Feds Convict Houston Group for Psychiatric Care ‘Sham’ Against Medicare

October 24, 2014 by Gregory J. Brod

Home healthcare, physical therapy and prescription drugs have been some of the more common examples of healthcare services that have been used to defraud Medicare, and, as our blogs have pointed out, many of the most notorious schemes have been emanating from Miami and South Florida, the national epicenter of Medicare fraud. However, San Francisco qui tam lawsuit lawyer Gregory J. Brod would note that healthcare fraud is spread throughout the country as well as focused on a variety of healthcare services. One example of a Medicare fraud scheme from a failing Houston hospital made headlines this week for its ambitious methods of stealing millions from the taxpayers.

According to the Houston Chronicle, the former president of the financially shaky Riverside Hospital, his son and two other persons affiliated with the facility were convicted in federal court Monday for their scheme to fleece $158 million from Medicare. Prosecutors in the case said that Riverside Hospital’s psychiatric care was a “sham,” and that the four people convicted – former hospital CEO Earnest Gibson III, his son Earnest Gibson IV, Regina Askew and Robert Crane – soaked taxpayers for services that were not rendered.

“For over six years, the Gibsons and their co-conspirators stuck taxpayers with millions in hospital bills, purportedly for intensive psychiatric treatment,” said Assistant U.S. Attorney General Leslie Caldwell. “But the treatment was a sham – some patients just watched television all day, others had dementia and couldn’t understand the therapy they supposedly received, and other patients never even went to the hospital at all.”

The convictions stemmed from an FBI probe that lasted from 2005 to 2012 and resulted in an indictment in 2012 against Gibson III and 10 others, including doctors, marketers and other persons affiliated with Riverside Hospital. Several of the 10 charged pleaded guilty, including assistant administrator Mohammed Khan, who admitted to conspiring to commit healthcare fraud.

Prosecutors stated that Gibson III paid kickbacks to recruiters and owners and operators of group care homes in return for delivering supposed patients to Riverside’s facilities. As far as the others who were convicted, Gibson IV operated a satellite patient care facility and Askew recruited patients and audited documents; both were convicted of conspiring to commit healthcare fraud and pay as well as receive kickbacks. In addition, Crane, who was a recruiter and shuttle driver, was convicted of conspiracy to commit money laundering.

Riverside Hospital has been financially beleaguered since the unsealing of the indictment in late 2012, which prompted the federal government to cut off funding to its facilities. As part of a bid to remain in business, Riverside surrendered its substance abuse treatment license in August and limited itself to detoxification services, no longer providing drug abuse and psychiatric treatment.

Continue reading "Feds Convict Houston Group for Psychiatric Care ‘Sham’ Against Medicare" »

Protecting Oakland Tenants from Harassment by Landlords Looking to Capitalize on Rising Rents

October 24, 2014 by Gregory J. Brod

Recently, there has been a lot of attention on both the local and national level to the ever-increasing rents in the city of San Francisco. Less attention has been paid to the rental market across the Bay, but the city of Oakland has experienced a similar rise in residential rental fees. When rents rise, long-term tenants often find themselves pressured to move so that the landlord can profit from the trend. In some cases, the landlord steps over the line by harassing the tenant with the intent of eventually evicting the tenant or making life unpleasant enough that the tenant feels forced to leave (“constructive eviction”). Our Oakland tenants’ rights attorney fights to protect tenants from illegal harassment and actual or constructive eviction.

Oakland Ordinance Looks to Protect Tenants from Landlord Bullies Trying to Profit from Rising Rents
oakland.jpgAccording to the San Francisco Chronicle, Oakland’s rent board has been fielding calls from some 200 people each month complaining that they are being harassed or intimidated by a landlord. Tenant advocates suggest landlords are trying to force out rent-protected tenants in order to make room for higher-paying renters. With renters coming into Oakland from San Francisco, ironically because many were forced out themselves, there is growing demand for rental units. The average rent in Oakland stands at around $2,100, a 10% increase from mid-2010 to mid-2014 with an even greater increase in some desirable neighborhoods like Lake Merritt where rents have shot up 53% since 2011.

The situation has Oakland eyeing a new law to punish “bully landlords.” The provision bans interfering with tenant privacy, failing to make needed repairs, taking away an amenity (ex. a parking spot), or making threats in order to push a tenant out. While the ordinance was still a proposal on Tuesday morning when the Chronicle piece came out, a short update in The Contra Costa Times confirms the city council approved the measure. Councilman Dan Kelb, who authored the measure, says that although most of the acts were already against state law, the new rule allows the city to fine or sue landlords who engage in these tactics. Landlord groups dispute the need for the rule, saying that the evidence of malfeasance is all anecdotal.

State and Local Rules Protecting Residential Renters in Oakland
On its Renter Resources page, Oakland’s Housing & Community Development highlights some of the previously-existing protections afforded to residential tenants in the city. Under the Rent Adjustment Program (aka rent control), landlords may only increase rents for existing tenants once a year and, with a few specified exceptions, only by an announced “CPI increase rate” (1.9% for 2014, 2.1% for 2013). Notably, the page specifically states: “In most cases, there is no limit on increases when a tenant moves out and a new tenant moves in.” This makes another tenant protection rule detailed on the page even more important -- landlords may only evict a tenant for just cause.

