damages are divided up according to percentage of fault.

One of the most important legal concepts in these cases is respondeat superior. As California Civil Jury Instruction 3701 explains, a company can be held liable for the actions of an employee acting within the scope of employment (i.e. doing his/her job). In order to try and avoid liability, companies have been known to try and distance themselves by renting vehicles and hiring drivers as independent contractors instead of employees. Federal laws and regulations have evolved to help avoid this and companies are generally held responsible for trucks bearing their name or their placard (a permit card typically affixed to the door) even if the driver is an independent contractor.

The Importance of Evidence and Professional Legal Counsel
As with all vehicle accidents, preserving evidence is crucial to obtaining compensation after a truck accident. There is a special law that requires a certified truck inspector review the scene of an accident to help determine the cause, particularly if mechanical issues came into play. Notably, it is usually the government agency that would have this report, not the police. Knowing where evidence may be housed is important to proving who is at fault. Whenever possible, our injury team would also want to have own experts visit the scene before it is cleared and view the scene ourselves.

We know it is tempting to think you can “go it alone” after an accident and the responsible parties will often try their best to get you to settle without consulting a lawyer (a warning in itself!). We urge you to reconsider. The law is complicated. All too often people sign away their rights in an attempt to put an accident behind them. You may have legal rights you don’t know about, including rights to compensation for the future. It is also important to consider all individuals and entities that may share in legal responsibility, in part because it can be difficult to collect large amounts from an individual.

If you are injured in an accident involving a truck or other commercial vehicle in Northern California, Attorney Brod can help. An experienced San Francisco truck accident attorney, Attorney Brod offers a free initial consultation and most cases are handled on a contingency fee basis meaning you only pay if you recover compensation.

See Related Blog Posts:
The Dangerous Intersection of Drowsy Driving and Big Rig Accidents
Hit-and-Run Crash in Fremont Between Truck and Motorcyclist Leaves Latter Dead and Unanswered Questions
(Photo by Mark Holloway)

Blood Test Company Accused of Paying Kickbacks to Referring Doctors

December 15, 2014 by Gregory J. Brod

Kickbacks to physicians are one of the most concerning forms of Medicare fraud. Why? Kickbacks to doctors create mixed incentives. Instead of being guided by concerns for their patient’s welfare, the doctors may be tempted to make choices, from seemingly innocuously ones to which lab to use to run a test to more important ones like whether or not to run that test at all, based on money. Certainly, money matters to doctors, like all of us, especially given the enormous financial burden of so many years of education. However, kickbacks make decisions unduly complicated and create unnecessary conflicts between profit motives and patient care. When whistleblowers partner with our Northern California anti-kickback law firm, we can fight back.

The Pending Investigation
Earlier this fall, The Wall Street Journal reported on a medical lab in Virginia that appears to be trying to use a loophole to pay doctors for sending them blood for testing. Health Diagnostic Laboratory Inc. (“HDL”) opened in 2008 and totaled $383 million in revenue for 2013 with 41% coming from Medicare. HDL sells tests that measure biomarkers that may predict heart disease, bundling together up to 28 tests per vial of blood. Medicare pays HDL $1,000 or more for these services and, until June, HDL in turn paid doctors $20 per sample which was much higher than other labs paid for similar services.

doctor2.jpgIn June, the Department of Health and Human Services issued a Special Fraud Alert warning that these payments could present “a substantial risk of fraud and abuse under the anti-kickback statute." The Alert is part of a larger investigation into HDL and other labs that allegedly paid physicians for cardiac-biomarker testing. Medicare suggests that a $3 fee fairly compensates providers for performing a blood draw. HDL denies any wrongdoing while the government questions whether the higher fee could give doctors an incentive to order tests that aren’t medically warranted. Notably, many labs use their own technicians for blood draws to avoid possible conflicts. HDL says its fees cover the draw plus packing and handling. One provider, who also served on HDL’s medical advisory board, submitted 120 claims for 12 patients in 2010 and received $23,580 in the first half of the year alone.

