San Francisco Injury Lawyer Blog

According to ABC News, the rate of Medicare fraud is on the rise. One of the areas in which Medicare fraud is growing is home health care fraud. It’s important to be aware of this type of fraud, as it makes up a significant portion of health care fraud and often takes advantage of some of the most vulnerable members of society.

Home health care fraud can include billing for medically unnecessary services or care that was not actually provided. Home health care companies may fraudulently obtain patients’ personal medical information –including their Medicare numbers -and falsify medical documents and records in order to send fraudulent bills to Medicare for costly home health care services.

Health care fraud whistleblowers play a critical role in ending the perpetration of Medicare fraud, including home health care fraud. To protect those individuals who are most at risk, it’s important for witnesses to report suspicions of health care fraud.

Major Miami Home Health Care Fraud

According to the U.S. Department of Justice, on May 12, 2015 the leader of a $13 million Medicare fraud scheme perpetrated by a Miami home health care company was sentenced to 10 years in prison and ordered to pay $13.7 million in restitution.

In that case, the owner of Longcare Home Health Corporation fraudulently billed the Medicare program for home health care services that were not provided or were not medically necessary. In addition, the owner paid kickbacks and bribes to patient recruiters and to doctors’ offices to fraudulently bill Medicare for home health care services.

Home Health Care Fraud Conspiracy

In April of 2015, according to the U.S. Department of Justice the owner of a Detroit adult day care center and two owners of Detroit-area home health care companies were sentenced to prison for their participation in a $29 million Medicare fraud conspiracy. In addition to prison sentences, the three conspirators were ordered to pay a total of $11.4 million in restitution.

In that case, the adult day care billed Medicare for services that were not provided, and sold patients’ private medical information to the owner of one of the home health care companies. Both owners of the home health care companies billed Medicare for services that were not provided

usa-dollar-bills-1431130-mMedicare Fraud Costs on the Rise

According to ABC News Medicare fraud costs taxpayers more than $60 billion each year. According to a statement made by a U.S. Department of Justice spokesperson to Modern Healthcare, “about half of Justice’s current healthcare fraud caseload involves home healthcare allegations.”

In order to combat Medicare Fraud, since 2007, the Medicare Fraud Strike Force has operated in nine cities and charged over 2,000 defendants who have fraudulently billed Medicare for more than $6.5 billion.

What can you do about Medicare fraud?

If you have witnessed Medicare fraud, including home health care fraud, you can stand up and make a difference. Let us help. Contact our government fraud attorney. We will help you navigate the process, protect your rights, and work together to pursue justice against those perpetrating fraud.

See Related Blog Posts:

Record Settlement in Non-Intervened Health Care Fraud Case

Medicare Fraud: A Problem Invading All Aspects of Health Care

Over the last few decades, the media has reported on a variety of lawsuits that it deems frivolous. These so-called frivolous lawsuits are often portrayed as being brought by plaintiffs who are just looking to make a quick buck. Few articles or news stories have gone into the details of these cases, but instead focus on the aspects that, at first, might make the lawsuit seem unfounded.

Recently, for a second time, a lawsuit over hot coffee has gained media attention. In both cases, plaintiffs filed suit based on burn injuries resulting from spills of the coffee. But are these cases really about simple coffee spills? Is there more at issue? explosion

The McDonald’s Case: The Original Hot Coffee Case

In 1994, Stella Liebeck was awarded $2.8 million, which was reduced to $640,000 by the judge, in a product liability lawsuit against McDonalds. This case has been held up as the prime example of frivolous lawsuits. ABC News identifies the case as the “poster child of excessive lawsuits.”

What the mainstream media does not report, and what most people don’t know, are the facts of the case. Ms. Liebeck was a passenger in car that was stopped in the parking lot of the McDonald’s where she purchased her cup of coffee. When she held the cup between her knees to add cream and sugar, the cup spilled on to her lap.

Coffee is commonly known to be hot, but the coffee from McDonald’s was excessively and dangerously hot. It was McDonald’s policy to keep its coffee at 180 to 190 degrees Fahrenheit. McDonald’s had received more than 700 complaints of injury due to the temperature of its coffee.

Ms. Liebeck suffered third-degree burns and required significant medical care, including skin grafts and hospital stays.

The New “Hot Coffee” Case

Earlier this month, a new “hot coffee” case began circulating in the mainstream media. In this case, a North Carolina police officer received a free cup of coffee from Starbucks, and asserts that the cup collapsed in his grip and resulted in third-degree burns which aggravated a pre-existing medical condition and led to high medical costs.