The City’s protections supplement tenant protections under state law. California law requires all residential units conform to basic standards of habitability, a set of minimum requirements that include having appropriate heating facilities, hot and cold running water, and electrical lighting (see California Statute 1941.1). State law also addresses constructive evictions. Section 789.3 forbids certain specific actions (ex. changing locks, removing tenant property from the unit) by a landlord that are undertaken with an intent to terminate a residential lease. A more general protection can be found in Section 1940.2 which provides that a landlord may not “[u]se, or threaten to use, force, willful threats, or menacing conduct constituting a course of conduct that interferes with the tenant's quiet enjoyment of the premises…that would create an apprehension of harm in a reasonable person” in order to force a tenant out. Notably, a tenant can sue even if they did not actually vacate the premises.

A Tenant Protection Attorney
Our Oakland landlord-tenant attorney is committed to protecting the rights of renters in the city, a commitment we feel is even more important given the ever-increasing cost of rental units. If you believe your landlord is trying to force you out in order to replace you with a higher paying tenant, our team can help you fight back. We also represent renters in other disputes throughout Northern California, such as a claim that the landlord violated the warranty of habitability. Call to arrange a no-cost consultation.

See Related Blog Posts:
Protecting Tenants from Unscrupulous Landlords in San Francisco’s Tight Housing Market

Bay Area’s Spike in Rents Presents Incentive for Landlords to Turn Over Units

(Image by Eric Fischer)

Holding Facilities Responsible for Inadequate Supervision of the Developmentally Disabled

October 23, 2014 by Gregory J. Brod

It has often been said that one of the best ways to judge a society is by how it treats its weakest, most helpless members. Individuals with significant developmental disabilities rely on their families and society as a whole for care and protection. When these individuals are placed in a specialized care facility, the facility has ethical, moral, and legal duties to protect the residents. As an Oakland law firm for the elderly and disabled, we are ready to advocate on behalf of vulnerable adults when care facilities fail to fulfill their duties. An obvious example of such a failure is when the resident is permitted to wander away from an institution that promised to care for and keep the resident safe. Wandering by developmentally disabled adults is a potentially deadly occurrence and we must hold institutions responsible for the failures that endanger their residents.

Developmentally Disabled Man Missing from Oakland Care Facility
The Oakland Tribune and other news outlets in our region are asking for help locating a missing man. On Thursday October 16 at around 1:30 P.M., Michael Kilroy wandered away from a residential care facility located on the 3200 block of 99th Avenue. Kilroy is 55 years old but has the functional capacity of a typical 6 year-old. He needs medicine that he doesn’t have with him. Police note he is 5’3” and 150 pounds with blue eyes and gray hair. Anyone who sees him is asked to call the missing persons’ unit at the Oakland Police Department (510-238-3641).

California Law and the Protection of Dependent Adults in Care Homes
California’s criminal and civil laws that address elder abuse also apply to “dependent adults,” a category that includes individuals who have physical and/or developmental disabilities that sharply limit their ability to care for themselves. Section 15600 of the Welfare & Institutions Code, part of the legislative findings at the start of the Elder Abuse and Dependent Adult Civil Protection Act (“the Protection Act”), reads: “The Legislature recognizes that elders and dependent adults may be subjected to abuse, neglect, or abandonment and that this state has a responsibility to protect these persons.” In addition to this general responsibility, California requires that care facilities agree to provide the best possible care to their residents in exchange for Medicare and Medi-Cal funding. Those duties are described in the Care Standards set forth by the California Advocates for Nursing Home Reform.

Together, California’s civil, criminal, and regulatory laws allow the state to hold care facilities responsible when they fail to provide appropriate care to the elderly and the developmentally disabled. Nursing homes and similar facilities must provide adequate supervision to prevent residents from wandering away. This can be especially important since some disabilities are characterized by a tendency to wander. Since, by definition, these individuals are not able to adequately protect themselves, wandering can lead to injury or even death.

An Oakland Law Firm Protecting the Developmentally Disabled
If you have a loved one who is developmentally disabled and was injured because a care facility failed to provide adequate care, our Northern California nursing home neglect attorney can help. Although money damages cannot reverse an injury, monetary compensation can allow you to place your loved one in an excellent facility and provide care aimed at addressing the physical and emotional consequences of neglect. Hitting negligent facilities in the pocketbook can also make them recognize the damage caused and enact meaningful change for the future.

See Related Blog Posts:
California Special Needs Lawyer Comments on Autistic Wandering & Elopement
Resident Missing from Local Assisted Care Facility

Older Pedestrians: Accident Statistics & Legal Rights

October 22, 2014 by Gregory J. Brod

San Francisco is consistently listed as one of America’s most walkable cities (see e.g., CBS article ranking San Francisco #4 in June 2014). Walkability attracts both residents and tourists to our region. Pedestrian accidents are one of the biggest threats to walkability. Older pedestrians in particular deserve extra deference from drivers. Walking can keep aging bodies healthy and choosing two feet over four wheels might be safer for some. Our San Francisco pedestrian accident law firm represents injured elderly pedestrians and families who have lost an older relative in these terrible crashes.