The Law Explained and a Law Firm for Fighting Back
In a related piece, the WSJ provides any easy-to-understand discussion of Medicare’s antikickback rules. The “What to Know” question and answer notes the law is focused on preventing fraud and abuse by making it illegal to pay for referral of federal program health care business. A “safe harbor” provision protects certain established practices. One such exception, the “personal services and management contracts” safe harbor, involves compensating doctors for certain services that the doctor performs. However, the payment must not be more than the fair market value of the service performed (i.e. paying the doctor for drawing the patient’s blood and sending it in for testing).

Whether HDL violated the law remains to be determined and the government is investigating. If you suspect Medicare fraud in the Northern California region, including if you believe a doctor’s medical expertise is being tainted by illegal payments. Together we can explore the facts, discuss the law, and determine whether a health care fraud case exists. If you assist in a case that allows the government to recoup diverted funds, you may be entitled to a substantial reward.

See Related Blog Posts:
Tainted Decisions: Kickbacks Leave Providers Focused on Money, Not Patient Care
Why We Fight: A Reminder of the Dangers Behind Fraudulent Referrals in the Health Care Arena

(Image by Alex E. Proimos)

After the Storm: The Threat of Mold After Residential Flooding

December 11, 2014 by Gregory J. Brod

As we write this post from our San Francisco tenants’ law firm, residents throughout the Bay Area are preparing for the arrival of a soaking and likely dangerous storm. By Wednesday afternoonn, Weather Channel reporters were predicting from three to five inches of rain in San Francisco and Sacramento with some areas slated to receive up to eight inches of rainfall. Forecasts suggest the storm could be one of the strongest wind and rain events to hit our region since 2009.

Weather events of this magnitude are a threat to safety and to property. We urge readers to use caution on the roads and remind drivers to never attempt to pass through flooded roadways. In addition to the immediate threats of severe weather, there can be long-term consequences of flooding that pose serious health threats. Mold is one of the most perilous (and sometimes sneaky) of these flood-related health hazards. While it is not the only way the dangerous spores make their way into residential dwellings, ignoring the link between flooding and mold can leave people sick and even contribute to early death.

Sick Buildings, Sick Tenants: A Brief Overview of the Danger of Mold After Floods flood.jpg
In the wake of East Coast storms Sandy and Isaac in 2012, the science-focused group The Why Files released an article discussing the dangers of mold in the wake of flooding. Referring to mold’s impact as a form of “biological warfare,” the article explains that mold can cause health problems in several ways. Mold releases spores that can irritate the lungs and the entire respiratory system, causing dangerous inflammation. Mold also creates mycotoxins, poisonous chemicals that can suppress the immune system, damage genes, and harm or kill other cells. Mold is particularly dangerous to people with other underlying health issues and is a trigger for allergies and asthma. Some researchers believe mold can also cause neurological damage.

After a flood, mold can grow rampant in indoor spaces contributing to a condition known as “sick building syndrome.” Water can become trapped in building materials and lead to mold growth that invades people’s bodies with every breath. One study found at least one mold-related toxin in 66 percent of building materials in flood-damaged buildings.

Mold and Landlord/Tenant Law
A guide produced by the San Francisco Chronicle provides a brief overview of the state and local landlord/tenant laws about mold in rental units. California Health and Safety Code Section 26167 requires landlords to provide a written disclosure to prospective tenants if the landlord knows (or should reasonably know) that mold levels in the unit exceed permissible level or pose a health threat. Additionally, a landlord who knows (or, again, should know with reasonable efforts) there is mold in a rental property must make a reasonable effort to remove the mold and, where appropriate, fix the problem that led to the mold growth. Mold growth may also violate the warranty of habitability and/or trigger duties under local laws.

If mold in your rental unit has left you or a family member ill, you may have legal recourse. While there are a number of steps you may be entitled to take, it is risky to do so with legal counsel. Attorney Brod has experience serving as a Northern California tenants’ lawyer, including representing renters sickened by mold. Call to arrange a free consultation.

See Related Blog Posts:
Mold Infestation Basics
The Danger & The Law of Toxic Mold in Northern California

(Image by Keith Tyler)

The Importance of Fact-Gathering in Injury Law

December 10, 2014 by Gregory J. Brod

One of the key parts of our job as an injury law firm is gathering evidence to help reconstruct life-changing moments. In the majority of cases, no one expected these moments to occur and it is only afterwards that the importance of the minutes or even seconds of an incident is realized. Fact-gathering is an important part of our work as an Oakland injury law firm and being brought onto a case in a timely fashion ensures we can collect the evidence necessary to help our client recover needed compensation.

