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1000 OPINION/ORDER
We repeat below a helpful overview of the Medicare program to set the scene before exploring the procedural and substantive facts of this case.1 The Medicare program is codified in Title XVIII of the Social Security Act. These insurance carriers are called Fiscal Intermediaries (
1000 UNITED STATES V. GARRISON (1/22/1998, NO. 95-9361)

We determine whether the owner and chief executive officer of a home healthcare provider properly was accorded a two level enhancement in her sentence under U.S.S.G. § 3B1.3 for abusing a position of public trust by submitting falsified Medicare claims to a fiscal intermediary. Because the two level enhancement for abuse of a position of public trust was improper. Was the owner. Health Care Financing Administration.
1000 UNITED STATES V. GARRISON (1/22/1998, NO. 95-9361)

We determine whether the owner and chief executive officer of a home healthcare provider properly was accorded a two level enhancement in her sentence under U.S.S.G. § 3B1.3 for abusing a position of public trust by submitting falsified Medicare claims to a fiscal intermediary. Because the two level enhancement for abuse of a position of public trust was improper. Was the owner. Health Care Financing Administration.
1000 UNITED SR ASSN INC V. SHALALA DONNA

Appellee

Appeal from the United States District Court

for the District of Columbia

(No. 97cv03109)

Kent Masterson Brown argued the cause for appellants.

With him on the briefs was Frank M. With him on the brief were

Frank W. Altman

were on the brief for amici Citizens Against Government

Waste. Contend that section 4507 is unconstitutional on

a number of grounds. Eliminates the injury

that is the basis of plaintiffs' constitutional attack.

I

Medicare is a comprehensive insurance program designed

to provide health insurance benefits for individuals 65 and

over. The program is administered

by the Health Care Financing Administration (HCFA). Which is not at

issue in this case. Which is the focus here. Part B is financed by a combination of

government funding and premiums paid by beneficiaries. See

id. 1395j. Are categorically excluded from Medicare coverage.

See id. 1395y(a)(7).

1000 OPINION/ORDER
With him on the briefs was Frank M. With him on the brief were Frank W. Altman were on the brief for amici Citizens Against Government Waste. Contend that section 4507 is unconstitutional on a number of grounds. Eliminates the injury that is the basis of plaintiffs' constitutional attack. I Medicare is a comprehensive insurance program designed to provide health insurance benefits for individuals 65 and over. The program is administered by the Health Care Financing Administration (HCFA). Which is not at issue in this case. Which is the focus here. Part B is financed by a combination of government funding and premiums paid by beneficiaries. Are categorically excluded from Medicare coverage. Those that are not categorically ex cluded may only be reimbursed when medically
1000 OPINION/ORDER
Is the subrogee/assignee of a Medicare supplemental insurance contract between National States Insurance Company (
1000 OPINION/ORDER
With him on the brief was Patrick Burkett. On the brief were Peter D. Plaintiff Appellant Laura Wilson is the personal representative of the estate of her deceased husband. Wilson's estate services that were paid for by Medicare. brought a medical malpractice action against a hospital and two doctors. She contended that the government's claim against her husband's estate was improper and therefore constituted an illegal exaction. Wilson's claim1 arose under the Medicare statutes and because jurisdiction over such a claim is vested exclusively in federal district court. Some background will help the reader to understand the issue in this case. Medicare is a system of federally funded heath insurance for the aged. It is administered by the Centers for Medicare and Medicaid Services. All statutory references are to the 2000 version of the United States Code. 3 For convenience. Medicare paid for medical services without regard to whether they were also covered by an employer group health plan. Which were designed to make Medicare a
993 OPINION/ORDER
BCBSA is immune from liability to the United States for payments its officers certify and disburse to Medicare beneficiaries. Analyzing both the context within which the subsection is made applicable to the Medicare Act. The Supreme Court cases that have construed it. Body was an employee of appellee Blue Cross and Blue Shield of Alabama from 1973 to 1989. Issues The Medicare program is administered by the Health Care Finance Administration (the
993 UNITED STATES V. BLUE CROSS AND BLUE SHIELD OF ALA.(6/26/1998, NO. 95-6429)

BCBSA is immune from liability to the United States for payments its officers certify and disburse to Medicare beneficiaries.

In part I. Analyzing both the context within which the subsection is made applicable to the Medicare Act. The Supreme Court cases that have construed it. Body was an employee of appellee Blue Cross and Blue Shield of Alabama from 1973 to 1989. Issued in the form of Administrative Bulletins.

Body was employed as a senior auditor by BCBSA in 1984. Was assigned to audit the 1983 cost reports of. Reversed his proposed adjustments.

Body contacted the Federal Bureau of Investigation in January 1989 to report BCBSA's reimbursements to Alabama hospitals of interest costs that he felt were not authorized under Medicare regulations. The OIG concluded that four of the fourteen adjustments were

993 OPINION/ORDER
BCBSA is immune from liability to the United States for payments its officers certify and disburse to Medicare beneficiaries. Analyzing both the context within which the subsection is made applicable to the Medicare Act. The Supreme Court cases that have construed it. Body was an employee of appellee Blue Cross and Blue Shield of Alabama from 1973 to 1989. Including: The Medicare program is administered by the Health Care Finance Administration (the
993 UNITED STATES V. BLUE CROSS AND BLUE SHIELD OF ALA.(6/26/1998, NO. 95-6429)

BCBSA is immune from liability to the United States for payments its officers certify and disburse to Medicare beneficiaries.

In part I. Analyzing both the context within which the subsection is made applicable to the Medicare Act. The Supreme Court cases that have construed it. Body was an employee of appellee Blue Cross and Blue Shield of Alabama from 1973 to 1989. Issued in the form of Administrative Bulletins.

Body was employed as a senior auditor by BCBSA in 1984. Was assigned to audit the 1983 cost reports of. Reversed his proposed adjustments.

Body contacted the Federal Bureau of Investigation in January 1989 to report BCBSA's reimbursements to Alabama hospitals of interest costs that he felt were not authorized under Medicare regulations. The OIG concluded that four of the fourteen adjustments were

991 OPINION/ORDER
The district court determined that the Secretary was precluded from disallowing University's bad debt claims and granted summary judgment in favor of University. Medicare bad debt constitutes an allowable cost if the following criteria are met: (1) The debt must be related to covered services and derived from deductible and coinsurance amounts. (2) The provider must be able to establish that reasonable collection efforts were made. (3) The debt was actually uncollectible when claimed as worthless. (4) Sound business judgment established that there was no likelihood of recovery at any time in the future. 42 C.F.R. § 413.80(e). Where a collection agency is used. If a provider refers to a collection agency its uncollected non Medicare patient charges which in amount are comparable to the individual Medicare deductible and coinsurance amounts due the provider from its Medicare patient. The debt remains unpaid more than 120 days from the date the first bill is mailed to the beneficiary. The Secretary's authority retroactively to modify Medicare bad debt reimbursement policy that was in effect on August 1.
991 OPINION/ORDER
We are called upon to address the applicability of the ADEA when an employer offers its Medicare eligible retirees health insurance coverage allegedly inferior to the coverage offered to retired employees not eligible for Medicare. Accordingly will reverse and remand the case for further proceedings. Would remain eligible only if they fell into one of four groups: employees unable to continue their employment due to a disability and who otherwise were eligible for a disability retirement pension. The plaintiff class in this action is composed of retirees who are aged 65 or older and thus eligible for Medicare who remain eligible for retiree health coverage under these restrictions. Pressure to reduce costs was enhanced when Highmark announced that it would increase the County's premiums for medical insurance coverage by an average of 48%. The district court described SecurityBlue as follows: SecurityBlue is a coordinated health care plan provided through Keystone Health Plan West. SecurityBlue is available to persons who have Medicare Part B Medical Insurance and who live in the SecurityBlue `service area' [which includes most of western Pennsylvania].
984 HARRIS CORP. V. HUMANA HEALTH INS. CO. OF FLORIDA (6/6/2001, NO. 99-14906)

The district court held that the plan of the Harris Corporation (
984 HARRIS CORP. V. HUMANA HEALTH INS. CO. OF FLORIDA (6/6/2001, NO. 99-14906)

The district court held that the plan of the Harris Corporation (
984 OPINION/ORDER
Gray LLP was on brief. Were on brief. Or reasonably should have known. That the tests were not reasonable and necessary for diagnosis or treatment of illness or injury of Medicare beneficiaries. Are the exclusive avenue for recovery by the United States of Medicare overpayments. The question presented is whether the district court lacks subject matter jurisdiction because the Medicare Act explicitly or implicitly repeals the grant of federal court jurisdiction under 28 U.S.C. § 1345 or displaces the underlying common law causes of action over which § 1345 gives federal courts jurisdiction. Medicare is a federally subsidized health insurance program for the elderly and certain disabled individuals.
980 UNIV. HEALTH SERV. V. HEALTH & HUMAN SERV.