Older Pedestrian Killed in San Francisco
Early Tuesday morning, a man in his 70s was hit and killed near the intersection of Sloat Boulevard and 43rd Avenue. ABC7 reported that the accident occurred just before 7 A.M., approximately one-quarter mile from the Zoo. Police believe the man, who lived on Sloat Blvd., was taking his morning walk. The driver was going west on Sloat, travelling the speed limit towards the ocean, when the pedestrian began crossing. Police say the pedestrian crossed mid-block and was not in the crosswalk. Light may have been a factor, daylight was breaking and fog keeps the beach area darker longer. However, the area is generally well-lit and accidents there are not common. At the time of the article, the driver was cooperating.

Statistics on Older Pedestrians
In June 2012, the National Highway Traffic Safety Administration (“NHTSA”) published a report reviewing safety research on pedestrians and bicyclists conducted from 1991 through 2007. By way of introduction, the report notes that 4,092 pedestrians were killed in 2009 and an estimated 59,000 pedestrians injured. The agency notes the figures include only traffic incidents and exclude those occurring on private property (e.g., parking lots, driveways, certain trails). Lower-severity injuries are often not reported to police and thus are also excluded.

oldfriendswalking.jpgNarrowing the focus to pedestrians ages 65 and older, the NHTSA reports that 2009 saw 775 deaths and approximately 5,000 injuries due to traffic events. In comparison, 996 older pedestrians died in traffic incidents in 2000. Notably, pedestrians 65 and older had a higher population-based fatality rate in 2009 than adults ages 21 to 54. Reviewing studies, the NHTSA found that, on a per capita basis, pedestrians 65 to 74 had a lower crash rate than any other age segment. However, the likelihood that a crash would lead to a pedestrian fatality increased steadily with pedestrian age, with the 75 and older segment having a fatality rate of 25%.

The studies revealed some interesting facts about the nature of accidents involving older pedestrians. For the 65+ group, 64% of the pedestrian deaths in 2009 involved non-intersection locations versus 78% for other pedestrians. Older pedestrians were involved in more fatal crashes in the fall and winter than in spring and summer. Those age 65+ were less likely than pedestrians in other age groups to be hit on the weekend. With the exception of young children, a higher portion of older pedestrian accidents occurred during daylight than other age groups.

Obtaining Justice for Older Pedestrians
Importantly, the law compensates victims for their injuries even if the same event might not cause as significant an injury to an “average” individual. Therefore, even if a younger pedestrian would not have been as severely injured, an older pedestrian hurt by a negligent driver can recover compensation for the injuries incurred. The same principle applies in a wrongful death case; the family of an older pedestrian killed in a car accident that is the driver’s fault can recover compensation regardless of whether the same accident would have killed a younger individual.

If you are an older individual and you were injured in a pedestrian crash in Northern California that was not your fault, or if an older relative was killed by a negligent driver while walking in our region, you deserve justice. Call to arrange a consultation with Gregory Brod, an experienced lawyer representing injured pedestrians in San Francisco and surrounding areas.

See Related Blog Posts:

San Mateo Collision Is Example of Perils for Pedestrians That Go Beyond Crosswalks
The “Eggshell Plaintiff” Rule in San Francisco Injury Lawsuits

(Image by Martin Fisch)

The False Claims Act: From Shoddy Civil War Uniforms to Costly Defense Contracts in 2014

October 20, 2014 by Gregory J. Brod

As readers of this blog know, the False Claims Act (“the Act”) is an important tool for combatting health care fraud. The Act allows our Northern California whistleblowers’ law firm to partner with private whistleblowers to fight back against schemes that divert tens of billions of dollars from Medicare, Medicaid, and other health care programs annually. This is a critically important battle, but the Act goes well beyond health care and defense contract fraud is one important example. A recently filed case illustrates the Act’s role in fighting the costly problem of fraud in military contracting. Further, the Act’s history serves as a reminder of the threat to our military personnel when companies try to cheat the government.

Government Joins Suit Alleging Defense Contract Fraud
On Thursday October 16, the Department of Justice (“DOJ”) issued a press release announcing that the government was joining a whistleblower complaint against Sikorsky Aircraft Corporation(“Sikorsky”), a subsidiary of United Technologies Corporation, and two Sikorsky subsidiaries. Originally, the case was filed under the Act’s qui tam provisions by a former employee of the subcontractor. A representative of the DOJ’s Civil Division explains the decision to intervene: “Today’s complaint demonstrates, once again, that the Department of Justice will not tolerate contractors who engage in schemes to defraud the armed forces or any other agency of the United States.”

contract2.jpgThe claims involve Sikorsky’s alleged approval of a cost-plus-a-percentage-of-cost subcontract. Such contracts are sometimes used when the cost of performance is not known upfront; compensation is calculated based on cost to perform plus a set percent of that cost. Defense/military contracting rules prohibit these arrangements because they provide no incentive for contractors to control costs. The complaint alleges Sikorsky approved an illegal subcontract and used it to overcharge the Navy for parts and materials used for aircraft maintenance. Echoing the DOJ official’s comments, U.S. Attorney James L. Santelle explained: ““Under the authority of the False Claims Act, we pursue fraud of this sort to ensure that taxpayer dollars are spent lawfully and that overcharges and other types of contracting misconduct are addressed.”