A Fact-Intensive Hearing in an Oakland Hit-and-Run
While focused on a pending criminal case (versus our work in civil court), a recent news report serves as a reminder that injury law is very fact-intensive. An Oakland Tribune report details some of the pieces of evidence that led a Santa Cruz County Superior Court to rule that there is enough evidence to have Oakland-scales.jpgresident Joanna Steele stand trial for the hit-and-run death of 70 year-old Adolfo “Adolf” Galvan. The incident occurred on August 24 on Pacific Avenue and Galvan spent 11 days in a coma before passing. Evidence presented at the preliminary hearing included: Testimony of a police officer who interviewed Steele after the incident and told the court she first denied and then later admitted to driving the vehicle believed to be involved in the crash; Records of a test that put Steele’s blood alcohol level at 0.15 three hours after the crash; Testimony of two brothers who together reported witnessing the moments before, during, and after a truck collided with a pedestrian sending him flying into the air; and Video recordings of the truck from a short period prior to the crash.

Steele remains out on bail. She is due back in court for another pre-trial hearing in January and faces up to four years in prison. Preliminary hearings are typically focused on the prosecution’s case and Steele’s defense attorney will no doubt present his own evidence when the case goes to trial.

The Intersection of Law & Facts: The Essential Role of Fact-Gathering in Injury Cases
Injury cases are about the intersection of the law and the facts. As California judges instruct juries: “In criminal trials, the prosecution must prove that the defendant is guilty beyond a reasonable doubt. But in civil trials, such as this one, the party who is required to prove something need prove only that it is more likely to be true than not true” (Civil Jury Instruction 200). Most injury cases rest on a theory of negligence and the plaintiff must show that the defendant was negligent, that the plaintiff suffered harm, and that the defendant’s negligence was a substantial factor leading to that harm (see Civil Jury Instruction).

When you are hurt, medical care should be your first priority. We do, however, urge you to contact a lawyer as soon as possible. While the law remains relatively constant, facts require proof and proof can be a fleeting thing -- witnesses can disappear, recordings may be taped over, cars are repaired. When we work for an injured client, we invest considerable time in uncovering all the evidence available in order to reconstruct the injury-causing event. In some cases, the police are also conducting an investigation but this is not always the case (in part because of the aforementioned difference in evidentiary standards) and it is important to conduct our own inquiry. Our team is experienced and thorough and we know what to look for in order to help prove our client is entitled to compensation. Call our offices 24/7 to talk to a representative and arrange a free consultation with at our injury law offices in Oakland, San Francisco, or Santa Rosa.

See Related Blog Posts:
Caught on Tape – Using Video Evidence in Support of a California Personal Injury Claim
Compensation & Change: Our Law Firm’s Goals Following a Pedestrian Death

(Photo by Clyde Robinson of work by Jason Luper)

A Victim-Centered Approach to Prescription Theft

December 9, 2014 by Gregory J. Brod

Asked to imagine a drug theft, many Americans would form an image that includes the threat of violence and illicit substances like marijuana, heroin, or cocaine. Drug theft in 2014 often takes a much different form, a much “quieter” affair that happens on a daily basis in the Bay Area when a trusted individual slides a prescription bottle from a home medicine cabinet or bedside pillbottle.pngshelf into a pocket and is gone well before the missing vial is noticed. Prescription theft often targets seniors who may be left facing a frightening health crisis because of the missing medications. In fact, as our Northern California prescription theft attorney understands, whether part of a larger pattern of financial and/or physical abuse or a standalone event, medication theft can be a form of elder abuse, leading to unnecessary pain, uncontrolled illness, or even death and the culprits can be those whom the victim least expects.

Firefighter Accused of Swiping Medications
Usually when a firefighter makes the news, he or she is being hailed for bravery and heroism. This weekend, however, local and national news sources including Sacramento’s KCRA carried a very different tale as police announced the arrest of Sacramento firefighter Craig White on five counts of burglary and three of elder abuse. White allegedly targeted seniors, gaining entrance to homes by claiming to be performing inspections of smoke and carbon monoxide detectors and then stealing prescription medications. Citrus Hills Police Department began investigating after eight area seniors reported similar incidents. The Sacramento Fire Department wants people to know that they do not perform surprise residential inspections.