The general skepticism surrounding the police officer’s claims is not difficult to find. In one article, the headline reveals, “Cop who sued Starbucks for hot coffee delayed ER.” In another article, the first line explains the facts by stating that the police officer was suing,  “after he apparently spilled a free cup of coffee on himself.” The articles focus on the fact that the cup of coffee was free, and identify the police officer as the person at fault for the spill. The police officer’s injuries do not receive the same prominent placement or attention. In this case, the jury found in favor of Starbucks.

However, if there is any takeaway from Ms. Liebeck’s case, it is that these claims and these injuries should not be treated with skepticism or assumed to be frivolous. Burn injuries can be serious and cause severe pain and suffering, as well as astronomical health care costs for those affected.

If you have experienced a burn injury and have questions about what options are available to you, contact our personal injury attorneys. They will guide you through your legal options and help you seek justice.

See Related Blog Posts:

The “Eggshell Plaintiff” Rule in San Francisco Injury Lawsuits

Toy-Related Injuries in the Holiday Season

trainspeedSpeeding is a factor in countless accidents every single day, leaving behind serious injuries and grieving families.  As we have all been reminded in the past week, the danger of speeding isn’t confined to cars.  The thoughts of our entire San Francisco/Oakland train accident law firm go out to the victims of the terrible train derailment in Philadelphia.  As with so many accidents, we believe the very best way to honor the victims is by ensuring such tragedies are prevented in the future.  Implementing Positive Train Control is one way we can prevent future train tragedies.

Speeding and Lack of Safety Controls Eyed in Philadelphia Derailment

According to CNN, eight people died and more than 200 were injured when a Amtrak train derailed just north of Philadelphia last week.  The accident occurred on a well-traveled route from Washington to New York, at a curve in the track near Frankford Junction.  As the news unfolded, the National Transportation Safety Board (“NTSB”) revealed a disturbing fact – the train was travelling 106 mph as it entered the curve, despite the fact that the curve carries a 50 mph speed limit.

CNN reports that Amtrak personnel spent the weekend after the tragic derailment installing an Automatic Train Control (“ATC”) system, technology that can slow a speeding train, on the track near where the accident occurred.  An ATC system was already in place on the curve’s southbound tracks, where a 110 mph speed limit leads into the curve, but was not installed on the northbound rail, where the preceding track carries an 80 mph limit.  CNN also noted that Amtrak is in the process of installing Positive Train Control (“PTC”) throughout its rail system, a programmable system ATC whereby transponders in the tracks communicate with train’s computer systems to convey information about speed limits to the conductor.  Like ATC, PTC systems will apply the brakes automatically if the engineer does not respond to the notification.

The NTSB’s Call for Automatic Speed Controls on U.S. Rails

Implementing PTC throughout the nation’s rail system is one of the ten items on the NTSB’s “Most Wanted List” for 2015, a yearly list of the agency’s advocacy priorities.  According to the agency, PTC can prevent accidents before they happen and “[w]ithout it, everybody on a train is one human error away from an accident.”  In the wake of an accident that killed 25 and injured more than 100 train passengers in Chatsworth, California in 2008, Congress passed a mandate requiring major carriers to implement PTC by the close of this year.  The NTSB suggests it is unclear when this mandate will actually be met.  Wikipedia notes that some form of Automatic Train Protection has existed on European rails for over a century and the continent is currently moving towards a unified system.

Preventing Derailments and Train Collisions

One line from the NTSB’s discussion of PTC rings particularly poignant after last week’s tragedy.  Discussing the fact that the agency has called for a system like PTC for more than 45 years, the agency notes: “In the meantime, more PTC-preventable collisions and derailments occur, more lives are lost, and more people sustain injuries that change their lives forever.”  CNN’s above-linked report quotes an Amtrak email that says last week’s derailment would not have occurred had the locomotive been travelling at the recommended speed limit for the Frankford Junction curve.

Our Northern California train derailment attorney believes strongly in the benefits of mass transit and in making the nation’s rails safe.  Safety is not negotiable.  Like a careless driver, rail companies that fail to take reasonable measures to keep their travelers safe must be held accountable.  Accountability provides justice for the victims and helps prevent others from facing a similar tragedy.