The Act’s History: Financially Strapped Civil War Era Congress Looks to Whistleblowers to Fight Fraud Endangering Union Soldiers
Earlier this month, KRCU, an NPR station at Southeast Missouri State University, reported on the history of the False Claims Act and its modern role. The report explains that the Act that has led to the recovery of tens of billions already this year began as a way to protect Union soldiers during the Civil War. Union troops relied on private contractors for a range of necessities, but contractors often cut corners and they found themselves with uniforms that dissolved in rain, horses that were weak and even blind, and gunpowder mixed with sawdust. Since the government lacked the money to investigate these frauds, Congress created an incentive for private citizens to report on their employers by promising to pay the employee half of any fine collected.

When the Civil War ended, the law was weakened and all but forgotten until the 1980s. As reports of outrageous military spending surfaced, Congress resurrected (and revised) the Act. Whistleblowers became increasingly important, this time reaching beyond military contracts to areas such as health care and pharmaceuticals.

Fighting Fraud in 2014
The report expresses some doubt about the Act’s current power to reduce fraud given that, in contrast to an era when companies were smaller and fines could bankrupt an organization and its leaders, shareholders tend to foot the bill following a claim and there is not personal accountability. However, the report doesn’t point to direct evidence of this assertion. Regardless, it is clear that legislation that began as a way to protect an army now helps the government recover billions of wrongfully diverted funds.

It is also clear that whistleblowers remain critical, in part because the size of companies makes it difficult if not impossible for an outsider to pinpoint fraudulent acts. If you have witnessed any form of government contracting fraud, including fraud in defense contracting as well as fraud tied to government health care programs, coming forward can provide both moral and financial rewards. In today’s environment, partnering with a law firm that understands the False Claims Act (including its whistleblower protections and potential rewards) is a necessity. Call any of our Northern California government contracts fraud law offices to arrange a meeting to discuss in greater detail how a Civil War era concept can fight modern day fraud.

See Related Blog Posts:
Whistleblowers’ Attorney Discusses Guilty Plea in Case Involving Contractor Providing Substandard Parts to Department of Defense
Fighting Fraud: Government Contract Fraud Attorney Examines Procurement Fraud

(Image by Dan Moyle)

Bay Area’s Spike in Rents Presents Incentive for Landlords to Turn Over Units

October 17, 2014 by Gregory J. Brod

With the San Francisco Bay Area long one of the most desirable areas in the country to live in and apartments in short supply for a variety of reasons, there is little surprise that rents in the region would be among the highest in the nation. But a report released Wednesday showed that rents have reached record highs in the Bay Area, a fact that prompts San Francisco landlord-tenant law attorney Gregory J. Brod to remind us that some landlords, especially of rent-controlled units, may be tempted to employ illegal means to get their tenants to move out so they can raise rents.

According to the San Jose Mercury News, a third-quarter report from RealFacts of Novato found that rents in the Bay Area have risen 11.4 percent from the third quarter of last year to an average of $2,234 per month, which is the highest level recorded since two decades ago. More category-specific, the rent increases are reflected in the following year-over-year gains in the nine-county region: for a studio apartment, $1,931, up 12.5 percent; one bedroom, one bath, $2,017, up 11.8 percent; two bedroom, one bath, $2,006, up 11 percent; two bedroom, two bath, $2,562, up 9.8 percent; three bed, two bath, $3,022, up 13.5 percent.
Among the five inner Bay Area counties, here are some additional figures concerning third-quarter 2014 over third-quarter 2013 average rents:

  • San Francisco: $3,400 a month, up 9.8 percent, with a 95.1 percent occupancy rate.
  • San Mateo County: $2,580 a month, up 10.7 percent, with a 94.3 percent occupancy rate.
  • Alameda County: $1,994 a month, up 11.6 percent, with a 97.3 percent occupancy rate.
  • Contra Costa County: $1,659 a month, up 8.8 percent, with a 96.8 percent occupancy rate.
  • Santa Clara County: $2,369 a month, up 10.7 percent, with a 95.8 percent occupancy rate.

With rent increases such as the foregoing, it’s not hard to imagine that there is an economic incentive for some landlords to turn over apartments, especially rent-controlled units, so that they can reap bigger rents or even take units off the market and repurpose them as condominiums for sale. The latter move is often accomplished in California through a controversial Ellis Act eviction, but landlords can also resort to various methods of harassment to get tenants to abandon their units. Harassment can appear in various guises, which include but are not limited to interrupting, terminating or failing to provide housing services required by contract or by state, county or local housing, health or safety laws; failure to perform repairs and legally required maintenance; abuse of the landlord’s right of access to the unit as provided by laws; and attempts to coerce the tenant to leave the premises with offers of payments that are accompanied by threats or intimidation. Indeed, the list of various forms of harassment is a long one, and harassment is spelled out in municipal ordinances, including San Francisco’s special provision on harassment, Section 37.10B.