The Growing Problem of Prescription Theft
Sadly, this is far from an isolated event and prescription theft is a problem of epidemic proportions with the elderly among the most frequent victims and the culprits often the most trusted of individuals. Earlier this year, Contra Costa Times reported on a Concord police officer accused of prescription theft and a related count of elder abuse. The stories of heroes-turned-villains are noteworthy, but caregivers probably who commit the largest share of residential prescription thefts. One example is a case pending in Ohio where, according to a December 2 report from ThisWeek News, police are investigating a nurse accused of stealing painkillers from residents of a senior care facility.

In an article titled “Medication Theft: Protecting Our Most Vulnerable Neighbors,” the National Neighborhood Watch cites a National Drug Intelligence Center report that found prescription thefts totaled $184 million in 2010, a figure that represents a whopping 350% jump from 2007. Referencing the terminology used by many government and research groups, the group confirms that older adults are particularly vulnerable and that most cases of “pharmaceutical diversion” involve someone the victim knows well and trusts with access to their home. The piece recommends older adults be aware of the possibility of drug theft, keep inventory of the drugs in their home, and even consider using a lockbox to secure medications.

A Form of Abuse with Potentially Devastating Effects
The effects of pharmaceutical theft are wide-ranging. Most discussions center on the thief and the problems associated with prescription misuse. While these are certainly important issues, we think too many discussions neglect to consider the impact on the victim. Forcing someone to face uncontrolled pain is absolutely a form of abuse. In many cases, even people who take pain medication exactly as prescribed will face serious withdrawal issues if they are suddenly left without their medications and the impact can be life-threatening. Pain medicines are not the only pharmaceuticals subject to “diversion” and being without medications can cause incredibly serious health consequences. There’s a reason why the perpetrators often face counts of elder abuse, counts many reports gloss over too quickly. Discussions about pill theft must not leave out the victim.

Northern California Elder Abuse Attorney Representing Prescription Theft Victims
If you or a loved one has been the victim of medication theft that caused pain, illness, or even death, you and/or your family member may have a civil claim against the offender. Often, prescription theft is part of a larger pattern of financial, physical, or metal abuse. We help victims. Call to schedule a free legal consultation. We serve all of Northern California with three convenient locations and you can arrange a consultation with our elder abuse lawyer in Santa Rosa, San Francisco, or Oakland or we will make other arrangements to meet your needs.

See Related Blog Posts:
Oakland Attorney on the Fight Against Financial Exploitation of Older Americans
Northern California Nursing Home Abuse Lawyer on the Threat of Nursing Home Prescription Theft

(Image by Pam Roth)

How the Federal Government Fights Health Care Fraud

December 8, 2014 by Gregory J. Brod

Medicare fraud is a topic that is receiving increasing attention from authorities and news media alike. Our California Medicare fraud law office believes this attention is rightly placed and we support efforts to both recover wrongfully diverted funds and prevent future frauds. Two of the ways that the government accomplishes these interrelated goals is through rulemaking and through intervening in whistleblower-led health care fraud claims.

Rulemaking – New Rule Limits Enrollment by Suspect Entities
Last week, the Center for Medicare and Medicaid Services (“CMS”) announced approval of a new rule that will allow the agency to prevent future frauds by identifying persons/entities that pose particular risk to the integrity of our federal health care programs. The rule, as detailed in a CMS Fact Sheet, attempts to prevent suspect groups from enrolling in or remaining part of the system and being permitted to bill Medicare for services provided to beneficiaries. Key elements include: Denying enrollment of providers and others associated with an entity that has an outstanding Medicare debt; Denying or revoking billing privileges of groups that have a managing employee who was previously convicted of certain felonies; and Revoking the billing rights of providers and suppliers that show a pattern of improperly billing for services that fail to meet program requirements.

Additionally, the newly finalized rule works to bring consistency to the effective date on which enrollees can submit bills to the system. This rule changes the previous policy of allowing ambulance suppliers to bill for services provided a year prior to enrollment to make it match the more commonly applied rule limiting filings to after the enrollment application date or the date the group began providing service at a new location. Ambulance providers will also, like other provider types, be required to file all outstanding claims within 60 days of their billing privileges being revoked. CMS predicts this rule alone will save $327 million per year.