See Related Blog Posts:

Major Initiatives Are Launched to Encourage Railroad Safety in Wake of Tragedies

Post-Chatsworth Accident Recommendations Still Lacking Among Bay Area Trains

Oil Train Derailment on Prairie Yet Another Example of Perilous Freight Traffic

(Image by Fraser Reed)

In many ways, government procurement contracts are similar to procurement agreements in the private sphere.  The basic elements of all contracts are the same, an offer and acceptance made between two or more competent parties for a legal purpose that creates obligations for both parties (e.g. payment for and the provision of goods/services).  However, the government contract system is much more controlled than the private contracting sphere.  The government contract bidding process is complex, highly-regulated process that relies upon companies filing honest, competitive offers to fill a given need.  Bid rigging is a violation of government trust and a form of government contract fraud.  As a bid rigging whistleblowers’ law firm, the Brod Law Firm partners with individuals who see this fraud happen and step forward to report it.  When fraud occurs in the private sphere, the companies involved can suffer.  When fraud occurs in the government contracting arena, the trust of every American is violated and every taxpayer suffers.

Bid Rigging: Overview and Forms

A useful explanation of bid rigging can be found in a Department of Justice contract2(“DOJ”) primer written to help people identify various forms of collusion among prospective government contractors.  As the primer explains, at a broad level, bid rigging involves competitors conspiring to raise the price of goods/services being purchased by the government.  Bid rigging occurs when competitors agree who will submit the best offer during the bidding process, agreements that eliminate/limit true competition.  In some cases, the collusion involves some, not all, of the bidders for a given project.  Although the primer focuses on antitrust matters, bid rigging can also be a violation of the False Claims Act.

There are several common types of bid rigging schemes.  According to the DOJ, the most common form is Complementary Bidding, a scheme in which some competitors agree to file bids that are essentially flawed, such as a bid containing a term the bidder knows is unacceptable or a price they know is too high.  These bids are not genuine attempts to win the contract, but rather attempts to make it look like companies are competitively bidding when they are actually concealing an inflated price agreement.  Other forms of bid rigging include Bid Suppression (a competitor agrees not to bid so the agreed-upon company wins), Bid Rotation (conspiring companies take turns being the lowest bidder), and Subcontracting Agreements (a competitor submits a losing bid or doesn’t bid at all in exchange for getting a share of the work via a subcontracting agreement with the winning bidder).

Bid Rigging: An Example

Bid rigging claims were part of a whistleblower suit that led to Accenture, a technology services company, agreeing to pay $63.67 million per a settlement agreement announced by the DOJ in September 2011.   As the Washington Post detailed, the suit accused Accenture, along with Hewlett-Packard and Sun Microsystems, of collecting payments from other vendors in exchange for granting the companies preferential status as subcontractors on existing government contracts or providing a strong recommendation to Accenture’s government contacts.  Whistleblowers Normal Rilke, a former senior manager with Accenture, and Neal Roberts, a partner at Pricewaterhouse Coopers who investigated the company’s “alliance partnership” system, filed suit in September 2004.  The government intervened in 2007, stating that the defendants “exploited the trust the government has reposed in them to act with honesty and candor… to act without conflicts of interest; and to serve as independent third party objective advisors.”

America’s Right to Honesty and the Power of a Whistleblower

In the above-referenced primer, the DOJ explains: “American consumers have the right to expect the benefits of free and open competition — the best goods and services at the lowest prices….The competitive process only works, however, when competitors set prices honestly and independently. When competitors collude, prices are inflated and the customer is cheated.”  The DOJ elaborates in the Accenture settlement announcement: “Kickbacks and bid rigging undermine the integrity of the federal procurement process….At a time when we’re looking for ways to reduce our public spending, it is especially important to ensure that government contractors play by the rules and don’t waste precious taxpayer dollars.”

Bid rigging is one form of collusion in which companies purportedly competing for government contracts actually work together to overcharge the government and defraud every taxpayer.  If you have information regarding or knowledge of collusion in the government contracting arena, call our California-based government contracting fraud law firm.  We work on government fraud cases across the country, protecting not only the government but also the whistleblowers who come forward in the interests of justice.

See Related Blog Posts:

Spotlight on Government Contracting Fraud: Violation of Price Reduction Clause in GSA Contracts

Fighting Fraud: Government Contract Fraud Attorney Examines Procurement Fraud

(Image by Dan Moyle)

Some time ago, a video made the rounds of in-boxes and television newsmagazines in which a driver pulled up close behind a vehicle being towed and woke his passenger up shouting, pretending they were staring into the headlights of an oncoming truck.  While many found the prank funny, our Northern California car accident law firm couldn’t help but think of the real nightmare of head-on wrong-way crashes.  Although relatively uncommon, wrong-way accidents are more likely to cause death or serious injury than an average collision.  We help the victims of these terrible crashes, those who saw real headlights approaching and the families whose loved ones final moments may have been marked by that terrible image.