Continue reading "Bay Area’s Spike in Rents Presents Incentive for Landlords to Turn Over Units" »

The Dangerous Intersection of Drowsy Driving and Big Rig Accidents

October 17, 2014 by Gregory J. Brod

Few among us haven’t experienced it, you feel your eyes get heavy and begin to close only to startle yourself back to reality; a moment of extreme fatigue that is extremely frightening when it happens while you’re behind the wheel. In modern America, being sleep deprived seems to be the norm and it is frightening to consider how many drowsy drivers are travelling at any given moment. Drowsy driving becomes even more frightening when the tired driver is at the wheel of a big rig truck. For too long, companies have incentivized drivers to push the limits and log as many hours as they can fit in a day. Our Oakland drowsy driving law firm represents those injured in accidents caused by drowsy truck drivers and also supports efforts to prevent truck drivers from driving while fatigued.

Truck Overturns in Vallejo, Driver Reports Fatigue Was Key Factor
On Tuesday morning, as ABC7 reports, a box truck overturned in Vallejo along I-80 West near the state Highway 37 overpass. Truck driver Jesus Osegura, age 24 of Sacramento, told the California Highway Patrol that he had been falling asleep and nearly collided with the back of another truck. Osegura made a sudden, abrupt turn to avoid the collision, causing the load to shift and the truck to overturn. CHP officers report that Osegura was able to climb out of the overturned vehicle but noted neck and leg pain. The incident occurred around 3 A.M.

Truck Industry and Safety Groups Debate Issue of Drowsy Driving Among Big Rig Drivers
This summer, the danger of drowsy big rig drivers took the national spotlight when actor Tracey Morgan was seriously injured in a crash allegedly caused by a truck driver who had not slept for over 24 hours. Reporting on the topic of drowsy truck drivers and relating the story of a previous drowsy driving truck accident that killed ten people, The New York Times noted: “What is remarkable about these events…is how common such accidents are.”

The article calls attention to a battle between authorities attempting to pass safety regulations and an industry where miles, and time, are money. Last year, federal rules reduced the maximum number of hours a trucker could work from 82 per week to 70 per week. Drivers who bigrig.jpgreach the high mark must rest for at least 34 hours including two segments of time between 1 A.M. and 5 A.M. The rules also include an 11 hour daily driving limit with at least one scheduled 30 minute break. Trucking industry officials say the new rules mean more trucks travelling during peak travel/traffic times. They say anti-trucking groups have overstated the issue of fatigue, suggesting drivers should be given flexibility in their work and shouldn’t be given mandates on when to rest.

Safety advocates disagree, taking the position is that fatigue is actually underreported (even if difficult to prove conclusively) and has become increasingly dangerous as traffic conditions demand maximum attentiveness. Part of the reason for the debate is the fact that it is difficult to prove that fatigue was a factor in a collision. Deborah A. P. Hersman, former N.T.S.B. chairwoman and current chief executive for the National Safety Council, states: “Until we have a blood test for determining fatigue, all estimates are likely going to underreport fatigue, because the dead don’t speak and the living often plead the Fifth, especially if they are facing criminal charges.”

Our Northern California Drowsy Truck Driving Crash Attorney on Prevention and Representation
While exact statistics may be difficult to pinpoint, we believe it is abundantly clear that drowsy driving is dangerous. We support efforts to combat drowsy driving in all forms. We also support efforts to prevent trucking accidents given the enormous potential for damage involved. We hope that conversations about the intersection of the two continue, the issue is too important to ignore. Our Oakland drowsy driving accident law firm will also continue to advocate on behalf of those injured or killed by drowsy drivers, whether the driver was behind the wheel of a large truck, a passenger car, or even operating a motorcycle.

See Related Blog Posts:
Sentencing in Sonoma Puts Spotlight on Underreported Problem of Drowsy Driving
Big-Rigs & California Injury Law: Considering Accident Law Following Fatal Bay Area Accident

(Image by Mark Holloway)

“The Sky Is Falling!”: Bay Area Injury Lawyer Examines Legal Rights Following Injuries from Falling Debris

October 15, 2014 by Gregory J. Brod

It may seem like something out of fiction, or even out of an old-school cartoon, but the problem of falling debris is quite real. There are a wide-range of related scenarios such as debris from a crumbling building hitting a passerby, a customer being injured by an item tumbling from a store shelf, or a worker buildingedge.jpgbeing injured by material falling off a warehouse storage rack. Whether it is debris, merchandise, or other materials, items falling from significant heights can cause significant injuries and even death. Our San Francisco injury attorney is here to help those injured by falling items recover needed compensation and begin the healing process. Note: This discussion will focus on events outside the employment context, although our firm can help with third-party suits and other recoveries beyond workers’ compensation in the on-the-job arena.

Recent Headlines Demonstrate the Threat of Falling Debris and Other Objects
If objects had minds, it would seem a building scheduled for demolition in San Francisco’s Financial District decided to get a head start on the process. ABC 7 News spoke with a fire dispatcher who confirmed that a call came in at 8:20 A.M. on Monday October 13 reporting the partial collapse of a building near the intersection of Pine and Montgomery Streets. Luckily, no one appears to have been injured as debris fell, creating a pile that pushed into the street. While the Fire Department had left the scene by the time of ABC’s report three hours later, there will be an investigation conducted by the Department of Building Inspection.