This document was created from RTF source by rtftohtml version 2.7.5 > Univ. The district court determined that the Secretary was precluded from disallowing University's bad debt claims and granted summary judgment in favor of University. Medicare bad debt constitutes an allowable cost if the following criteria are met:<p> (1) The debt must be related to covered services and derived from deductible and coinsurance amounts.<p> <p> (2) The provider must be able to establish that reasonable collection efforts were made.<p> <p> (3) The debt was actually uncollectible when claimed as worthless.<p> <p> (4) Sound business judgment established that there was no likelihood of recovery at any time in the future.<p> <p> 42 C.F.R. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="980"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug97/95-9493.opa.html">UNIV. HEALTH SERV. V. HEALTH & HUMAN SERV.<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Univ. The district court determined that the Secretary was precluded from disallowing University's bad debt claims and granted summary judgment in favor of University. Medicare bad debt constitutes an allowable cost if the following criteria are met:<p> (1) The debt must be related to covered services and derived from deductible and coinsurance amounts.<p> <p> (2) The provider must be able to establish that reasonable collection efforts were made.<p> <p> (3) The debt was actually uncollectible when claimed as worthless.<p> <p> (4) Sound business judgment established that there was no likelihood of recovery at any time in the future.<p> <p> 42 C.F.R. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="954"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0314p-06.pdf">OPINION/ORDER</A><BR> Are acute care hospitals and participating Medicare providers located in southwestern Michigan. Plaintiffs are non profit. Both plaintiffs are parties to a Medicare participation agreement with defendant. Medicare beneficiaries are responsible for paying a portion of the cost of hospital services in the form of deductibles and coinsurance. 42 C.F.R. §§ 409.80 409.83. Whereby hospital operating costs are reimbursed on a per discharge basis through prospectively fixed rates that are based upon the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="941"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/15061B820BD0BE1C88256DCC00750AAD/$file/0235020.pdf?openelement">OPINION/ORDER</A><BR> Which was a Medicare provider operating under fiscal intermediary Blue Cross of California. I. Because this case was dismissed for lack of subject matter jurisdiction. Among the services covered under Medicare are home health services. Blue Cross of California is such a fiscal intermediary. Gary and Verlene Kaiser (along with the other individual plaintiffs in this lawsuit1) were shareholders of Community Home Health (CHH). Since almost all of its patients were Medicare or Medicaid beneficiaries. CHH was highly dependent on the payments it received from the government through Blue Cross of California. The government was its primary source of revenue. Were made in installments based on estimates of CHH's volume of business. These regulations were issued on January 2 and March 31. CHH was notified that its ERP request was denied and told that 100% of its future Medicare payments would be withheld until the entire overpayment was recouped. This recoupment was proposed without issuance of a Notice of Program Reimbursement (NPR). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="939"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/jan98/95-9408.man.html">UNITED STATES V. SUBA (1/9/1998, NO. 95-9408)<BR></A><BR> Managed Risk were convicted of one count of conspiracy to defraud the United States and to commit offenses against the United States. Kelly was convicted of four additional counts of mail fraud (Counts 112 115). 30 32).<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="939"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//jan98/95-9408.man.html">UNITED STATES V. SUBA (1/9/1998, NO. 95-9408)<BR></A><BR> Managed Risk were convicted of one count of conspiracy to defraud the United States and to commit offenses against the United States. Kelly was convicted of four additional counts of mail fraud (Counts 112 115). 30 32).<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="939"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDAzLTEyOTFfb3BuLnBkZg==/03-1291_opn.pdf">OPINION/ORDER</A><BR> This appeal is being decided by the remaining two members of the panel. Who are in agreement. Judge) as sentenced John Canova to a one year term of probation after a jury trial at which defendant was found guilty of various substantive and conspiratorial crimes relating to his involvement in a multi million dollar Medicare fraud. Its request for de novo review of the district court's departure decision pursuant to 18 U.S.C. § 3742(e) is now foreclosed by United States v. We conclude that there was such an error in the district court's calculation of the loss amount relevant to the fraud guideline. Was charged in a six count indictment with (1) conspiring to defraud the United States from October 1999 through October 2001 by making false statements to Medicare agents in violation of 18 U.S.C. § 1001. 1999 letter to Medicare that Raytel was in compliance with Medicare specifications for testing pacemakers when he knew that it was not. By directing Raytel's Connecticut employees falsely to represent that Raytel was in full compliance with government testing specifications. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="934"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/05/983521P.pdf">OPINION/ORDER</A><BR> 2000 9:54:01 AM </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="932"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=04-1349.01A">OPINION/ORDER</A><BR> Inc.</SPAN> was on brief. LLP</SPAN> were on brief. Was on brief. A nursing home which is currently in Chapter 11 bankruptcy. Was overpaid by Medicare because it took Medicare money for the expenses of third party provided services but then did not pay those third parties as required. 42 U.S.C. § 1395g(a). Alleging that this was an improper setoff within the context of bankruptcy. Is whether the government may recover the overpayments to Slater to put them back into Medicare or whether Slater's estate gets the funds to be distributed to its many creditors. </SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="930"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-4088.wpd">OPINION/ORDER</A><BR> Concerned that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="924"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTEyMjQtYWdfb3BuLnBkZg==/05-1224-ag_opn.pdf">OPINION/ORDER</A><BR> Yale successfully argued that the denial of the claims on the categorical ground of FDA classification was predicated on a rule altering the previous Medicare practice of conducting device by device review of safety and efficacy. That the rule change was improperly adopted. We agree with the district court that the new rule is unenforceable because the Secretary did not satisfactorily explain his reasons for its promulgation. Which at the time of the events at issue was administered by the Health Care Financing Administration ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="906"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0363p-06.pdf">OPINION/ORDER</A><BR> Schell's central allegation is that Battle Creek violated the FCA. Battle Creek Health System Page 2 entire multi dose vials of anesthetic medication when less than the full vial of medication was administered to a patient. The district court below concluded that Battle Creek was entitled to summary judgment because Schell failed to demonstrate that Battle Creek's billing methodology resulted in increased payments by Medicare. Schell was employed by Battle Creek as a certified registered nurse/anesthetist ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="906"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1966OPN2.01A">OPINION/ORDER</A><BR> Were on brief. Russoniello</SPAN> and <SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="900"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1966.01A">OPINION/ORDER</A><BR> Were on brief for the United States.</SPAN> <BR WP= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-9.gif" ALT="900"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTQ4NTMtY3YgdyBFcnJhdGEucGRm/05-4853-cv%20w%20Errata.pdf">OPINION/ORDER</A><BR> Is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="898"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/792C113C5EA2DF0588256CED005284F4/$file/0117512.pdf?openelement">OPINION/ORDER</A><BR> At issue is the Secretary's obligation to reimburse the Providers for bad debts arising from the failure of Medicare Part B participants to make coinsurance 3868 COMMUNITY HOSPITAL v. Medi Cal was liable for particular coinsurance or deductible payments under the applicable law. After the system was designed. We will reverse the summary judgment entered by the district court in favor of the Providers and remand with instructions that summary judgment be entered in favor of the Secretary. Is the component of the Department of Health and Human Services that administers the Medicare program for the Secretary. CMS is headed by the Administrator. Medicare is divided into two parts. Everyone who is eligible for Social Security benefits is also eligible for Part A benefits. Reimbursement for outpatient hospital services provided to Part B enrollees is handled by private insurance companies. Cost shifting occurs in the following two ways: (1) the necessary costs of delivering health care to Medicare enrollees are borne by individuals who are not Medicare recipients. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="898"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200416091.pdf">OPINION/ORDER</A><BR> Inc. (collectively the health care agencies will be referred to as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="887"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar97/95-5398.man.html">BROOKS V. BLUE CROSS AND BLUE SHIELD<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Brooks v. Senior Circuit Judges.<p> <p> PER CURIAM:<p> <p> The district court's grant of summary judgment to the Defendants is AFFIRMED based upon the holding and rationale contained in Part III.A of the district court's September 22. A copy of which is attached as Appendix A hereto. We have no occasion to reach the remaining issues addressed in other parts of that order and imply no view concerning any of them.<p> AFFIRMED.<p> ATTACHMENT<p> <p> APPENDIX A<p> <p> UNITED STATES DISTRICT COURT. It is hereby<p> ORDERED and ADJUDGED as follows:<p> 1. Defendant Blue Cross's motion to dismiss the amended complaint (DE # 31) is GRANTED. Defendant New York Life's motion for instructions and an Order directed to Plaintiff's counsel (DE # 46) is DENIED AS MOOT. Defendant New York Life's combined motion to dismiss and/or for summary judgment (DE # 47) is GRANTED. Defendant New York Life's corrected motion for more definite statement and for RICO case statement (DE # 56) is DENIED AS MOOT. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="887"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar97/95-5398.man.html">BROOKS V. BLUE CROSS AND BLUE SHIELD<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Brooks v. Senior Circuit Judges.<p> <p> PER CURIAM:<p> <p> The district court's grant of summary judgment to the Defendants is AFFIRMED based upon the holding and rationale contained in Part III.A of the district court's September 22. A copy of which is attached as Appendix A hereto. We have no occasion to reach the remaining issues addressed in other parts of that order and imply no view concerning any of them.<p> AFFIRMED.<p> ATTACHMENT<p> <p> APPENDIX A<p> <p> UNITED STATES DISTRICT COURT. It is hereby<p> ORDERED and ADJUDGED as follows:<p> 1. Defendant Blue Cross's motion to dismiss the amended complaint (DE # 31) is GRANTED. Defendant New York Life's motion for instructions and an Order directed to Plaintiff's counsel (DE # 46) is DENIED AS MOOT. Defendant New York Life's combined motion to dismiss and/or for summary judgment (DE # 47) is GRANTED. Defendant New York Life's corrected motion for more definite statement and for RICO case statement (DE # 56) is DENIED AS MOOT. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="887"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200514864.pdf">OPINION/ORDER</A><BR> We find that her loss amount was erroneously calculated at sentencing. We also find that her loss amount was erroneously calculated at sentencing. Was the other 50% owner of Ocean. Santos was a codefendant at trial. Was acquitted pursuant to a motion under Rule 29 of the Federal Rules of Criminal Procedure. Carlos Gonzalez was the other 50% owner at United and was convicted at trial along with Guerra. He is not a party to this appeal. 2 Ocean dealt in Durable Medical Equipment ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="882"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6E06BB9E832E19CD88256AAA00577161/$file/9915605.pdf?openelement">OPINION/ORDER</A><BR> ORDER The government's petition for rehearing is granted. Is withdrawn. Remand to the district court for its consideration of whether the statutory penalty and the treble damages awarded are unconstitutionally excessive under the Eighth Amendment. I. The Medicare Program is administered by the United States Department of Health and Human Services. Which is not at issue here. Medicare Part B is a federally subsidized. Reimbursement for Medicare claims is made by the United States through HCFA. The Medicare fiscal intermediary involved in this case was Blue Shield of California. By a qualified employee of a physician or physician directed clinic (whose services are rendered `incident to' a physician's services). A </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="882"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0120p-06.pdf">OPINION/ORDER</A><BR> (2) denying Winters's motion for summary judgment on Count II of the complaint on the grounds that the deferred compensation accrual on the final cost report was immaterial. (4) denying Winters's motion for a new trial on the grounds that (a) the jury verdict was against the clear weight of the evidence. (b) there was no evidence the Government sustained any harm. (c) the jury was confused in calculating damages. The jury verdict and remitted award of damages is AFFIRMED. All of which were managed through Medshares Management Group. Which was in place at all of the other home health agencies owned by Winters and managed by MMGI. The Plan was a deferred profit sharing and stock bonus plan. It was Winters's policy that after buying a home health agency. I at 132) ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="882"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/255B20297A94A63C88256A16006274B3/$file/9915605.pdf?openelement">OPINION/ORDER</A><BR> Remand to the district court for its consideration of whether the statutory penalty and the treble damages awarded are unconstitutionally excessive under the Eighth Amendment. 