Three Dead in Sacramento Wrong-Way Crash

A wrong way-crash claimed three lives in Sacramento not long after midnight on Tuesday April 12.  According to The Oakland Tribune, a 24 year-old Hayward man from and a 25 year-old South San Francisco man were killed when their vehicle was struck by a Ford F-150 pickup truck on I-80 near Madison Avenue.  Police say the truck was going the wrong direction in the highway’s fast lane at the time of the crash.  The driver of the pickup, identified only as a male as of the time of this writing, also died in the collision.

A Study of Crashes Involving Wrong-Way Freeway Entrywrongway

In the May/June 2012 issue of Public Roads, a Federal Highway Administration publication, two highway safety experts focused on wrong-crashes.  The study was limited to wrong-way crashes on Michigan freeways from 2005 to 2009 where the subject vehicle was known or believed to have entered the freeway by travelling the wrong direction on an exit ramp.  Researchers studied 110 of these wrong-way freeway entry crashes.

  • Basic Characteristics of the Drivers

In 101 of the crashes for which impairment (or lack thereof) was recorded, 60% of the wrong-way drivers were under the influence of alcohol and/or drugs at the time of the crash.  Looking at all 110 incidents, 57% occurred between 11 P.M. and 6 A.M.  In contrast, only 16% of all Michigan freeway crashes in the 5-year period occurred in that timeframe.  Even more markedly, 71% of the wrong-way crashes that resulted in death or incapacity occurred in that overnight period.  The authors suggest this is not surprising since wrong-way entries generally involve driver confusion which is more likely to occur in the dark.  Further statistics suggest confusion is amplified in younger impaired drivers and older drivers regardless of impairment.  When gender was noted, males were implicated in 75 crashes and females in 33, numbers consistent with the overall gender distribution in serious crashes.

  • Road Design Issues

Researchers also examined the location of wrong-way crashes and the type of road design involved.  A greater share of the most serious crashes occurred on the freeway itself rather than the ramp, possibly due to vehicle speed.  The authors suggested installing additional warning signals or other control devices along the full length of exit ramps rather than only near the intersection might help prevent these crashes.  Echoing other studies, the researchers found interchanges that place an exit ramp immediately next to an entrance ramp (including the style of interchange known as a partial cloverleaf) are disproportionately likely to cause confusion and wrong-way entries.  When the style of entryway was known, 60% of wrong-way crashes involved a partial cloverleaf interchange even though only 21% of Michigan interchanges use that format.

Accountability, Compensation, Prevention

Municipal authorities can take a number of steps, some relatively inexpensive, to prevent wrong-way crashes.  Still, ultimately it is a matter of driver attentiveness.  Wrong-way drivers put themselves, their passengers, and everyone on the roads at risk.  As in other cases, negligent drivers should be held accountable for the results of their actions.  If you were hurt or lost a family member because of a wrong-way driver in Northern California, call our wrong-way crash lawyer in San Francisco, Oakland, or Santa Rosa.  We will fight to get you compensation, helping help you move forward and helping prevent future tragedy.

See Related Blog Posts:

Wrong-Way Accidents, Catastrophic Consequences

Dangerous Road Lawsuits: Compensation & Protection

(Image by Jacobo Tarrío)

When we mention train safety, people often focus on the possibility of a collision between a train and a car or similar motor vehicle.  However, train safety is also about pedestrians.  As a developing story reminds us, pedestrian train accidents are a very real, often fatal, threat.  Our San Francisco train accident attorney stands ready to help when a pedestrian rail crash stems from the actions (or inaction) of a careless conductor, a risky corporate policy (formal or informal), or another negligent decision that puts innocent pedestrians at risk.

Muni Light Rail Car Hits and Kills San Francisco Boy

A tragic accident stunned San Francisco’s Ocean View neighborhood on Tuesday when a child pedestrian was hit by a Muni vehicle and died at the scene.  At the time of this writing, the facts were slowly unfolding and the story still developing.  The San Francisco Chronicle was reporting that a 12 year-old boy had been hit by a Muni light rail vehicle near San Jose and Lakeview avenues.  Officials told reporters that the boy was running through the crosswalk to catch another train to get to school at the time of the incident.  Muni service in the area was stopped while the medical examiner responded.