Litigation – Government Partnering with Private Whistleblowers
gavel2.jpgThrough rulemaking, CMS seeks to prevent future frauds. On the other side of the coin, False Claims Act litigation is one tool for addressing already-occurred frauds and recovering wrongfully diverted funds. Despite what seems to us a bit of an unfortunate title, an article published by the New York Times on December 1 highlights the partnership between the federal government and private whistleblowers: Tattletales Embraced as Whistle-Blower Programs Gain Support. The Times notes that the government has stepped up efforts to embrace whistleblowers and the Department of Justice is touting a record $5.69 billion in False Claims Act recoveries last fiscal year including $2.3 billion recovered in health care fraud matters. Many of these matters were brought to the government’s attention by private whistleblowers and the government shared some $435 million with these individuals in recognition of their efforts last year and the 1,400 qui tam actions filed in the last two years. These whistleblower partnerships are critical to ending fraudulent schemes and the law reward whistleblowers with both protection and financial compensation for their efforts (amounts vary based on whistleblower involvement, whether or not the government intervenes as plaintiff). Last year saw a 10% increase in tips presented with one award stretching to $30 million for information that would have been nearly impossible to detect without the insider’s aid.

A Law Firm for the Truth Tellers
“Tattletale” is a bit of a dirty word, we’d suggest Truth Teller. No one called Woodward & Bernstein tattletales. Rulemaking looks ahead, using new lessons to prevent future harm. Civil fraud suits, such as health care fraud claims brought via the False Claims Act (“FCA”), look back and attempt to remedy crimes already done. If you have information about a scheme that is defrauding federal or state programs, you can play an important role in recovering lost funds. If you are interested in learning more, call Attorney Brod at his Northern California Medicare fraud firm. While this post has focused on Medicare issues, we do work on cases involving other frauds such as price fraud in procurement contracts, questionable parts provided in defense agreements, and much other area under the FCA and similar statutes. Call our San Francisco, Oakland, or Santa Rosa government fraud law offices to arrange a consultation at our offices or, particularly if you are a bit outside our region, a location amenable to you.

See Related Blog Posts:
Health Care Whistleblowers: Dedicated to Ending Health Care Fraud
Hardly a Victim-less Crime: The Victims of Health Care Fraud

(Image by Brian Turner)

Safety on the Golden Gate Bridge

December 5, 2014 by Gregory J. Brod

Saint Louis has its Arch, Philadelphia has the Liberty Bell, New York has its famed skyline, and San Francisco has the Golden Gate Bridge, symbols that people nationwide (or even worldwide) associate with their respective cities. Along with being an icon of the city, Golden Gate Bridge stands out since it is also a heavily trafficked transportation route. While less common that one may expect, accidents on the storied span are a reality. Bridge accidents are particularly frightening and, as a San Francisco auto accident law firm, we encourage the city to move forward with long-delayed plans that may further reduce the accident rate.

Drunk Driver Wedges Car Onto Golden Gate Pedestrian Path
sanfran.jpgEarly Tuesday morning, a strange accident left a car wedged onto the Golden Gate Bridge’s pedestrian walkway. The San Francisco Chronicle reports that Daniel Soto, age 22, was driving drunk when he turned into a parking lot near the span’s north end at 5:10 A.M. California Highway Patrol Officer Andrew Barclay said that Soto then hit the gas, plowing through a security gate and onto the bridge’s west-side walkway. He drove about 400 yards before his Ford Mustang became stuck and his air bags deployed. Police did briefly take Soto to the hospital after arresting him for suspected DUI, taking him into custody after he was released from the hospital. Bridge officials shut down all traffic to bring in a forklift and flatbed truck to remove the vehicle.

Long-Delay In Safety Plans for Golden Gate
In a report on a planned bridge renovation, the Golden Gate Bridge Highway & Transportation District estimates that 40 million vehicles cross over the 1.7 mile-long span each year. A reduction of the speed limit to 45MPH in the 1980s along with the widening of the roadway by 2 feet and increased law enforcement presence substantially reduced the prior accident rate. The latest numbers in the report show an accident rate of 0.61 accidents per million vehicle miles, down from 1.25 accidents per million miles.