3496 I. The Medicare Program is administered by the United States Department of Health and Human Services. Which is not at issue here. Medicare Part B is a federally subsidized. Reimbursement for Medicare claims is made by the United States through HCFA. The Medicare fiscal intermediary involved in this case was Blue Shield of California. By a qualified employee of a physician or physician directed clinic (whose services are rendered `incident to' a physician's services). A </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="882"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/E50C2F69B7569CCC88256E5A00707C58/$file/9915605.pdf?openelement">OPINION/ORDER</A><BR> ORDER The government's petition for rehearing is granted. Is withdrawn. Remand to the district court for its consideration of whether the statutory penalty and the treble damages awarded are unconstitutionally excessive under the Eighth Amendment. I. The Medicare Program is administered by the United States Department of Health and Human Services. Which is not at issue here. Medicare Part B is a federally subsidized. Reimbursement for Medicare claims is made by the United States through HCFA. The Medicare fiscal intermediary involved in this case was Blue Shield of California. By a qualified employee of a physician or physician directed clinic (whose services are rendered `incident to' a physician's services). A </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="882"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/79237C43F065F2C188256E5A00707AA6/$file/9915605.pdf?openelement">OPINION/ORDER</A><BR> Remand to the district court for its consideration of whether the statutory penalty and the treble damages awarded are unconstitutionally excessive under the Eighth Amendment. 3496 I. The Medicare Program is administered by the United States Department of Health and Human Services. Which is not at issue here. Medicare Part B is a federally subsidized. Reimbursement for Medicare claims is made by the United States through HCFA. The Medicare fiscal intermediary involved in this case was Blue Shield of California. By a qualified employee of a physician or physician directed clinic (whose services are rendered `incident to' a physician's services). A </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="880"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0409p-06.pdf">OPINION/ORDER</A><BR> He was required to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="871"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//nov94/94haynes.html">HAYNES AMBULANCE SERVICE V. ALABAMA HAYNES AMBULANCE SERVICE V. INDIVIDUALLY AND FOR AND ON BEHALF OF A CLASS OF PERSONS OR ENTITIES PROVIDING SERVICES TO RECIPIENTS OF MEDICARE AND MEDICAID BENEFITS AS IS MORE PARTICULARLY REFERRED TO IN THIS COMPLAINT. THIS PAYMENT IS KNOWN AS PART B COINSURANCE. WE HAVE JURISDICTION UNDER 28 U.S.C. 1291 AND. 838 F.SUPP. 243 (E.D.VA.1993) (FOLLOWING THE SECOND CIRCUIT HOLDING IN PERALES ). THE SOLE ISSUE BEFORE US IS WHETHER THE ALABAMA PLAN CAN. THUS EXPLAINS WHY THE ATTEMPT TO CAP PAYMENT AT THE MEDICAID RATE IS INCONSISTENT WITH THE STATUTE. SNIDER ADDRESSES EACH OF THE ARGUMENTS. (E)(I) FOR MAKING MEDICAL ASSISTANCE AVAILABLE FOR MEDICARE COST SHARING (AS DEFINED IN SECTION 1396D(P)(3) OF THIS TITLE) FOR QUALIFIED MEDICARE BENEFICIARIES DESCRIBED IN SECTION 1396D(P)(1) OF THIS TITLE. THE MEDICARE COST SHARING WHICH THE QUOTED PORTION OF THE STATUTE REQUIRES A STATE TO PAY IS DEFINED IN 1396D(P)(3)."><BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="871"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/052082p.pdf">OPINION/ORDER</A><BR> We will affirm. Intermediaries contract with the Secretary to determine the amounts due and are bound by the Secretary's regulations and interpretive rules. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="871"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov94/94haynes.html">HAYNES AMBULANCE SERVICE V. ALABAMA HAYNES AMBULANCE SERVICE V. INDIVIDUALLY AND FOR AND ON BEHALF OF A CLASS OF PERSONS OR ENTITIES PROVIDING SERVICES TO RECIPIENTS OF MEDICARE AND MEDICAID BENEFITS AS IS MORE PARTICULARLY REFERRED TO IN THIS COMPLAINT. THIS PAYMENT IS KNOWN AS PART B COINSURANCE. WE HAVE JURISDICTION UNDER 28 U.S.C. 1291 AND. 838 F.SUPP. 243 (E.D.VA.1993) (FOLLOWING THE SECOND CIRCUIT HOLDING IN PERALES ). THE SOLE ISSUE BEFORE US IS WHETHER THE ALABAMA PLAN CAN. THUS EXPLAINS WHY THE ATTEMPT TO CAP PAYMENT AT THE MEDICAID RATE IS INCONSISTENT WITH THE STATUTE. SNIDER ADDRESSES EACH OF THE ARGUMENTS. (E)(I) FOR MAKING MEDICAL ASSISTANCE AVAILABLE FOR MEDICARE COST SHARING (AS DEFINED IN SECTION 1396D(P)(3) OF THIS TITLE) FOR QUALIFIED MEDICARE BENEFICIARIES DESCRIBED IN SECTION 1396D(P)(1) OF THIS TITLE. THE MEDICARE COST SHARING WHICH THE QUOTED PORTION OF THE STATUTE REQUIRES A STATE TO PAY IS DEFINED IN 1396D(P)(3)."><BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="871"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200415283.pdf">OPINION/ORDER</A><BR> Walker is a qui tam relator. Walker contends that the district court erred in limiting the scope of information discoverable in the case to that information relevant to the time period during which she was employed by LFM as a nurse practitioner. I. BACKGROUND & PROCEDURAL HISTORY The Medicare Program is a system of health insurance administered by the United States Department of Health and Human Services. CMS was formerly known as the Health Care Financing Administration (HCFA). Medicare Part B is a federally subsidized. Reimbursement for Medicare Part B claims is made through CMS. These insurance carriers are known as Fiscal Intermediaries. When a healthcare service is rendered to a patient covered by Medicare Part B. Among these manuals are the Medicare Carrier's Manual. Of LFM's patients are covered by Medicare Part B. These claims are made on HCFA 1500 forms in electronic 3 form. FECA AND BLACK LUNG) I certify that the services shown on this form were medically indicated and necessary for the health of the patient and were personally furnished by me or were furnished incident to my professional service by my employee under my immediate personal supervision. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="867"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/DFA926E7AF1CC15C88256EAF005445A8/$file/0316408.pdf?openelement">OPINION/ORDER</A><BR> Whose claims for coverage of their health care services were denied based on Local Coverage Determinations ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="861"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTQ4NTMtY3Zfb3BuLnBkZg==/05-4853-cv_opn.pdf">OPINION/ORDER</A><BR> Is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="852"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-1389.pdf">OPINION/ORDER</A><BR> On the brief were James P. Of counsel was Peter L. With her on the brief were Peter D. Of counsel on the brief were Alex Azar. The United States District Court for the Northern District of California held that Telecare was liable as a secondary payer. Medicare was enacted in 1965 as Title 18 of the Social Security Act. Congress provided that where beneficiaries are covered for medical expenses by both a group health plan and Medicare. This provision is known as the Medicare Secondary Payer ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="852"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1259.wpd">OPINION/ORDER</A><BR> Lawrence was indicted by a federal grand jury for carrying out a scheme to defraud Medicare. Although chelation therapy is generally not covered by Medicare. Lawrence submitted bills to Medicare indicating the clinic had performed a form of intravenous therapy which was covered by Medicare. Lawrence was convicted of four counts of wire fraud in violation of 18 U.S.C. 1343. Lawrence appeals arguing that: (1) the district court should not have refused to use several instructions he proposed. (2) there was insufficient evidence to support his convictions. (3) the district court erred in denying his motion for a judgment of acquittal because the claims made to Medicare were unpayable on their face. Lawrence also argues that his sentence is unconstitutional under Blakely v. OIG discovered that billings for medical services were being made to Medicare from the clinic using the provider identification number of a Dr. Mitchell was between eighty one and eighty two years old and did not live in Denver. Mitchell was only at the clinic on Wednesdays for part of the day. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="852"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/FAE8520783ADAC9588256B36008220A6/$file/9956319.pdf?openelement">OPINION/ORDER</A><BR> Thompson is substituted for his predecessor. Circuit Judge: This is a consolidated appeal brought by Medicare service providers against the Secretary of the Department of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="852"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200116782.pdf">OPINION/ORDER</A><BR> We conclude that the dismissal was in error. Historical Background The underlying case is result of an order by the Judicial Panel on MultiDistrict Litigation. Sitting by designation. 2 * details of the underlying claims are not of significance to the disposition of the appeal before us. It is enough to observe that. Or fear that they will contract. Union Carbide Chemical & Plastics Co. 3 After the modifications were publicized to class members. After the settlement was restructured to take account of Dow Corning's bankruptcy filing. The participating implant manufacturers are referred to collectively as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="852"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/98opinions/98-5164a.html">N BROWARD HOSP DIST V. SHALALA DONNA E.<BR></A><BR> With her on the briefs were <i><p> Frank W. <p> the statute provides for a disproportionate share adjustment <p> for any hospital that<p> <p> is located in an urban area. 158. <p> The change to the present wording was made by a 1987 <p> amendment. <i>See</i> The Omnibus Budget Reconciliation Act of <p> 1987 (OBRA). The single <p> issue is whether the 30% set forth in the provision is a <p> percentage of all net inpatient care revenues or whether it is <p> a percentage of net inpatient revenues <i>excluding</i> revenues <p> from Medicare and Medicaid. The question is <p> whether the antecedent of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="848"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199904/98-5164a.txt">OPINION/ORDER</A><BR> With her on the briefs were Frank W. The statute provides for a disproportionate share adjustment for any hospital that is located in an urban area. The change to the present wording was made by a 1987 amendment. The single issue is whether the 30% set forth in the provision is a percentage of all net inpatient care revenues or whether it is a percentage of net inpatient revenues excluding revenues from Medicare and Medicaid. The question is whether the antecedent of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="843"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/031588.P.pdf">OPINION/ORDER</A><BR> Brown was admitted to the Fairfax Hospital emergency room for a perforated sigmoid colon and significant sepsis. Brown informed the intermediary that she had decided to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="835"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/98opinions/98-5155a.html">MCCREARY MAURICE V. OFFNER, PAUL<BR></A><BR> Jr.</i> argued the cause for appellants. <p> With him on the briefs was <i>Allen V. With her on the brief were <i><p> Frank W. Were on the brief for <p> appellee Paul Offner.<p> <p> Before: Wald. Enrollment in Part A is <p> automatic. Part B is voluntary. Doctors and other health care providers are <p> not required to service Medicaid patients. 1396<i>o</i>. <p> State Medicaid rates for any given service are almost always <p> lower than the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="835"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/12/003139P.pdf">OPINION/ORDER</A><BR> The </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="835"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200005/99-7089a.txt">OPINION/ORDER</A><BR> With him on the briefs was Laura J. With him on the brief were Stephen A. Until it is exhausted. (as a result of a federal regulatory process that we will soon describe) all offer at least 365 days of post Medicare hospital benefits. While the Medicare reimbursement rates of most hospitals are governed by the so called Prospective Payment System. The patient's liability is the bedrock without patient responsibility. There is no insurer responsibili ty. Insurer liability is often less than all of the primary obligor's. Provisions for deductibles and co insurance are common. No such limita tions are before us. Under which providers are eligible for Medicare reimbursement only if they execute a contract with the Secretary of Health and Human Services agreeing. Not to charge ... any individual or any other person for items or services for which such individual is entitled to have payment made under this subchapter. The most obvious difficulty with this provision as support for Physicians Mutual is that it appears to have nothing to do with charges for post Medicare services. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="835"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199801/96-5074a.txt">OPINION/ORDER</A><BR> Webber was on the briefs. Attorney at the time the brief was filed. Were on the brief. Circuit Judge: The ten appellants in this case provide outpatient kidney dialysis services to patients who are suffering from end stage renal disease. They dispute the amount of money to which they are entitled from the Secretary of Health and Human Services as reimburse ment for medical services rendered under the Medicare pro gram. The appellants challenge (1) the Secre tary's decision that the merger of their parent company with another corporation was a related party transaction. Such that certain costs associated with the merger were not reimbursa ble under Medicare. Which they claim is inconsistent with the statutory requirement that Medicare reimburse each dialysis provider in a prospectively set amount. We agree with the district court that the merger was a related party transaction. Whether the regulation is based upon a reasonable interpreta tion of the Medicare statute. I. Background Under the Medicare program the Secretary reimburses providers of ESRD dialysis services at 80% of a prospectively set rate and the Medicare beneficiary is responsible for the remaining 20% as a co payment. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="828"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/F256D93E40FFDC5E882570D6007C196A/$file/0317195.pdf?openelement">OPINION/ORDER</A><BR> The governing documents are undisputed and their language is clear. While Omega is now the real party in interest seeking to recover the funds. RainTree is the debtor whose rights and liabilities are at issue. The nursing home could not have participated in the Medicare program while its application was pending. RainTree had provided the services and was the holder in 1998 of the provider number as the operator of the facility. Central Standard Time on February 28 and RainTree was to terminate its lease simultaneously with the execution of the Transfer Agreement (which was signed on February 29). Summary judgment is to be granted if the pleadings and supporting documents. Show that there is no genuine issue as to a material fact and the moving party is entitled to judgment as a matter of law. The question is whether RainTree or Suncrest was entitled to the Medicare reimbursement funds on February 29. The answer is dependent upon this Court's interpretation of the relevant Medicare statute and of the intent of the parties as reflected in the Transfer Agreement. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="815"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/08/061717P.pdf">OPINION/ORDER</A><BR> This opinion is being filed by the remaining judges of the panel pursuant to 8th Cir. The Parties and the Allegedly Illegal Practices Extendicare is a for profit healthcare company that operates long term care. It is a Delaware corporation with its principal place of business in Wisconsin. The reimbursement rate Medicare pays to Extendicare is substantially higher than the rates paid to Extendicare by the other sources. Buytendorp alleges that she received no adverse performance reviews and was denied no raises nor opportunities for advancement prior to 2003. Practices she believed to be illegal.3 The objectionable practices Although Buytendorp also alleges she was denied advancement opportunities in 2003 and 2004. Cut staffing to levels that were adverse to the patients' interests. Buytendorp states that there was some emphasis within Extendicare to maximize the admission and retention of Medicare patients dating back to 1996 but that she was neither instructed nor pressured to participate in practices she believed to be illegal until the 2003 04 time frame. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//jan2003/01-14291.opn.html">UNITED STATES V. AETNA LIFE INS. CO. (1/28/2003, NO. 01-14291)<BR></A><BR> We held that an insurance company occupying the role of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/August2004/032292p.pdf">OPINION/ORDER</A><BR> Buckwalter) At issue is an acute care hospital's reimbursement from Medicare for graduate medical training. 2004 ) Mercy Catholic Medical Center is an acute care hospital located in Philadelphia. We will reverse and remand. Is the largest public program financing health care services for the aged and disabled. Hospitals that provide services to Medicare patients are reimbursed for their expenses under Title XVII of the Social Security Act (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/jan2003/01-14291.opn.html">UNITED STATES V. AETNA LIFE INS. CO. (1/28/2003, NO. 01-14291)<BR></A><BR> We held that an insurance company occupying the role of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0071p-06.pdf">OPINION/ORDER</A><BR> The district court lacked subject matter jurisdiction over all of BP Care's claims and therefore should not have reached the due process issue. Barbara Parke became insolvent and was unable to continue lease payments. It was able to continue operating the nursing home without interruption. The name of this arm of the Department of Health and Human Services changed from Health Care Financing Administration to Centers for Medicare and Medicaid Services while the CMP proceeding was pending. Ordering that CMS </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=95-1964.01A">OPINION/ORDER</A><BR> Wheeler & Dittmar were on brief for appellant. Were on brief for appellee. The question in this appeal is CYR. The RIIIFA requires all insurers licensed in Rhode Island to make pro rata monetary contributions to the Fund to meet certain types of insurance claims lodged against licensed Rhode Island insurers which have become insolvent. The Fund is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="809"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/96/04/943067P.pdf">OPINION/ORDER</A><BR> Medicare patients are often responsible for both deductible and coinsurance payments for hospital care. The government We affirm in will reimburse hospitals if they have made reasonable collection efforts. 42 C.F.R. § 413.80(e). The 42 U.S.C. § is considered the decision of the Secretary. 1395oo(f)(1). 42 C.F.R. § 405.1877. involves a decision by the Secretary to disallow a reimbursement for 1983 Cross & Blue Shield of Minnesota was the intermediary used by the Secretary provider may seek judicial review under most circumstances. Federal jurisdiction in this case also is based on the Administrative Procedure Act. 000 in payments. some of the services listed in the request were not eligible Blue for As Cross did a full field audit of the request in early 1985 and found that reimbursement under Medicare.1 It reduced the claimed amount accordingly and then issued a notice of program reimbursement in September 1985. debts. Blue Cross was auditing HCMC's 1985 reimbursement request. The intermediary was concentrating on reviewing the bad debt collection policies of providers. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="804"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Oct2003/031268p.pdf">OPINION/ORDER</A><BR> This is an action seeking an injunction against a planned Medicare audit of New Jersey teaching hospitals by the inspector general of the Department of Health and Human Services. The District Court held that it did not have standing to consider plaintiffs' claims under the Administrative Procedures Act. We will affirm. Plaintiffs contend defendant's planned audit of their billing records would use an improper standard and should be enjoined.1 The Medicare program is the responsibility of the United States Department of Health and Human Services. The program is administered by the Centers for Medicare and Medicaid Services. Plaintiffs are the University of Medicine and Dentistry of New Jersey and two corporations associated with it: the Cooper Health System. The claims of all parties are based on the proposed audit of the university's teaching hospitals. 4 the carriers handle the billing and payment. They have initial responsibility for ensuring compliance with the statutes and regulations governing Medicare billing of individually billable services.2 Medicare payments to healthcare providers fall under two categories. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="804"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199904/98-5155a.txt">OPINION/ORDER</A><BR> With him on the briefs was Allen V. With her on the brief were Frank W. Were on the brief for appellee Paul Offner. Enrollment in Part A is automatic. Part B is voluntary. Doctors and other health care providers are not required to service Medicaid patients. State Medicaid rates for any given service are almost always lower than the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-8.gif" ALT="804"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/972773.P.pdf">OPINION/ORDER</A><BR> The two drugs have different rates of action. Lupron is administered in liquid form by an intramuscular injection with a 22 gauge needle. While Zoladex is administered as a pellet injected under the skin with a larger. Which are less likely to occur with a Lupron injection. Such procedures are unnecessary with Lupron. Many patients who receive Lupron or Zoladex have a portion of their health care costs covered by Medicare Part B. Which are typically administered by doctors during office or hospital visits. The policy provides that doctors will be reimbursed for the cost of Lupron only at the reimbursement level of the lessexpensive Zoladex. Palmetto based this change in policy on its conclusion that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/96/11/961561P.pdf">OPINION/ORDER</A><BR> The We granted Clarinda's motion for injunctive relief We conditioned this grant of Secretary responds that the courts are without jurisdiction to consider Clarinda's claims. during enjoining the Secretary from suspending past and future Medicare payments the pendency of this appeal. injunctive relief upon Clarinda's posting of a bond in an amount and under the terms and conditions as set by the district court. There is little dispute as to the facts. Provided health services to elderly and handicapped persons in southern Iowa. 1993 Clarinda Home Health was certified by Medicare to be reimbursed for health care supplies. Notified Clarinda that an investigation was being conducted for acts of fraud and/or willful misrepresentation. That it was suspending all payments to Clarinda for services billed to the Medicare program. (Clarinda) may have committed acts of fraud and/or willful misrepresentation regarding claims submitted for Medicare reimbursement. totalling Clarinda. Which authorizes suspension of payment where authorities have obtained reliable evidence of fraud or willful misrepresentation. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200107/99-5064a.txt">OPINION/ORDER</A><BR> With her on the briefs were David W. Attorney at the time the briefs were filed. With her on the brief was Harry R. These costs include Medicare's share of a provider's deprecia tion expenses and capital losses.2 The regulations use the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/99opinions/99-1402.html">WILLIAM O. SCHISM V. U.S.<BR></A><BR> Argued for plaintiffs appellants.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/99opinions/99-5064a.html">TENET HEALTHSYSTEMS HEALTHCORP V. TOMMY THOMPSON<BR></A><BR> Ar gued the cause for appellant.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/98/06/973401P.pdf">OPINION/ORDER</A><BR> Were jurisdictionally barred by 42 U.S.C. §§ 405(h) and 1395ii. We supplement the complaint with the district court's findings where the complaint is silent on jurisdictionally significant facts. Partial hospitalization is an intensive outpatient service covered under Part B of the Medicare Act. Part B claims are processed by Medicare carriers chiefly insurance companies. Mutual denied thousands of the hospitals' Midland related claims on the grounds that Midland's services were unsupervised by a physician and medically unnecessary. Midland was not a party to the hospitals' administrative appeal. Midland maintained it was not eligible to join the appeal. Midland would have to prove. Section 405(h) is a provision of the Social Security Act made applicable to the Medicare Act by 42 U.S.C. § 1395ii. § 405(h) reads: The findings and decision of the [Secretary of Health and Human Services] after a hearing shall be binding upon all individuals who were parties to such hearing. Its claim was barred by sentence two of § 405(h). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar2002/99-15197.opn.html">UNITED STATES V. WHITESIDE (3/22/2002, NO. 99-15197)<BR></A><BR> We reverse the defendants' convictions and sentences in light of the government's failure to prove that the alleged statements were knowingly and willfully false. Overview of Programs</STRONG></SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="798"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar2002/99-15197.opn.html">UNITED STATES V. WHITESIDE (3/22/2002, NO. 99-15197)<BR></A><BR> We reverse the defendants' convictions and sentences in light of the government's failure to prove that the alleged statements were knowingly and willfully false. Overview of Programs</STRONG></SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="793"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200514219.pdf">OPINION/ORDER</A><BR> Plaintiffs sought to recover for the Medicare program the cost of certain health care services </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="793"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200114291.opn.pdf">OPINION/ORDER</A><BR> We held that an insurance company occupying the role of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="787"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200402/03-5046a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="776"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/oct96/95-1331.wpd.html">PAINTER V. SHALALA<BR></A><BR> Is composed of two parts A and B. Is funded from social security taxes. Which is at issue in this case. Is a voluntary program that provides Medicare beneficiaries with supplemental medical insurance benefits for physicians' and other health care services. Funding for Part B is derived from monthly premiums paid by beneficiaries. HHS is responsible for administering the program. The payment amount for Part B claims was the lesser of (1) the physician's actual charge. The payment amount is calculated by multiplying three factors: (1) the relative value for the service. The three factors utilized in determining the payment amount are all established by the Secretary. Only the conversion factor is at issue in this case. The Secretary was directed by Congress. In what is referred to by the parties as the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="776"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1999/03/98-3146a.htm">98-3146A -- U.S. V. LAHUE -- 03/23/1999<BR></A><BR> Were indicted on one count of conspiracy under 18 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="776"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/199915197.opn.pdf">OPINION/ORDER</A><BR> We reverse the defendants' convictions and sentences in light of the government's failure to prove that the alleged statements were knowingly and willfully false. Overview of Programs Medicare is a federal health insurance program designed to provide medical services. We will discuss the Medicare program. A hospital that elects to participate in the Medicare Part A program is known as a provider. The cost reports include a certification that each cost report filed is true. Are capital related costs. These costs are more financially beneficial to the provider. The FI is responsible for reviewing the cost reports and processing payment of claims. Both the FI and the provider have a three year period in which to reopen a cost report in order to make changes. Fawcett was BAMI's second largest hospital. Bachner was unsure when PRC discovered the mistake. PRC worried about amending the 1986 cost report because it was likely to expose the mistake in the 1985 cost report in which Fawcett had claimed the interest as 100% capital related. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="776"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1999/03/98-3146.htm">98-3146 -- U.S. V. LAHUE -- 03/23/1999<BR></A><BR> Were indicted on one count of conspiracy under 18 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="770"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200113608.opn.pdf">OPINION/ORDER</A><BR> For herself and all other persons from whom Defendant has or will demand. We have before us a litigant who contends that she should be allowed to circumvent the administrative remedies available to her not because resort to them would be futile. Her position is that the likelihood ­ she says it is a near certainty ­ that she would succeed in the administrative appeals process should excuse her from having to resort to it. Believing that what this litigant fears is one of the principal reasons for and benefits of the requirement that administrative remedies be exhausted. Was injured by an elevator door at the Tuscaloosa County Courthouse in Tuscaloosa. Is likely to require continued treatment for them. Have been paid by Medicare. The United States Health Care Financing Administration (HCFA)1 sent her a letter informing her that it was statutorily subrogated to her right of recovery against the elevator company. Telling him that he was required to send HCFA a copy of his representation agreement with Cochran. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="770"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/00opinions/00-5455a.html">P.I.A. MICHIGAN CITY INCORPORATED V. TOMMY THOMPSON<BR></A><BR> Neustadter argued the cause for appellant.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="770"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/06/971943P.pdf">OPINION/ORDER</A><BR> Attacking the Secretary's interpretation (embodied in an informally distributed booklet entitled Questions and Answers Pertaining to Graduate Medical Education) of various Medicare regulations under which the costs that determine the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="770"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200206/00-5455a.txt">OPINION/ORDER</A><BR> With him on the briefs was Patric Hooper. With him on the brief were David S. Attorney at the time the brief was filed. Because we agree with the district court that the Secretary's application of regulations was reasonable and the Secretary's decision was supported by the record. The statutory distinction between a generic hospital ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="763"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug1994/94a0797p.txt">OPINION/ORDER</A><BR> Francis Medical Center (SFMC) is a provider of health care services covered under Part A of Title XVIII of the Social Security Act. Which is commonly known as the Medicare Act. Medicare providers were reimbursed for the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="763"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/2E073DC3C3B1C8EA88256BF1007DFF23/$file/0056401.pdf?openelement">OPINION/ORDER</A><BR> He was a 75 year old retired bus driver. Appellee Lucy Diane Hofler is his widow. These defendants have appealed and will be collectively referred to as Aetna. This second group of defendants is not party to this appeal. 1 HOFLER v. The regulations implementing M+C contain two preemption provisions: (1) a general preemption provision providing that inconsistent state laws are preempted. Providers are paid a fixed amount per month for each enrolled patient regardless of how much care the patient receives. 42 C.F.R. § 422.208(a). In return the plan is to provide the patients all necessary covered care. Congress and the Heath Care Financing Agency have authorized use of capitated payment. 42 C.F.R. § 422.208. 9628 HOFLER v. Hofler's doctors: (1) left untreated for seven years an unstable aortic aneurysm2 which grew to nearly twice the size at which surgical intervention was appropriate. Which is an indication of prostate cancer. His doctor told him that although he was entitled to a second opinion. The clinic was unlikely to pay for it. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="763"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/01/013677P.pdf">OPINION/ORDER</A><BR> The two remaining judges on the panel have decided the case. 1 HANSEN. The company publicly disclosed that it was the subject of an investigation by the federal government relating to its compliance with the Medicare program. Beverly announced that the civil investigation had been expanded to a criminal investigation by a grand jury in San Francisco and that two former employees were identified as the targets of the investigation. The resulting Medicare reimbursement for nursing time spent on Medicare patients was artificially inflated. Its statement of compliance with Medicare laws was false and misleading. 3 Count II of the second amended complaint asserts that the individual defendants are liable as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="763"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/02/02-30533.0.wpd.pdf">OPINION/ORDER</A><BR> The Court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. We decline to consider the issues raised by the defendants in their letter submitted under Rule 28(j) that were neither raised in the district court or argued in their initial brief. 2 1 I. John and Martha Herring were charged and convicted of violating 18 U.S.C. §§ 371 (conspiracy). Martha Herring was charged and convicted of two additional counts of bankruptcy fraud in violation of 18 U.S.C. §§ 157(1) and (2). Were also charged with conspiracy. HCC served as the Agencies' home office and was owned by and employed the Herrings. A cost report was prepared by each Agency and submitted to Medicare. All costs associated with running the Agencies are included on the reports. Medicare reimburses only those costs that are reasonable. Certain employee appreciation expenditures are costs allowed by Medicare. The cost reports are used to derive pay rates for different care services. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200013536.OPN.pdf">OPINION/ORDER</A><BR> Sitting by designation. * ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov2001/00-13536.opn.html">UNITED STATES V. RENICK (11/20/2001, NO. 00-13536)<BR></A><BR> Renick ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/02/01/992356P.pdf">OPINION/ORDER</A><BR> The defendant hospitals are Unity Hospital. Also named as defendants are hospital employees John Murphy and Allina Health System Corp. Which is an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//nov2001/00-13536.opn.html">UNITED STATES V. RENICK (11/20/2001, NO. 00-13536)<BR></A><BR> Renick ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2003/10/02-6142.htm">02-6142 -- BARTLETT MEMORIAL MEDICAL CENTER V. THOMPSON -- 10/20/2003<BR></A><BR> This litigation was successful. The Plaintiff Hospitals in this case sought to have cost reports from the early 1990s reopened and adjusted to reflect the new interpretation. Their requests were denied because of Ruling 97 2's instruction that reports could not be reopened with respect to the DSH reimbursement. The Secretary argues there is no other jurisdictional basis to hear these claims. Primarily contending that the district court should also have found federal question jurisdiction. <p> Because we find that the Secretary did not owe any clear. We REVERSE the district court's grant of summary judgment to Plaintiffs and its denial of summary judgment to the Secretary because we determine that Plaintiffs cannot prevail as a matter of law on any of their claims.<strong></strong> <ol> <li><strong>BACKGROUND</strong></li> </ol> <p> Plaintiffs are or operate Oklahoma for profit. Is the agency of HHS responsible for administering the Medicare program. <p> Some of the hospital services provided by Plaintiffs are covered by Medicare. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="757"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200302/01-5295a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/90ED0685C5E977DC88256EF5007FDC99/$file/0217278.pdf?openelement">OPINION/ORDER</A><BR> The resulting </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar99/96-5105.man.html">VENCOR HOSPITALS V. BLUE CROSS BLUE SHIELD OF R.I. (3/8/1999, NO. 96-5105)<BR></A><BR> Because we are uncertain exactly which documents comprise the contract. Are not renewed each benefit period). He is not eligible for Medicare hospitalization benefits until the beginning of a new benefit period.</P> <P> In response to this and other limits on Medicare coverage. Butler and Esposito were both admitted to Vencor Hospital in Ft. Was paid for by BCBS under the Medigap policy). Vencor's costs during this period were reimbursed by Medicare. Were therefore greatly in excess of the amount Vencor had previously been receiving as cost reimbursement from Medicare.</P> <P> After Butler and Esposito finished their hospital stays. Butler's and Esposito's Medigap policy provided for coverage as follows: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/98opinions/98-5254a.html">COUNTY OF LOS ANGELES V. SHALALA DONNA<BR></A><BR> With </P> <P>him on the briefs were Frank W. With him on the briefs were David H. The more they were </P> <P>reimbursed. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200704/06-5295a.pdf">OPINION/ORDER</A><BR> With her on the briefs were Peter D. With him on the brief were Vicki Gottlich and Patricia B. Michael Schuster were on the brief for amicus curiae American Association of Retired Persons in support of appellees. The plaintiffs have over the course of the litigation invoked two statutory bases for relief. About 20% have opted to have the Social Security Administration ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar99/96-5105.man.html">VENCOR HOSPITALS V. BLUE CROSS BLUE SHIELD OF R.I. (3/8/1999, NO. 96-5105)<BR></A><BR> Because we are uncertain exactly which documents comprise the contract. Are not renewed each benefit period). He is not eligible for Medicare hospitalization benefits until the beginning of a new benefit period.</P> <P> In response to this and other limits on Medicare coverage. Butler and Esposito were both admitted to Vencor Hospital in Ft. Was paid for by BCBS under the Medigap policy). Vencor's costs during this period were reimbursed by Medicare. Were therefore greatly in excess of the amount Vencor had previously been receiving as cost reimbursement from Medicare.</P> <P> After Butler and Esposito finished their hospital stays. Butler's and Esposito's Medigap policy provided for coverage as follows: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="750"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-2064.01A">OPINION/ORDER</A><BR> McGovern's sentence was enhanced for obstruction of justice. We reject this argument on the grounds that the Medicare and Medicaid audits had an adequate link to the ensuing criminal proceedings and so were during the course of the investigation of the offense of conviction.</SPAN></P> <P ALIGN= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="744"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199910/98-5254a.txt">OPINION/ORDER</A><BR> With him on the briefs were Frank W. With him on the briefs were David H. The more they were reimbursed. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="744"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/July2002/012555p.pdf">OPINION/ORDER</A><BR> Which is located in New Brunswick. There is a procedure under Medicare for reclassification of a hospital into an adjacent metropolitan statistical area (MSA) so that the hospital can use that MSA's higher reimbursement rate. One of those criteria is that the average hourly wage of the hospital seeking reclassification must be 84% of that of the hospitals in the area to which it seeks reclassification. It sought to have the average 2 hourly wage of the New York City hospitals reduced by interpreting a statutory provision to require inclusion of the average hourly wage of the hospitals located in Orange County. It was unsuccessful in this attempt. As will soon be seen. The statutory issues presented by this appeal are much more complex than suggested by this simplified introduction. B. Provider Payment System Most health care providers which have entered into provider agreements with the Secretary. Are reimbursed through the Prospective Payment System (PPS). The payment rates for the upcoming federal fiscal year (FFY) for each DRG are published in the Federal Register. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="744"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Jan2002/005172.txt">OPINION/ORDER</A><BR> This is an appeal by defendant Robert U. Syme was convicted on several counts of wire fraud. Syme's corporate co defendants were convicted on all counts and are not involved in this appeal. When the claim should have been billed at the (lower) Delaware or Maryland rates. (2) falsely representing that ambulance transport was medically necessary. (4) providing false information about the type of treatment that the patient being transported was going to receive. The principal challenge is that the indictment alleged and the District Court instructed the jury on a theory of fraud that is invalid as a matter of law. Syme 2 contends that the government's theory that he committed fraud by misrepresenting that Pennsylvania was the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="744"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/04/97-4047.htm">97-4047 -- ST. MARK'S CHARITIES LIQUIDATING TRUST V. SHALALA -- 04/14/1998<BR></A><BR> The hospital was sold on December 31. 284 was allocated to the building and fixed equipment. The historical cost of these assets was $15. Our review of the Secretary's underlying decision is governed by 42 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="737"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/sept2001/00-14134.opn.html">UNITED STATES V. LISS (9/21/2001, NO. 00-14134)<BR></A><BR> Was a Florida laboratory that conducted blood and urine testing. The TRO agreements purportedly allowed the doctors to authorize lab work for an individual if his or her own doctor was not available to do so. The TRO agreements served to disguise the kickbacks that were given in return for the patient referrals.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="737"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//sept2001/00-14134.opn.html">UNITED STATES V. LISS (9/21/2001, NO. 00-14134)<BR></A><BR> Was a Florida laboratory that conducted blood and urine testing. The TRO agreements purportedly allowed the doctors to authorize lab work for an individual if his or her own doctor was not available to do so. The TRO agreements served to disguise the kickbacks that were given in return for the patient referrals.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="737"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200014134.OPN.pdf">OPINION/ORDER</A><BR> Was a Florida laboratory that conducted blood and urine testing. The TRO agreements purportedly allowed the doctors to authorize lab work for an individual if his or her own doctor was not available to do so. The TRO agreements served to disguise the kickbacks that were given in return for the patient referrals. Medicare reimbursed CCL 1 Liss and Spuza are medical doctors. 2 $183. The government concedes that all of those referrals were made for legitimate medical reasons. It is undisputed that those referrals were made for legitimate medical reasons. The PSI combined all counts into a single group because the offense level was to be determined by the total amount of harm or loss. Which is the guideline for fraud or deceit. Restitution was set in the amount of $55. It was not convinced that Liss had obstructed justice. Alleging that he was entitled to a downward departure on the grounds of (1) physical health. The enhancement was unwarranted. He argued that those payments were legitimate and that he had received no funds from CCL for the equipment sublease because CCL paid the bank directly. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="728"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/4191A0541D6B3B1388256E5A00707C2D/$file/9957009.pdf?openelement">OPINION/ORDER</A><BR> Thompson is substituted for his predecessor. Circuit Judge: We are again confronted1 with the failure of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="728"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug97/97-2229.opa.html">AM. ACADEMY OF DERMATOLOGY V. DEP'T OF HEALTH & HUMAN SERVS.<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Am. These programs are administered by the United States Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="728"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/713E472C8ADA430088256AA1005C2341/$file/9957009.pdf?openelement">OPINION/ORDER</A><BR> Thompson is substituted for his predecessor. Circuit Judge: We are again confronted1 with the failure of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="728"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug97/97-2229.opa.html">AM. ACADEMY OF DERMATOLOGY V. DEP'T OF HEALTH & HUMAN SERVS.<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Am. These programs are administered by the United States Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="722"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//apr98/96-8594.man.html">UNITED STATES V. MILLS (4/10/1998, NO. 96-8594)<BR></A><BR> Facts</CENTER> </P> <P> The Millses were officers and majority shareholders of a Medicare services provider. A reasonable jury could have found the following facts true based on the evidence. Some detail is necessary because of the harmless error and sufficiency of the evidence issues that are presented.</P> <P><CENTER>A. <EM>Background</EM></CENTER> </P> <P> The Medicare home health care system has three players. Are entitled only to return of their costs in exchange for their services. Aetna Life Insurance Company was First American's intermediary during most of the time period relevant here.</P> <P> Providers generally receive biweekly payments in an amount based on quarterly figures of how many patients the provider has visited and how much each visit cost. This true up for years as far back as 1990 was incomplete at the time of trial.</P> <P> Jack brought a businessman's outlook to this cost based system. Believing that Aetna was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="722"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/002520.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. (2) Bondy's retaliation claim was barred by res judicata in that Bondy previously sued Group Health Association unsuccessfully in connection with the same termination of employment. The assets of Group Health Association were transferred through various transactions to Consumer Health Foundation. Nor ha[d] he identified what those claims are. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="722"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-4288.wpd">OPINION/ORDER</A><BR> Defendant was charged in a second superceding indictment with five counts of knowingly aiding and abetting the (1) After examining the briefs and appellate record. The case is therefore ordered submitted without oral argument. This Order and Judgment is not binding precedent. Defendant was charged with directing the clinic's billing clerks to submit five Medicare claims representing that Defendant performed medical services </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="722"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/apr98/96-8594.man.html">UNITED STATES V. MILLS (4/10/1998, NO. 96-8594)<BR></A><BR> Facts</CENTER> </P> <P> The Millses were officers and majority shareholders of a Medicare services provider. A reasonable jury could have found the following facts true based on the evidence. Some detail is necessary because of the harmless error and sufficiency of the evidence issues that are presented.</P> <P><CENTER>A. <EM>Background</EM></CENTER> </P> <P> The Medicare home health care system has three players. Are entitled only to return of their costs in exchange for their services. Aetna Life Insurance Company was First American's intermediary during most of the time period relevant here.</P> <P> Providers generally receive biweekly payments in an amount based on quarterly figures of how many patients the provider has visited and how much each visit cost. This true up for years as far back as 1990 was incomplete at the time of trial.</P> <P> Jack brought a businessman's outlook to this cost based system. Believing that Aetna was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="713"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200516935.pdf">OPINION/ORDER</A><BR> Sitting by designation. * Appellant Gulfcoast Medical Supply (Gulfcoast) is a Florida based supplier of durable medical equipment (DME). A DME supplier unequivocally establishes that such equipment is medically </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="713"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/024078.P.pdf">OPINION/ORDER</A><BR> Miller argued that the proper measure of loss for sentencing purposes was the difference between the amount he actually received from Medicare and Medicaid and the amount to which he was legitimately entitled for the services he rendered. The offense level based on the estimated loss should therefore have been increased by four levels. The Government conceded that some of Miller's objections to the PSR were reasonable and that the defense expert's loss estimate was based on better data than the PSR. The Government argued that the proper formula for calculating loss was the difference between the amount Miller billed (rather than the amount he actually received) and the amount to which he was legitimately entitled. Most generous estimate of the amount of money to which he was entitled. The court held that the total loss amount was between $73. The Guidelines limit intended loss to the amount of loss that was likely. The loss calculated by the district court was not likely. The district court held that the amount of loss was the total amount claimed on the false vouchers. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="713"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/A1F54949BF4B57E18825707A004E0DEA/$file/0474204.pdf?openelement">OPINION/ORDER</A><BR> Leavitt is substituted for his predecessor. The Administrator rejected the proposed amendment on two alternative grounds: (1) that it was inconsistent with the statutory requirement of efficiency. We conclude that the Administrator's interpretations of the statute and regulation were permissible and deny the petition for review. 13030 ALASKA DEP'T OF HEALTH v. A. BACKGROUND Statutory Framework Medicaid is a cooperative federal state program through which the federal government reimburses states for certain medical expenses incurred on behalf of needy persons. Participation by states is voluntary. Have approved. Was 57.58%. The state is responsible for the balance. The tribal facilities at issue in this case are unique. See 42 U.S.C. § 1396d(b).1 There are seven such facilities one in Anchorage and six in rural areas. Care and services available under the plan . . . as may be necessary to safeguard against unnecessary utilization of such care and services and to assure that payments are consistent with efficiency. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="713"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar99/96-3587.man.html">UNITED STATES V. FISCHER (3/4/1999, NO. 96-3587)<BR></A><BR> QMC's accounts receivable already were pledged to another QMC creditor. Even if it were. Questions were raised about WVHA's authority to loan money to QMC. Was authorized to invest its excess funds in only instruments backed by the federal government.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="713"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar99/96-3587.man.html">UNITED STATES V. FISCHER (3/4/1999, NO. 96-3587)<BR></A><BR> QMC's accounts receivable already were pledged to another QMC creditor. Even if it were. Questions were raised about WVHA's authority to loan money to QMC. Was authorized to invest its excess funds in only instruments backed by the federal government.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200306/01-5294a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/oct96/95-8171.opa.html">UNITED STATES V. CALHOON<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>United States v. Calhoon was charged in a 14 count indictment with violation of 18 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/99a0434p-06.pdf">OPINION/ORDER</A><BR> The billing standards by which they routinely measured the amount of their claims were consistent with the rules and regulations of the Department of Health and Human Services. After several years in which the hospitals' billing standards are said to have been tacitly approved by the Secretary. Through trade associations of which they are members. She contended that ­ she is not subject to suit for her alleged misuse of the False Claims Act because. Discretion to sue under the Act is vested solely in the Attorney General. Jurisdiction to grant declaratory relief as to the propriety of the billing standards is barred by an express statutory preclusion of federal question jurisdiction over any claim arising under the Medicare Act. We conclude that the court was right to accept the first contention but wrong to accept the second. The dismissal order will therefore be vacated and the case will be remanded for further proceedings. 4 Ohio Hospital Assoc. This recital is unchallenged on appeal. The salient facts are these. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/98opinions/98-5108.html">NEW YORK LIFE INSURANCE V. USA<BR></A><BR> With him on the brief were <U>Michael W. Of counsel on the brief was <U>John B. With him on the brief was <U>David M. Based upon its conclusion that Medicare was a secondary payer and that New York Life was responsible as the primary payer. Paid for services without regard to whether they were also covered by an employer group health plan. These amendments are known as the ". They are codified at 42 U.S.C. § 1395y. It is the ". It is the ". 73 (5th Cir. 1993). </P> <P ALIGN= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/991905.P.pdf">OPINION/ORDER</A><BR> Who are radiation oncology service providers. The United States had suspended the administrative process pending judicial determination in this case of whether the oncology service providers defrauded HCFA and whether they are entitled to reimbursement. The United States alleges that the defendants claimed reimbursement on bills for radiation oncology services that were neither provided nor ordered by the physician and on bills for unnecessary radiation oncology services. That the defendants misrepresented the medical services rendered in order to obtain both higher and double reimbursements for services. 