Remembering Another San Francisco Pedestrian Killed in Caltrain Tunnel in February

Back in February, another pedestrian died in another Bay Area train crash, this one with a tragic ironic twist.  On Monday February 23, a man died after being struck in one of the three Caltrain tunnels that lead out of the San Francisco to the Peninsula.  As The San Francisco Chronicle reported, the pedestrian crash involved a train that was en route to pick up passengers who had been delayed because of an earlier accident in which a woman was killed after a Caltrain vehicle hit her car in Menlo Park.  The report noted that wanderers and homeless individuals are known to frequent the Caltrain tunnels and transit officers frequently patrol the area, often calling in to hold a train while the track is cleared.

Report Cites Increase in Pedestrian Rail Crashes

trackcurveIn August 2013, The St. Louis Post-Dispatch examined the problem of pedestrian railroad crashes.  Citing federal data, the paper found a 26% jump in the number of pedestrians fatally struck by trains during the first five months of 2013 versus the same period the year before (199 deaths in January through May 2013 versus 158 fatalities in January through May 2013).  The report notes that people walking on railroad tracks in the U.S. are deemed trespassers because the rail network is private property.  Nonetheless, people often use rail tracks as part of shortcuts.  This is one factor that likely contributes to a surprising fact – in every year from 1997 through the Post-Dispatch review more people were killed while walking on tracks than as occupants of vehicles struck at train crossings.  While total train accidents have been on a downward trend, falling 16.5% in 2012, the pedestrian problem is growing with pedestrian railroad deaths rising 7.5% that year.

Causes & Liability in Pedestrian Rail Collisions

Many factors contribute to pedestrian rail accidents.  Sadly, some of these deaths are likely suicides.  In other cases, the pedestrian simply failed to exercise due caution (see Operation Lifesaver for safety tips).  Still, far too often, the train company or one of its agents is at fault.  One threat is distracted conductors, including those using mobile communication devices while at the helm.  Other train accidents stem from a dangerous decision made in the train company’s corporate offices, such as declining to install safety gates.

If you or a loved one has been involved in a pedestrian rail accident and you believe someone else is to blame, call our San Francisco train crash lawyer.  Remember: Under California law an injured party can recover even if his/her own negligence contributed to the accident.  In those cases, the amount of the recovery will be reduced to account for the plaintiff’s share of fault.

Edited 5/13, 8:15 A.M. — In a terrible twist, between the time we wrote the post and it went live on the blog, a major train derailment happened on the East Coast.  From California to Pennsylvania, our thoughts go out to all those affected by this tragedy.

See Related Blog Posts:

Danger on the Tracks: The Risky State of the BART Rail System

Fatal Crash Involving Train, SUV in Oakland Adds Another Grim Statistic for 2014

(Image by Ari Herzog)


Bed bugs have long plagued humans.  A recent Salon article points to evidence of bed bugs in an Egyptian archeological site dating between 1352 and 1336 B.C., suspected bed bug infestations in ninth century Iraq, and possible references to the pests in ancient Jewish and Islamic texts.  Nonetheless, even old problems may call for new solutions that take into account the realities of modern life.  Our San Francisco bed bug lawyer monitors changes to bed bug laws in California and across the nation, following news that can help us represent people who are dealing with a bed bug invasion because of someone else’s negligence.

Proposed California Landlord/Tenant Law Would Clarify Bed Bug Responsibilities

bedbugsAt the state and local level, particularly in the Bay Area, California is known for protecting residential renters.  Currently, a number of different laws can be used to help tenants whose landlords contributed to a bed bug problem and/or failed to take appropriate responsibility for keeping the property vermin-free.  As the LA Weekly reported on Friday, State Assemblyman Adrin Nazarian has crafted a bill aimed at clarifying the responsibilities of both landlords and tenants when bed bugs infest residential rentals.  Assembly Bill 551 would:

  • Prohibit tenants from knowingly bringing infested items onto the premises;
  • Require tenants to notify landlords within 7 days if they know of or suspect a bed bug infestation;
  • Require landlords to contact a pest control company within 3 days of such notification, provide findings to tenants within 48 hours, and then prepare/implement a pest control plan;
  • Make tenants responsible for managing their belongings and cooperating with a reasonable pest control plan;
  • Prohibit renting or leasing a property when the landlord knows or should know it is infested.

If passed, the law would trump local ordinances with a notable exception permitting San Francisco’s regulations/ordinances to stand.

Landlord/Tenant Proposals in Other States

California is far from the only state looking to clarify bed bug laws in the landlord/tenant arena.  A proposal in Connecticut, discussed in the April 6, 2015 edition of the Hartford Courant, would make landlords responsible for inspecting units when a tenant reports bed bugs, require landlords to disclose previous or nearby infestations, and hold landlords accountable for the cost of an exterminator if they cannot control the infestation themselves.  However, the bill would shift costs to tenants if they fail to comply with treatment and/or do not provide appropriate access to their unit for extermination purposes.