Currently, crews manually place plastic tubes into sockets in order to mark the opposing traffic lanes and move them to reconfigure the traffic plan several times per day to address traffic flow. In the 1980s, the District rejected a plan to use a moveable median barrier (“MMB”) system to create a semi-rigid median barrier that would be moved by machine. Technology improved and the District began reexamining the MMB option in 1996, concluding in May 1998 that the system could virtually eliminate crossover accidents and associated delays. Additional studies do suggest the MMB might make it more difficult to clear other accidents such as rear-end collisions. Over time, the District decided to go forward with the MMB plan. Despite the study starting in 1996, the MMB is yet to be installed. Current plans call for construction in January (and the first-ever closure of the span for the weekend).

When Delays Threaten Traveller Safety and the Importance of Experienced Injury Counsel
While Golden Gate crashes are relatively rare, they do happen. In late 2012, the Chronicle reported on a head-on crash that injured three women and caused hours of traffic. Bridge officials acknowledged that at least part of the chain-reaction crash could have been prevented had the MMBs been in place. The article notes drawings for the project had been submitted in 1997 and funding approved since 2007, but the MMB project faced continued delays. Counsel for a woman paralyzed in a 2008 head-on bridge collision called the delay political and compared not installing the MMB to not putting an airbag in a car. A District representative noted that the MMB would eliminate only certain forms of accidents saying “[a]ccidents are not going to go away, but the severity will decrease.”

This week’s crash may not have been prevented by the MMB, but delays in implementing safety-related changes threaten lives and risk injuries. When we work for an injured client, we explore all relevant claims to determine whose actions (or inactions) contributed to the crash. Usually the other driver will be a defendant, but they are not always the only one. Cases that involve potential claims against municipal bodies require precise timing and detailed procedural requirements. This is yet another reason we would advise any accident victim to obtain legal counsel.

If you are injured in a bridge crash or other car accident in the Northern California region, give our office a call. Our San Francisco accident attorney has the experience and the knowledge that can help you get the compensation you deserve.

See Related Blog Posts:
Witnesses Call Into Question the Safety of the Bay Bridge, 4 Months After Re-Opening

A Step Towards Safer Travels on the Golden Gate Bridge

(Image by Leonardo Pallotta)

Child Injury Lawyer Watching Federal Investigation Into Defective Child Safety Seats

December 3, 2014 by Gregory J. Brod

Earlier this year, our San Francisco child injury attorney highlighted a recall that at the time involved some 1.3 million car seats , a number that has since ballooned to include an unprecedented 6.1 million seats. This week, the story became even more disturbing as an investigation opened into allegations that the company knowingly delayed alerting authorities to the potentially defective child safety seats.

Federal Agency Looks At Whether Company Delayed Reporting Child Seat Defect carseat.jpg
According to The New York Times, federal safety regulators opened an investigation this week into Graco Children’s Products focusing on whether the company delayed reporting a safety defect that became the subject of the nation’s largest child car seat recall. Earlier this year, Graco recalled approximately 6.1 million child safety seats because of concerns that the buckles may become difficult to unlatch and hinder the ability to remove a child during an emergency. Graco had resisted the recall, asserting that the seats were safe and claiming any problems were the result of food or liquids being spilled on the buckles rather than a safety defect. The National Highway Traffic Safety Administration (“NHTSA”) disagreed.

Regulators allege that Graco’s files show that the company knew about latch-related complaints as early as 2009 and was working to address the issue by 2012. Federal laws require that a manufacturer must inform the safety agency of a safety problem within five business days from the time the company becomes aware of the issue. Failing to meet this deadline can result in a civil fine of up to $35 million. Graco denies wrongdoing and also suggests there have been no injuries related to the alleged safety issue. However, company documents reviewed by the NHTSA include a report on a lawsuit filed in Los Angeles County Superior Court by the family of a two year-old allegedly killed in a car fire in 2011 while seated in a Graco car seat. A spokeswoman for the company said the buckle was not to blame but did not provide details, citing a confidentiality clause in a settlement agreement.

Notably, this is not the first time Graco has been accused of failing to inform officials of safety concerns. In 2005, the company paid a $4 million fine to resolve similar allegations by the Consumer Products Safety Commission.

Protecting the Injured: Child Injury Lawsuits in California
Recalls are an important safety tool. However, they cannot compensate those already harmed by the product. This is typically the job of the civil product liability laws.