7 Before this action was commenced. Took the position that the administrative process should be suspended until judgment was reached in this action because the administrative forum was neither intended nor sufficient to deal with cases of Medicare fraud. A step that is a condition precedent to the providers' right to challenge HCFA's position through the administrative process. The United States also took this position before the district court ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//oct96/95-8171.opa.html">UNITED STATES V. CALHOON<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>United States v. Calhoon was charged in a 14 count indictment with violation of 18 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19958171.OPA.pdf">OPINION/ORDER</A><BR> Calhoon was charged in a 14 count indictment with violation of 18 U.S.C. § 1001 (false statements) and 18 U.S.C. § 1341 (mail fraud). We have jurisdiction under 28 U.S.C. § 1291 and 18 U.S.C. § 3741(a) and affirm. Georgia and composed of both was medical/surgical psychiatric hospitals. To audit cost reports to determine the amount of reimbursement to which the provider of Medicare insured services is entitled. Some costs included in a cost report are clearly identifiable as either reimbursable or nonreimbursable. Other costs are subject to dispute. hospital to preserve its right to In order for the provider challenge any potential disallowance of an item of cost or part thereof. The This is referred to as filing </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-7.gif" ALT="704"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=99-1133.01A">OPINION/ORDER</A><BR> Was on brief. Weitzel and Ropes & Gray were on brief. I. BACKGROUND If social programs are meant to furnish a safety net. Medicare is a notoriously porous one. A main cause of this porosity is that most outpatient prescription drugs are not covered. Participation in the Program is conditioned on providers offering basic Medicare benefits. The BBA includes the following provisions discussing the Program's preemptive effect: (b) Establishment of other standards . . . (3) Relation to state laws (A) In general The standards established under this subsection shall supersede any State law or regulation (including standards described in subparagraph (B)) with respect to Medicare + Choice plans which are offered by Medicare + Choice organizations under this part to the extent such law or regulation is inconsistent with such standards. (B) Standards specifically superseded State standards relating to the following are superseded under this paragraph: (i) Benefit requirements. (ii) Requirements relating to inclusion or treatment of providers. (iii) Coverage determinations (including related appeals and grievance processes). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="696"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Mar2000/971412.txt">OPINION/ORDER</A><BR> Circuit Judge: We have granted en banc review to resolve a conflict in our court's jurisprudence that has surfaced following the publication of United States v. We granted the government's petition for rehearing and vacated the panel decision.2 We will now affirm the convictions entered against defendants Universal Rehabilitation Services (PA). Inc. ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="696"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/07/041372P.pdf">OPINION/ORDER</A><BR> (PTS) and two of its employees were convicted by a jury for filing false Medicare and Medicaid claims. PTS is an Arkansas company owned by Donald Wise that provides ambulance transport services. Is a licensed paramedic who worked as the general manager of PTS. In that capacity Kevin Wise was in charge of all personnel and oversaw billing procedures. Shirley Wallace is the cousin of these two brothers. She was the office manager and supervised the billing clerks who filed claims with Medicare and Medicaid. In advance of each transport Wallace prepared a transfer form which stated that the patient was confined to bed and could only be moved by stretcher to and from the hospital. The transfer form was given to the paramedics operating the ambulance. After the patients were transported. PTS was The government investigated PTS and uncovered evidence that these patients had not been confined to bed. Medical personnel from the treatment centers testified that each of these twelve patients could have been transported to and from the centers by other means without endangering their health. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="696"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-1186.pdf">OPINION/ORDER</A><BR> Of counsel on the brief was Thomas J. With him on the brief were Jeffrey J. With him on the brief was Lara E. With her on the brief was Bruce Vignery. Of counsel on the brief was Michael Schuster. With him on the brief was Roy H. With him on the brief were William E. Inc. ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="687"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/April2004/024328np.pdf">OPINION/ORDER</A><BR> This is a cross appeal from an order of summary judgment approving the termination of plaintiff's health care benefits. We will vacate and remand to the District Court for further development of plaintiff's equitable estoppel claim. Was employed as a dentist by KidsPeace Corporation. Post developed severe joint problems and was ultimately diagnosed with irreversible arthritis. The KidsPeace Health Care Plan provides that termination is one of the five enumerated ways an employee. The Plan provides: Coverage under this Plan for you and your covered dependents will terminate on the earliest of the following dates: 1. The last day of the month in which an employee is terminated. 2 2. 3. 4. 5. Except if an employee is not working because of an approved leave of absence. Coverage will be continued during that time until discontinued by the Employer. (emphasis added). Employment with KidsPeace will be terminated. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="687"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199712/96-5215a.txt">OPINION/ORDER</A><BR> Were on the brief. It has entered into Medicare provider agreements with the Secretary of Health and Human Services and its hospitals thus are qualified to receive Part A reimbursement for the inpatient health care services they provide to covered beneficiaries. Appalachian is reimbursed under the Prospective Payment System (PPS) created by section 601 of the Social Security Amendments of 1983. Although a detailed explanation of this rather complex system is not required here. Reimbursement depends on the DRG to which a patient is assigned and the average cost of treating such a diagnosis. Is reimbursed the same amount for each similarly classified patient discharge. Even if the actual cost of caring for patients in that DRG varies.1 Until PPS was enacted. Providers were reimbursed under a cost based system. Whichever was lower. Appellant's annual reimbursement is calculated based on the annual cost report it must submit to its so called </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="687"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/C13272C1707802B788256D800051CE88/$file/0216778.pdf?openelement">OPINION/ORDER</A><BR> Is GRANTED. 11096 UNITED STATES v. Is hereby withdrawn and replaced with the following opinion. 2003 are denied as moot. Concluding that it was not grossly disproportional to the gravity of Mackby's offense. Who is neither a physician nor a physical therapist. Medicare Part B is a voluntary insurance program that pays a portion of the costs of some services not covered by Part A. 42 U.S.C. § 1395k. The clinic was subject to the cap applicable to a PTIP. Because the government was led to believe that Dr. Mackby was supervising physical therapy. Did not provide or direct any medical services at the clinic and did not know his son was using his PIN. Mackby himself is a layperson and did not provide physical therapy or other medical services to patients. A physical therapist in independent practice was defined as one who engaged in the practice of physical therapy on a regular basis without the administrative and professional control of an employer. We further held that both the treble damages and the civil monetary penalty provided for in the FCA are. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="687"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200311392.pdf">OPINION/ORDER</A><BR> I. Plaintiffs are ambulance suppliers based in Georgia. Holding that the mandamus jurisdiction invoked by plaintiffs under 23 U.S.C. § 1361 is both available and appropriate in this case. Certifying a class of ambulance providers.2 The threshold issue we must decide is whether the district court correctly assumed mandamus jurisdiction over this action. R.E. 32 34. 4 2 Mandamus jurisdiction is appropriate3 only where (1) the defendant owes a clear nondiscretionary duty to the plaintiff and (2) the plaintiff has exhausted all other avenues of relief. Plaintiffs cannot invoke the extraordinary remedy of mandamus because they have an alternative </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="678"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTE1MzktY3Zfb3BuLnBkZg==/05-1539-cv_opn.pdf">OPINION/ORDER</A><BR> The judgment of the district court is AFFIRMED in part and MODIFIED in part. Leavitt is. The New York City MSA was slightly expanded and now includes certain additional hospitals in northern New Jersey. Because the New Jersey hospitals' wages are somewhat lower. Plaintiffs allege they will receive $812 million less in reimbursements over the next ten years than they would have under their former wage adjustment. Plaintiffs argue both that the use of MSAs as proxies for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="678"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/02/02-4222.PDF">OPINION/ORDER</A><BR> Were indicted on charges of Medicaid and Medicare fraud. The alleged fraud involved billing for services that were not provided (ghost billing). Overstating what services were provided (upcoding). After one of the mail fraud counts was dismissed. A new trial was ordered for all but these two counts. Mitrione was sentenced to a term of 23 months and DeVore to 15 months. Restitution for each was set at $11. We will mention only those that have arguable merit. Are presented in the light most favorable to the verdict. Who was his assistant at the time. CPTs are listed in a book of codes used for medical billing which is published by the American Medical Association. The handbook for physicians provided: The provision of psychiatric services is limited . . . and must be personally provided by the physician who submits charges. Etc. are not reimbursable. Is a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="678"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/07/00-6344.htm">00-6344 -- U.S. V. KLUDING -- 07/03/2001<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Defendant Christopher Kluding appeals his convictions and sentence for Medicare fraud and conspiracy to commit Medicare fraud. Christopher Kluding was terminated from Monarch. <p> During the year of 1995. Defendant Christopher Kluding was convicted on the conspiracy and Medicare fraud charges. Was acquitted of causing a false statement to be submitted to Medicare. He was sentenced to thirty one months' incarceration. Was ordered to pay $532. Defendant appeals his convictions and sentence. <p> Defendant argues first that the evidence was insufficient to support his conviction for conspiracy and Medicare fraud. To determine whether any rational trier of fact could have found the elements of the crime proven beyond a reasonable doubt. There was more than enough evidence to support the jury's verdicts. <p> Providers of home health care for Medicare patients are carefully regulated. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="678"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/03/03-1086.PDF">OPINION/ORDER</A><BR> The proponents of this view argue that the federal courts are overburdened. We have little doubt that this case would have been better brought in an Indiana state court. It was the appellee that chose to file its complaint in federal court and it was that complaint which sought novel remedies. Although we are not fans of delay. It is with limited sympathy that ultimately we must certify several of the questions raised in this appeal to the Indiana Supreme Court. DFS purchased </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="678"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/00a0067p-06.pdf">OPINION/ORDER</A><BR> Francis's HB SNF is relevant for purposes of this appeal. Francis's HB SNF is to rehabilitate. A patient's total costs are less than they would be at other facilities. Closer analysis reveals that the PRM rule is not analogous to the two tier system. An HB SNF that spends $100 to provide routine services and anywhere from $1 to $20 on atypical services will receive no reimbursement at all for its atypical service costs. These expenditures are arbitrarily deemed to be 100% inefficient or. Are subjected to a 100% </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/2DC2AF1C268A46E388256D95005CC9AD/$file/0215057.pdf?openelement">OPINION/ORDER</A><BR> The district court held that these amendments were not an establishment of religion. The cross referenced section x(ss)(1) reads in relevant part as follows: Religious nonmedical health care institution (1) The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/sept2002/00-14144.opn.html">UNITED STATES V. EDGAR (9/12/2002, NO. 00-14144)<BR></A><BR> We have carefully considered these various arguments and have concluded that the district court did not commit reversible error in this case. Edgar argues that 18 U.S.C. § 666 is facially unconstitutional because Congress lacks the power to enact criminal laws under the Spending Clause of the Constitution.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug95/94-2683.opa.html">SARASOTA MEMORIAL HOSP. V. SHALALA<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Sarasota Memorial Hosp. v. Appeal from the district court's grant of summary judgment in favor of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/94opinions/94-5356a.html">SOFAMOR DANEK GRP V. GAUS CLIFTON R.