According to WKZO, lawmakers from Kalamazoo, Michigan have also proposed state legislation tasking landlords with taking steps to end a bed bug infestation.  However, unlike many other laws, this one would require the party that introduced the bugs onto the property pay for the extermination.  This provision concerns our bed bug law firm because it would be very difficult to implement in practice and may be unjust in cases such as when an accidental introduction becomes an epidemic due to a landlord’s indifference or an infestation that spreads from one unit to another when bugs migrate between shared walls.  The Michigan law would also ban landlords from renting infested properties.

Another Bed Bug Proposal Outside the Residential Arena

Notably, bed bug issues are not confined to the landlord/tenant arena.  In mid-2014, a state assemblyman began pushing for legislation requiring New York City’s Metropolitan Transit Authority (“MTA”) to notify the public within 24 hours if bed bugs are located on subway cars or city buses.  The call followed an outbreak of bed bugs on MTA vehicles.  ABC 7  cited the case of a train conductor who was bitten several times and the New York Daily News said the pests were spotted on trains 21 times in a single month and were also found in crew rooms and MTA offices.

Bed Bug Laws and Legal Rights: Communication and Clarification

Two themes run throughout the recent legislative proposals involving bed bugs – communication and clarification.  The proposals seek to clarify an often confusing web of laws and regulations applicable to the pests, with most focusing on protecting individuals from companies that refuse to act upon notice of an infestation.

Our Northern California bed bug lawyer helps individuals who have been twice victimized, by insect pests and by “human pests” such as an unresponsive landlord or another negligent individual/corporation whose actions or inactions allow the bugs to thrive.  Call our bed bug lawyer in Oakland, San Francisco, or Santa Rosa for more information.  We are currently accepting cases on behalf of both individuals and potential class action matters.

See Related Blog Posts:

California Bed Bug Lawyer on Why Landlords Must Take the Lead in Bed Bug Extermination

Bed Bugs in the Courts (Not Literally!) — Using Individual Lawsuits and Class Actions to Protect California Renters

(Image by Michael Wunderli)

cash2When it comes to the world of health care fraud, there’s one truth we cannot emphasize enough – Honest individuals are the key to winning the fight against fraud.  It is a truth we see again and again in our work as a whistleblower’s law firm.  The False Claims Act (“FCA” or “the Act”) provides a financial incentive for people to elect the morally right path and report suspected cases of health care fraud and other forms of government claims fraud.  The importance of health care fraud whistleblowers in the fight for right is emphasized by the emerging story of a record-breaking case against one the nation’s largest kidney dialysis companies.

DaVita Settles False Claims Act Case for $495 Million

syringeIn 2007, according to last week’s Denver Post, Dr. Alon J. Vainer and nurse Daniel D. Barbir filed a whistleblower lawsuit against Denver’s DaVita HealthCare Partners.  The pair had been working for DaVita when they noticed the company was throwing out good medicine and dividing single use doses into multiple vials.  They only filed suit after internal questions/complaints went unanswered.  DaVita was, per the allegations, overbilling Medicare and Medicaid.  For example, the lawsuit suggests a physician would use part of a 100mg vial of Zemplar (vitamin D) or Venofer (an iron supplement), charging for the whole dosage despite the fact that the patient only needed 25mg.  In other cases, doctors were told to treat a patient who needed 8mg of medicine with a 10mg vial instead of a cheaper option of four 2mg vials.

After investigating the matter for two years, the government opted not to intervene in the lawsuit.  Undaunted, Vainer and Barbir continued the fight, re-filing in civil court in 2011 via the FCA.  Last Monday, DaVita announced that it will pay up to $495 million to settle the case, although the company did not admit any wrongdoing and suggests settling was in the best interest of company stakeholders given the potentially astronomic penalties if they lost the case.  Other news sources such as Atlanta’s Daily Report call this the largest non-intervened False Claims Act in history, easily trumping the previous $125 million record.  The Denver Post’s report adds that Vainer and Barbir may receive up to $135 million in conjunction with the settlement which follows two other settlements by DaVita in whistleblower lawsuits.  Those claims, which together with the current settlement may exceed $1 billion in payouts, involved allegations of over-use and double-billing tied to an anemia drug and the offering of kickbacks to doctors in return for referrals.