A quick glance at recent headlines shows this is hardly an isolated incident and that falling debris often results in injuries. On October 1, a metal bracket fell from a building in New York City’s Times Square sending two pedestrians to the hospital according to NY1. Headlines on the same day as the San Francisco incident, a woman in Oklahoma was injured when concrete from an overpass fell onto her vehicle. She incurred serious injuries impacting her head, arm, and torso and the region’s News on 6 reported she remained hospitalized the following day but was upgraded to fair condition.

The Law, Possible Claims, Potential Recovery, and a Plaintiffs’ Lawyer
There are a range of potential legal claims that can arise from a falling debris incident along with a range of possible defendants. A premises liability claim may apply if the incident was the result of a property owner’s negligence, such as a poorly secured piece of lumber falling from an outdoor store display during a wind gust. A product liability claim could apply if the debris fell because of a defective item, such as a piece of scaffolding that collapsed sending objects falling to the ground. Special laws may apply in some cases, such as rules about securing loads in a case involving debris falling off of a truck.

As with any injury case, calling an attorney promptly is essential. Evidence disappears fast and your attorney will want to inspect the incident site while it is in a similar condition to the state at the time of the accident. It is also helpful if you or someone else can take good pictures of the accident scene in the moments just after the incident. Your lawyer will also want to talk to witnesses while memories are fresh. Additionally, there are always time limits in the law and these may be particularly stringent if your claim is against a government entity (ex. a claim against a highway department for negligent construction leading to debris falling on your vehicle and causing injury).

If falling debris or other falling objects in Northern California left you or a loved one injured, call our falling debris injury lawyer in San Francisco, Santa Rosa, or Oakland. Attorney Brod has the breadth of experience that is crucial to evaluating a complex incident, bringing all appropriate claims against all appropriate defendants, and, ultimately, helping our firm’s clients recover all the money the law allows.

See Related Blog Posts:
Theatre Collapses Injures Dozens, Investigator Say No Criminal Liability
Witnesses Call Into Question the Safety of the Bay Bridge, 4 Months After Re-Opening

(Image by Bradley Gordon, not of any of the reported incidents)

Brazenness, Perhaps Overconfidence Were Evident in Detroit Medicare Fraud Case

October 14, 2014 by Gregory J. Brod

Medicare fraud and brazenness seem to be pairing up with troubling frequency these days, as individuals determined to illegally enrich themselves at the taxpayers’ expense are coming up with increasingly blatant schemes. We learn about these fraudulent endeavors when the fraudsters are caught stealing, but unfortunately, as we have discussed in our blogs, many of the schemes have gone unpunished. But San Francisco qui tam lawsuit attorney Gregory J. Brod would point to one scheme in particular in Detroit that was recently uncovered and prosecuted for being one of the more brazen cases of Medicare fraud.

According to the FBI’s Detroit Division, a case was unsealed in U.S. District Court in the Eastern District of Michigan on October 8 to which Usman Butt pleaded guilty for his role in a $22 million conspiracy to defraud Medicare. The plea of Butt, a former owner and manager of two metro Detroit home health care agencies, followed that of his former business partner and co-conspirator, Muhammad Aamir, who had already pleaded guilty on August 20.

In the plea documents, Butt admitted to conspiring with others to bill Medicare for home health services that were not actually provided, nor were medically necessary and that were procured through the payment of illegal kickbacks. Through the scheme, which ran from 2008 through January 2013, false claims were submitted to Medicare that resulted in the program paying out approximately $12,607,262. Butt specifically admitted that the nursing care services provided by his companies, Prestige Home Health Services in Troy, Mich., and Royal Home Health Care Inc, of Clawson and Troy, Mich., were neither medically necessary nor even needed.

What made the Butt scheme particularly brazen was the fact that he also admitted to having helped a co-conspirator to file a false corporate tax return for Prestige in which the illegal kickbacks were deducted as “business expenses.” That ploy saved Prestige at least $321,485 in taxes that were due for 2009.

Sentencing for Butt has been scheduled for Jan. 13, 2015. His case, investigated by the FBI, Health and Human Services Office of the Inspector General and IRS, represents another success story for the federal government’s Medicare Strike Force, which, since its inception in 2007, has charged nearly 2,000 defendants with more than $6 billion in collective fraud against Medicare.

While the case against Butt and other successful cases that the Medicare Fraud Strike Force has pursued have been encouraging developments in the fight against Medicare fraud, conservative estimates of the value of schemes that may slip by the government’s watch every year have been pegged at $100 billion per year, and more generous estimates place the total much higher at upward of $300 billion every year.

Continue reading "Brazenness, Perhaps Overconfidence Were Evident in Detroit Medicare Fraud Case " »

Carbon Monoxide Poisoning in Motor Vehicles: Details, Dangers, and Liability

October 14, 2014 by Gregory J. Brod

Even if the harm catches you off-guard, the basis of most threats can be seen - the car doing 60mph in a 25mph zone, the slip-potential of water pooling atop a flight of stairs, the driver focused on his phone instead of the road. Carbon monoxide, however, is neither seen nor smelled. It is a dangerous, even deadly, threat. In this entry, our San Francisco poisoning attorney focuses on automobiles and carbon monoxide, a dangerous mix.