In California, whether in product liability or traditional negligence actions, there are some important differences between a child injury claim and that of an adult. Most child injury claims, like most other personal injury suits, settle prior to trial. However, the court must approve these settlements in order to provide an extra layer of protection for the child (called a Minor’s Compromise, see Probate Code 3600 et seq. and the related pages provided by Alameda Probate Court for details). Typically the proceeds of a settlement or the funds awarded at trial are placed in a trust until the child turns 18, although monies can be accessed for injury-related care with court approval. Damages can include money for pain and suffering in addition to projected economic costs. Parents may have their own legal claim for reimbursement of money spent on the child’s medical expenses and, in some cases, for emotional distress and/or for the impact on the parent/child relationship.

If your child is injured because of a defective car seat, you should contact an experienced injury lawyer. You can be certain any manufacturer has an attorney on their side and your child deserves the protection of an experienced legal professional. Attorney Greg Brod can help and an initial conversation is always free. Call our child injury law firm in Santa Rosa, San Francisco, or Oakland to arrange a consultation.

See Related Blog Entries:
Recall Highlights the Importance of Child Safety Seats
Tools to Keep Children Safe: WHALE Program and Rules on Car Seat Replacement

(Image by Daniel X. O'Neil)

Child Onboard, Drunk Driver Behind the Wheel

December 2, 2014 by Gregory J. Brod

Imagine a DUI crash in which a child is one of the innocent victims injured or killed because of the driver’s intoxication. When asked to consider this tragic scenario, most people probably imagine a lone drunk driver plowing into a family vehicle. However, there’s another scenario that may be even more upsetting to consider -- when the drunk driver and the child are in the same car. While California’s criminal laws rightly impose extra penalties in such cases, it is the civil law that can truly provide for the victim. As a child injury lawyer in Northern California, Attorney Brod understands the unique contours of these cases, knows the unique needs of child DUI victims, and considers it an honor to fight on their behalf.

A Look at the Statistics
According to the National Highway Traffic Safety Administration’s (“NHTSA”) Traffic Safety Facts: Alcohol-Impaired Driving (2012 Data Sheet), a total of 10,322 people died in the United States during 2012 in a vehicle accident involving an alcohol-impaired driver. This figure, which includes crashes in which at least one driver has a blood alcohol level of 0.08 or higher, represents 31% of all traffic fatalities that year. There were 239 children aged 14 and under killed in alcohol-involved accidents in 2012, 20% of the total 1,168 young people killed in traffic crashes during 2012. More than half – 124 of the 239 – were occupants of the impaired driver’s vehicle. Mothers Against Drunk Driving’s Child Endangerment http://www.madd.org/laws/law-overview/DUI_Child_Endangerment_Overview.pdf position paper notes that a child riding with an impaired driver is at risk not only because of the hindered driver but also because the child is less likely to be properly restrained. In fatal crashes, 30.5% of sober drivers used child restraints compared to only 18% of alcohol-impaired drivers.

California’s Vehicle Code and Penal Lawsbeercar.jpg
California Vehicle Code 23572 provides that a driver who is convicted of misdemeanor DUI and who had a child under age 14 in the vehicle is subject to a sentencing enhancement. This applies regardless of intent, level of intoxication, and driving pattern. The only relevant facts are that the driver was under the influence and a child was in the driver’s vehicle. In some cases, courts have used the more general Child Endangerment Law (Penal Code 273a) to provide a harsher punishment in place of the sentencing enhancement.

A Law Firm for the Child Victim
Criminal laws penalize offenders, but the civil side of the justice system focuses more closely on the victim. Child DUI crash victims may face decades of repercussions including ongoing medical bills, reduced earning capacity, the continuing need for assistance with daily living tasks, and lasting emotional trauma. If someone else, including someone you entrusted with your child’s care like a babysitter or nanny, drove while intoxicated with your minor child onboard and this terrible decision left your child injured or killed, call our San Francisco, Santa Rosa, or Oakland child injury law offices. Our civil law firm can help you and your child get critically important compensation.

See Related Blog Posts:
DUIs with Child Passengers
The Threat of Drunk Driving Deaths in California and Nationwide

(Image by Jørgen Schyberg)