The False Claims Act & Qui Tam Lawsuits

According to the The False Claims Act: A Primer, available through the United States Justice Department, the Civil War-era statute creates liability for anyone who knowingly submits, or causes another to submit, a false claim to the government or makes false statements in order to receive payment on a claim filed with the government.  Pursuant to the Act’s qui tam provisions, private individuals known as realtors can file FCA claims on the government’s behalf.  The government is then given the opportunity to intervene or take over the prosecution.  If a qui tam claim is successful, a realtor is entitled to a share of the recovery, 15 to 25% in cases where the government intervened and 25 to 30% in non-intervened cases.

Partnering to Fight Fraud

If you have witnessed health care fraud or other forms of government contracting fraud, you know what the right move is.  Let our government fraud attorney help you make it.  We will support you throughout the dispute, ensuring your rights are protected including your right to be free from retribution and your right to compensation for your efforts, while together we fight back against fraud.

See Related Blog Posts:

Medicare Fraud: A Problem Invading All Aspects of Health Care

The False Claims Act and the Role of Whistleblowers in Stopping Health Care Fraud

(Syringe image by Dawn Huczek; Cash image by Nic McPhee)


Certain areas of injury law are governed by their own systems and rules.  Workplace injury suits involve a unique scheme set apart from the typical civil compensation system.  It is important to understand the limits of worker’s compensation, when it applies and when it does not and the injured can and should bring a traditional civil claim.  San Francisco injury lawyer Greg Brod has been following a developing case that, much like the case we recently discussed that tested the boundaries of medical malpractice law, helps clarify the rules for California’s injured.

Overview & Facts in Wright vs. California

In late April, as reported in the San Francisco Chronicle, the Supreme Court of California declined to review a decision issued by the Court of Appeals, allowing the ruling that paved the way for a prison guard’s civil injury suit to stand.  According to the appellate court, a year after beginning work at San Quentin State Prison (“San Quentin”), Monnie Wright voluntarily moved into a State-owned rental unit owned within the prison’s gated grounds.  He was not required to move and he paid market rent.  The lease did require Wright to obtain rental insurance.

Per the appellate court, Wright took a “lengthy walk from his home to his actual place of work” (equivalent to several city blocks).  On December 14, 2010, Wright fell on a staircase just outside his unit when a concrete step allegedly collapsed.  He received workers’ compensation and elected early disability retirement.

Wright also filed a civil premises liability claim against the state.  The State suggested the injuries arose out of Wright’s employment and thus the claim was barred and Wright was limited to worker’s compensation remedy.  The State filed for Summary Judgment and the trial court granted the motion.  According to the trial court, the “coming and going” rule which typically holds the trip to and from work is not covered by worker’s compensation did not apply because Wright was on his employer’s premises at the time of injury.  The court suggested employment begins upon entry to the employer’s premises, even for resident employees.  Wright filed for a new trial and, after that was denied, he appealed.

Appellate Ruling: Distinguishing Tenant Employees and Focusing on Facts

gavel2The appellate court reversed, holding it was error to bar the tort claim simply because Wright was on his employer’s premises when he fell, especially given that he lived there.  According to the decision (which the Supreme Court allowed to stand), the worker’s compensation bar against tort claims applies where the injury arose out of and happened in the course of employment.  Typically, injuries sustained during the commute to and from work are not covered by worker’s compensation (“the coming and going rule”).

Despite sounding simple, this rule can be difficult to apply so the courts eventually developed a premises line rule which holds employment commences when the employee arrives on the employer’s premises.  However, the appellate court criticized the lower court’s failure to consider that Wright lived on premises.  Reviewing cases involving resident employees, the court finds that worker’s compensation usually applies and bars tort suits where an employee is required to live on-site (the “bunkhouse rule”).  In contrast, the court notes Wright was not required to live on site, paid market rent, and was neither on-call nor did he perform work at his residence.

As added support for its ruling, the appellate court pointed to the requirement that Wright obtain rental insurance.  If the State was responsible for all injuries Wright suffered on its premises even injuries in or near his rental unit, in other words if worker’s compensation covered him at all times, this insurance would unnecessary.

Tenant Employees and the Limits of Worker’s Compensation

Ultimately, the court found the facts warranted closer attention, creating a “triable issue of material fact whether Wright was acting in the course of his employment at the time he was injured.”  While it passed the ultimate decision on to the trial court (as procedural rules require), the appeals court suggests that where an employee voluntarily chooses to live on-site and is injured in the residential area a civil claim outside worker’s compensation may be appropriate.  Per the court, tenant employees are different from non-residential employees “and that they have not entered the course of employment simply by virtue of living on their employers’ premises.”  Tenant employee’s injuries must be closely examined and the court must apply basic worker’s compensation principles and decide if the injuries arose out of the employment relationship.