Brief Refresher on CO Poisoning poison.png

The Centers for Disease Control explains that carbon monoxide ("CO") is an odorless, colorless gas that forms in combustion fumes. People and animals are put at risk when CO builds up in an enclosed or semi-enclosed space. As the gas builds in the air, it also begins to replace oxygen in the blood and deprives bodily tissues of the same. Early symptoms of exposure include headache, nausea/vomiting, weakness, chest pain, and confusion. Since these symptoms are vague and mimic many other conditions, diagnosing CO poisoning is tough.

Continued exposure can lead to a loss of consciousness and even death. Notably, the patient rarely notices their own irrational thoughts patters and a third-party may be the one who sees something amiss. If someone is acting strangely out-of-character, ask questions and consider bringing them to a hospital for evaluation; you could save their life. If you notice some of the initial symptoms yourself, especially if you are working near cars or and older furnace, seek medical help immediately

CO and Motor Vehicles
A piece from Iowa State University's Department of Agricultural and Biosystems Engineering ("ABE") points to the specific danger of CO and automobiles. Introducing the
matter, ABE explains:

"The lethal consequences of CO in engine exhaust is tragically illustrated by the hundreds of persons who die each year from carbon monoxide poisoning caused by a running vehicle inside a closed garage Others die or become ill in homes with attached garages, while stranded in their car, or while driving or riding in a vehicle with a defective exhaust system."

There are numerous ways in which vehicles can lead to CO poisoning. Defective exhaust (including a blocked tailpipe) or emissions systems and even a poorly tuned engine can lead to CO buildup during normal vehicle operation. Likewise, operating or driving an automobile with the trunk/tailgate open or with holes in the vehicle's body can also cause CO buildup. A more commonly known danger is allowing a car to warmup or otherwise run in a garage or enclosed area, which can threaten people in the same or an attached structure.

Notably, most newer cars are equipped with catalytic converters that add additional oxygen to deadly CO gas to turn it into the more common (and non-poisonous!) CO2. However, exhaust may leak out before the catalytic converter is able to do its job. The converter is also ineffective during cold starts or when oxygen is limited.

In addition to the general dangers of CO, there are added risks when CO and cars combine. When the blood concentration of CO grows and CO intoxication occurs, the poison begins to interfere with driving skills. CO intoxication causes confusion in addition to slow and increasingly irrational though patterns. Patients often do not see this themselves and taken together this can lead to dangerous, deadly, multi-car pile-ups.

How Our Northern California Injury Lawyer Can Help
If you or someone you love experienced CO poisoning, particularly if it caused permanent impairment or death, an experienced lawyer like Attorney Brod can help. Lawyers are top-notch investigators and we can help figure out when and how the patient was exposed. Depending on those answers, we might be able to bring suit such as a defective products claim against the car maker who used a risky exhaust system set-up, a repairperson who did shoddy work, or even a home builder who did not provide proper ventilation for the garage. Likewise, if you were injured in a car crash and the at-fault driver is blaming it on CO intoxication, we may be able to go after the source of the driver's intoxication.

See Related Blog Posts:
California Lawyer on the Dangers of Carbon Monoxide Poisoning

California Toxic Torts Law and the Many Dangers (and Uses) of Chlorine

(Image by resignent)

Best Price Fraud – A Form of Manufacturer-Committed Health Care Fraud

October 13, 2014 by Gregory J. Brod

Best Price Fraud, like many other types of health care fraud, is at once complex and quite simple. At heart, Best Price Fraud is about drug manufacturers lying to the government in order to increase profits. Likewise, the claims filed against the perpetrators are about the truth. Whistleblowers come to our Northern California health care fraud law firm because they believe in uncovering the truth. In doing so, they can help return money to programs that desperately need every dollar.

The Medicaid Drug Reimbursement Process & The “Best Price”
Understanding best price fraud on a more detailed level requires understanding a bit about how Medicaid deals with pharmaceuticals. If a pharmaceutical company wants to supply drugs to health$.jpg Medicaid patients, they are required to pay a rebate to the states. Manufacturers submit a Quarterly Report that includes data on each individual drug including the Average Manufacturer Price (“AMP”) and the “Best Price.” The Best Price is the lowest price at which the manufacturer sells the drug to any outpatient purchaser nationwide. It takes into account volume discounts, cash discounts, rebates, and any free goods offered with that drug. Best Price excludes a few explicitly laid forth prices such as the amount charged to the Veterans Administration and the Indian Health Service. Using the AMP and Best Price information, the Centers for Medicaid and Medicare Service will tell the manufacturer what rebate the state is owed.

In a notice titled “OIG Compliance Program Guidance for Pharmaceutical Manufacturers,” the Office of the Inspector General for the Department of Health and Human Services warns: “Given the importance of the Medicaid Rebate Program, as well as other programs that rely on Medicaid Rebate Program benchmarks…manufacturers should pay particular attention to ensuring that they are calculating Average Manufacturer Price and Best Price accurately and that they are paying appropriate rebate amounts for their drugs.”

Best Price Fraud: Explanation and Example
Best Price Fraud occurs when the manufacturer provides false data as part of the foregoing process. As is noted in the Guidance, these frauds can give rise to liability under the False Claims Act. In addition to providing data that is simply inaccurate, Best Price Fraud can arise where the manufacturer pays kickbacks or uses other arrangements that provide disguised discounts not taken into account when the manufacturer calculates the figures.

The largest settlement in the health care fraud arena was GlaxoSmithKline’s (“GSK”) 2012 agreement to pay $3 billion to resolve various claims. Among the allegations resolved by that settlement was the claim that, from 1994 to 2003, GSK provided certain discounts to drug purchasers for products purchased in “bundles.” Properly accounted for, these discounts would be allocated proportionally among all the bundled products. However, these were not included in GSK’s Best Price calculations. This resulted in GSK underpaying Medicaid rebates and overcharging other public entities. $300 million of the settlement was specifically tied to resolving these allegations.

Partnering With Private Individuals to Fight Fraud
Best Price Fraud, like other forms of health care fraud, steals from government programs and ultimately from the American people. If you have information that a drug manufacturer is not complying with Medicaid rules and is providing inaccurate Best Price information, please call. The law protects whistleblowers from retaliation and, when a case results in money being returned to the government, offers rewards for their time and effort.

See Related Blog Posts:
Focusing on a Form of Pharmaceutical Fraud: Doctor Indicted for Selling Narcotic Prescriptions
Medicare Advantage and Risk-Adjustment Fraud

Furnishing Alcohol to Minors: California’s Limited Social Host Law Protects Victims of Underage DUIs

October 10, 2014 by Gregory J. Brod

The problem of underage drinking is not new and, sadly, neither is the problem of underage drunk drivers causing serious accidents. However, it seems like only recently we have begun to ask the logical next question: How did they get the alcohol? As an Oakland DUI injury law firm, we believe this is a critical question. We also believe in holding adults accountable for accidents that occur because they were providing alcohol to minors.

Fremont Woman Arrested for Providing Alcohol to Teen Involved in Fatal DUI Crash
On Tuesday, as reported by ABC News, 42 year-old Tabassum Yousuf was arrested in Fremont on suspicion of felony involuntary manslaughter and a misdemeanor charge of contributing to the delinquency of a beercar.jpgminor. The charges relate to a fatal car accident in Fremont that claimed the life of a 17 year-old boy last year.

According to police, evidence suggests that Yousuf bought and furnished alcohol for a large party held at her home during the overnight hours of October 26 into October 27, 2013. Large amounts of alcohol were consumed at the event. Shortly after 1 A.M. on the 27th, three seventeen year olds who had attended the party crashed into a tree located near the intersection of Durham Road and Topaz Road. The front-seat passenger died at the scene.

Police arrested the 17 year-old driver. He was eventually convicted of felony drunk driving and vehicular manslaughter. As authorities investigated further, they concluded Yousuf also bore responsibility for the crash because she had supplied alcohol at the party the teens had attended.

California Law on Providing Alcohol to Minors: Criminal & Civil “Social Host” Laws
California takes providing alcohol to minors very seriously. Section 25658 of the Business & Corporations Code makes providing alcohol to someone under age 21 a misdemeanor. If the alcohol is consumed by someone under age 21 who then causes great bodily injury or kills him/herself or anyone else, the provider is guilty of an additional misdemeanor.

winespill.pngIn addition to the criminal penalties, the adult also risks civil liability. Section 1714 of the Civil Code provides that people are responsible for their own acts as well as injuries caused to another due to his failure to use ordinary care. The Code specifically states that furnishing alcohol is not the proximate cause of any injury that stems from the resulting intoxication, instead the consumption of the alcohol is the cause of those injuries. This eliminates the “social host” doctrine.

However, Section (d) specifically makes an adult, including a parent/guardian, who furnishes alcohol in his/her own residence to someone the adult knows (or should have known) is under 21, can be held liable for injuries or deaths resulting from the intoxication of the younger individual. This brings back the social host rule for these specific circumstances. The rule is further clarified by the California Civil Jury Instructions 427 which reiterates the existence and elements of such a claim.

Two Lessons: Urging Responsible Hosting, Ensuring Accountability
We urge parents considering hosting an underage drinking party to reconsider. Likewise, adults hosting general parties involving alcohol must to take care regarding who consumes the alcohol. Serving someone under age 21 opens you up to criminal and potentially civil liability. If the minor goes on to injure or kill someone, via a DUI crash or otherwise, you may be liable for substantial civil damages.

On the opposite side of the equation – If you were injured or lost a relative in a crash caused by an intoxicated individual under age 21, you may have a civil claim against both the driver and the adult who supplied the alcohol, depending on the circumstances. Importantly, a settlement or verdict is only useful if you can collect on it and the adult is more likely to have sufficient insurance and/or assets to pay your claim.

Our DUI victims’ law firm in Oakland, San Francisco, and Santa Rosa represents the injured and the grieving. We work diligently to explore all potential avenues for recovery and to ensure our clients can actually collect on any judgment or settlement amount. Call to arrange a free consultation.

See Related Blog Posts:
Why 21? Exploring the Drinking Age and Its Impact on Drunk Driving Crashes
Additional Charges Brought In Case of Teenage Drinking and Fatal DUI

(Beer Photo by Jørgen Schyberg; Wine Photo by Ryan Gageler)