Worker’s compensation provides greater certainty that an employee will be compensated for on-the-job injuries.  In exchange, employees give up the right to file a civil suit for covered injuries.  Worker’s compensation is an important protection, but it has its limits and it often does not provide the extent of coverage that might be available in civil court.  Attorney Brod understands the contours of the worker’s compensation system.  If your employer is arguing your claim is limited to worker’s compensation and you disagree, call our injury law offices in San Francisco, Santa Rosa, or Oakland.

See Related Blog Posts:

Beyond Workers’ Comp: A Look at Third Party Claims Inspired by Scary Moments for Two Sets of California Window Washers

Court Rules on Claims of “Ordinary Negligence” in a Medical Setting

(Image by Brian Turner)

dangerousSome roads are known for good things, perhaps picture-perfect scenery or a time-saving shortcut.  Other roads are more infamous than famous.  From a too-sharp curve to an inadequate merge lane, from a poorly constructed intersection to a pothole-ridden surface, there are a myriad of problems that can render a road unsafe.  Dangerous road conditions are a factor in many accidents, including single- and multi-vehicle crashes.  Dangerous roads lawsuits are complex, but Northern California dangerous roads lawyer Greg Brod knows they are essential to helping the injured and the grieving recover much-needed compensation and they can also push government authorities to make changes that can prevent future tragedies.

Business Owners Express Concerns After Sonoma Crash

A report by the Press Democrat about a weekend crash in Sonoma County calls attention to the issue of dangerous roads.  Around noon on Sunday, a 29 year-old driver crashed her Honda CRV into a Subaru Outback parked outside of Wild Flour Bakery on Bohemian Highway in Freestone.   In turn, the Outback crashed into a bench before plowing into the entryway of the popular bakery.  A 52 year-old sitting on the bench was injured in the chain-reaction accident.  Police arrested the driver of the CRV on suspicion of felony-level drunk driving.

An interview with local business owners suggests that there may have been more to the crash than just drunk driving.  Jed Wallach, the bakery’s owner, told the paper that his store is often quite busy on the weekend, forcing some customers to park across the road from the bakery, one factor in the area’s high number of pedestrians.  The owner of a neighboring store said that she is particularly concerned with vehicles coming off Highway 12 and travelling too fast when they approach the sharp turn onto Bohemian Highway.  She said the speeders put pedestrians at risk.   Another business owner echoed these concerns, pointing to speeding drivers attempting to negotiate a nearly 90-degree turn in the road.

Sonoma County Supervisor Efren Carrillo joined the chorus of voices expressing concern about the safety of the area which is popular with tourists.  He said he is talking to the business owners, law enforcement, and transportation officials and will look into whether the issues warrant added precautions.  Carrillo referenced another portion of Bodega Highway where he helped get rumble strips installed to slow drivers.  One business owner suggested even a sign would help.

The Danger in Dangerous Roads

Dangerous road conditions are a problem throughout our region.  In the summer of 2012, the San Francisco Chronicle compiled a list detailing some of Northern California’s most dangerous roads, stretches the columnist dubbed “Highways to Hell.”  The piece focused on narrow, twisting roads, warning drivers to slow down and to watch for those who insist on putting speed over safety.

While drivers certainly bear responsibility for their speed, we also have a right to expect roads to be reasonably safe.  Dangers can arise from faulty designs, poor construction, inadequate maintenance and/or the failure to reevaluate road conditions as usage evolves.

Bringing a Dangerous Roads Lawsuit

Proving a road condition contributed to a crash is difficult, but possible.  These claims require an attorney who will thoroughly investigate the issue and one who can partner effectively with experts in the engineering field.   In general, a suit against a government for injuries or death due to dangerous road conditions requires not only showing the condition existed and contributed to the accident but also that the government knew or should have known about the danger and failed to respond appropriately.  A claim may also be appropriate if a government employee wrongfully did (or failed to do) something that created the risk (ex. using inadequate materials when building a road barrier where a car drove through the barrier and into a pedestrian).

Attorney Greg Brod understands this complex area of law.  If you have been injured or lost a loved one and you believe a dangerous road was (partially or wholly) to blame, call our dangerous roads injury law firm in Santa Rosa, San Francisco, or Oakland.  Remember – bringing a dangerous roads claim can not only help you recover compensation but affords you the opportunity to help make the roads safer for everyone.

See Related Blog Posts:

Government Immunity & Injury Law

Fatal Single-Vehicle Crash Serves as a Reminder of the Threat of Dangerous Road Conditions

(Image by Joaquin Uy)