<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=97-1014.01A">OPINION/ORDER</A><BR> Rosenthal P.C. were on brief for appellant. Were on brief for appellee. Participating hospitals which retain ownership of the capital assets used to provide services to their Medicare recipients are entitled to periodic reimbursement for estimated actual depreciation on those assets. A hospital which has closed would be eligible for further depreciation reimburse ments from HHS on a Medicare related capital asset which was sold within one year after its closure for less than its depreciated basis. HHS regulations allowed hospitals forty five days after their withdrawal from the Medicare program to submit a The HHS depreciation methodology is similar to that utilized for federal tax purposes. Since HHS already would have reimbursed the hospital $40. Were the asset to sell for only $500. The HHS regulations likewise allow hospitals a three year period within which to reopen and amend a final cost report which was timely filed. The Trustee obtained two extensions of the forty five day filing deadline from the bankruptcy court and the Hospital's final cost report was submitted to HHS within the extended deadline. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//sept2002/00-14144.opn.html">UNITED STATES V. EDGAR (9/12/2002, NO. 00-14144)<BR></A><BR> We have carefully considered these various arguments and have concluded that the district court did not commit reversible error in this case. Edgar argues that 18 U.S.C. § 666 is facially unconstitutional because Congress lacks the power to enact criminal laws under the Spending Clause of the Constitution.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6662FBE72165A60E88256E3100792791/$file/0215057.pdf?openelement">OPINION/ORDER</A><BR> 2003 is amended as follows: Insert at Slip. Judges McKeown and Rawlinson have voted to deny the petition for rehearing en banc and Judge KONG v. The petition for rehearing is DENIED and the petition for rehearing en banc is DENIED. 2004 in which to file a reply brief is GRANTED. The district court held that these amendments were not an establishment of religion. SCULLY 1739 (1) The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="670"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug95/94-2683.opa.html">SARASOTA MEMORIAL HOSP. V. SHALALA<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Sarasota Memorial Hosp. v. Appeal from the district court's grant of summary judgment in favor of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="659"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-1901.01A">OPINION/ORDER</A><BR> Murphy</SPAN> was on the brief for appellant.<SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="659"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=04-2839_011.pdf">OPINION/ORDER</A><BR> Some background concerning that program is necessary in order to understand the context of this appeal. The Medicare program is a federallysubsidized health insurance program primarily for elderly and disabled individuals. Which is a hospital insurance program that covered payments for the costs of inpatient hospital services. Much of the administration of Part A is handled by private contractors. The costs of educational activities and of inpatient hospital services were reimbursed by Medicare based upon a provider's reasonable costs. Whereby hospitals were paid a standardized rate based on the diagnostic classification for the services rendered. Costs incurred in connection with graduate medical education ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="659"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/05-5102.pdf">OPINION/ORDER</A><BR> On the brief were Peter D. Of counsel on the brief was Clifford Pierce. Which was an approved provider of services under the Medicare Act. While the appeal was pending. Or obligations that the parties may have with respect to any other issues or cost reporting periods. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="659"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/062287p.pdf">OPINION/ORDER</A><BR> We will affirm. A professional service corporation that is effectively controlled by HUMC. Which is a private practice of infectious disease physicians. The CID and HUMC are separate entities. Sperber provided at the HUMC Clinic were covered under a grant. Collins signed certifications that included the following: I certify that none of the above service units have been previously submitted and paid. All of the billable units are in compliance with the authorized budget and contracted for scope of service. All services below have been provided and/or delivered as specified. One of the conditions of the Grant was that it could not be used to replace existing financial support. HUMC understood this provision to mean that it was entitled to reimbursement by the Grant for services that were payable by Medicare. This was an incorrect interpretation. This was caused by a breakdown in HUMC's billing system. Billing information was generated by physicians and then sent to the physician billing department. Flynn explained that for claims that were reimbursable by the Grant. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/033695p.pdf">OPINION/ORDER</A><BR> We will reverse the judgment of the District Court. Which is at issue in this appeal. The Premier Participants were rewarded if they purchased Zimmer's products in sufficient numbers to increase Zimmer's market share. Among these rewards was a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200008/99-5166a.txt">OPINION/ORDER</A><BR> With her on the brief were David W. With him on the brief was Tamara V. Long term care hospitals are one such category. Citing regulations that require new hospitals to have six months of experience before they can qualify as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/08/062115P.pdf">OPINION/ORDER</A><BR> Horras is the founder. Christine Richards is Hawkeye's former Director of Finance. Its headquarters were Horras's basement. There were more than 500 employees and seven branch offices across Iowa (in addition to Knoxville home office). Her supervisor was a Director of Finance who left in July 1993. The IG alleged that Horras </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/99opinions/99-5166a.html">TRANSITIONAL HOSPITALS CORPORATION OF LOUISIANA V. DONNA E. SHALALA<BR></A><BR> With her on the brief were </p> <p>David W. With him </p> <p>on the brief was Tamara V. Long term </p> <p>care hospitals are one such category. Citing regulations that require new hospitals to </p> <p>have six months of experience before they can qualify as </p> <p>". The Secretary of </p> <p>HHS took the position that an initial data collection period is </p> <p>statutorily required. We remand the case to permit her to determine </p> <p>whether she wishes to retain the existing regulations knowing </p> <p>that other options are permissible.</p> <p>I</p> <p>Medicare is a federal health insurance program for the </p> <p>aged and disabled that is administered by the Health Care </p> <p>Financing Administration (HCFA) of HHS. Institutional health </p> <p>care providers are reimbursed for their services to eligible </p> <p>patients. Hospitals are reimbursed according to flat rates estab </p> <p>lished in advance for the various categories of patient diag </p> <p>noses (known as ". For the care of patients whose hospitaliza </p> <p>tions are extraordinarily costly or lengthy. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0162p-06.pdf">OPINION/ORDER</A><BR> Because we find that the claims in this action were previously disclosed and trigger the public disclosure bar of the False Claims Act. We hold that the district court did not have subject matter jurisdiction and that dismissal was appropriate. I. BACKGROUND Defendant Appellant Medtronic is a medical device manufacturer. Medtronic manufactures four types of heart pacemaker leads which are the subject of this litigation: Models 4004. Stating that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="648"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/07/033905P.pdf">OPINION/ORDER</A><BR> Leavitt has been appointed United States Secretary of Health and Human Services and is substituted as appellee under Federal Rule of Appellate Procedure 43(c). 1 St. DRG Payments and Bundling Medicare is health insurance funded by the federal government for the aged and disabled. The reimbursement rates were set according to historic costs in a given region and applied on a prospective basis to the hospitals during the upcoming fiscal year. These new payments were made according to patients' diagnoses. Treating hospitals would get a payment that was tied to the patient's diagnosis related group (DRG). Posed significant problems to hospitals that had followed a practice of having ancillary providers furnish services and seek reimbursement from Medicare separately because their accounting and billing systems would have to be changed. Which was later included in the U.S. The part B payments to the ancillary providers were not calculated according to the patient's DRG. Those payments were calculated on a reasonable cost basis. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/08/054372P.pdf">OPINION/ORDER</A><BR> All Medicare eligible costs incurred by a provider hospital were reimbursed on a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0185p-06.pdf">OPINION/ORDER</A><BR> The declaration that Citizens is first in priority for the payment of medical expenses incurred as a result The Honorable Dan Aaron Polster. The holding of the district court is reversed. The case is remanded for proceedings consistent with this ruling. I. FACTUAL AND PROCEDURAL HISTORY The facts in this case are undisputed. Jacqueline Bradshaw ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1284.01A">OPINION/ORDER</A><BR> Were on brief. Will &. Emery</SPAN> were on brief. This timely appeal ensued.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=97-2047.01A">OPINION/ORDER</A><BR> Were on brief for appellants. Anne Robbins and Palmer & Dodge LLP were on brief for appellees. Holding that HCFAR 96 1 was a substantive. The court also found that the equipment in dispute was not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/03a0322p-06.pdf">OPINION/ORDER</A><BR> 2 1 the complaint was filed under seal and served upon the United States. Relator's case subsequently was transferred to the Middle District of Tennessee. Claiming that he was entitled to a relator's share of the settlement proceeds. An order to this effect was entered on the same day. The other listed defendants in the original complaint were Forstmann Little & Co. (a privately owned compa ny that wholly owns CHS ). Which is one of several hospitals owned by CHS. CHS was approached by the government about possible upcoding at two different CHS hospitals. OIG HHS simultaneously worked with the Department of Justice ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0143p-06.pdf">OPINION/ORDER</A><BR> Was convicted by a jury of scheming to defraud private health insurance companies and Medicare/Medicaid. Defendant was sentenced to 27 months of imprisonment. Defendant argues: (1) the jury's conviction as to all counts should be reversed because defendant alleges there is insufficient evidence to sustain his conviction. Defendant's Medical Practice Defendant is a physician who owned and operated two clinics in 1997. Defendant became an employee of MAHC and was issued one sixth of the shares of stock in MAHC. The billing for both clinics was done at the McKee clinic. All billing for the six MAHC clinics was performed by an outside billing service. One type of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="637"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0328a-06.pdf">OPINION/ORDER</A><BR> Was convicted by a jury of scheming to defraud private health insurance companies and Medicare/Medicaid. Defendant was sentenced to 27 months of imprisonment. Defendant argues: (1) the jury's conviction as to all counts should be reversed because Defendant alleges there is insufficient evidence to sustain his conviction. Defendant's Medical Practice Defendant is a physician who owned and operated two clinics in 1997. Defendant became an employee of MAHC and was issued one sixth of the shares of stock in MAHC. The billing for both clinics was done at the McKee clinic. All billing for the six MAHC clinics was performed by an outside billing service. One type of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200507/04-5366a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Michael B. With her on the brief were Peter D. The district court rested its decision on the ground that the judgment did not require the remedy Heartland seeks a direction that it is entitled to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/feb2001/99-14192.man.html">UNITED STATES V. REGUEIRO (2/6/2001, NO. 99-14192)<BR></A><BR> Regueiro and Perez established more than 100 nursing groups whose ostensible purpose was to provide home health care services to qualified patients. Regueiro and Perez used the nursing groups to bill Medicare for thousands of services that were never performed. Or that were performed on patients who were not eligible to receive Medicare benefits. Both of them were extensively involved in all aspects of the scheme. Regueiro's total offense level was 28. The district court had notified the parties that it was considering imposing an upward departure on Regueiro because her conduct had significantly disrupted a governmental function. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/00a0166p-06.pdf">OPINION/ORDER</A><BR> Plaintiffs are the United Steelworkers of America union and several retirees formerly employed by defendant. Plaintiffs' complaint was based on their claim that their benefits were vested and could not unilaterally be altered by Joy. Summary judgment was granted to Joy against those plaintiffs retiring after August 19. Plaintiffs' motion for attorneys' fees was denied. The district court is affirmed. Plaintiffs are former Joy employees who were represented by the United Steelworkers of America union ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Apr2002/012846u.pdf">OPINION/ORDER</A><BR> We will affirm. 567 (3d Cir. 1999) (issues of statutory interpretation are reviewed de novo). 983 (3d Cir. 1996) (a district court's interpretation of state law is reviewed de novo). The district court's findings of fact are reviewed for clear error. The MSP is a series of amendments to Social Security Act. The MSP provides that even where a subscriber is eligible for Medicare. A group health plan is the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//feb2001/99-14192.man.html">UNITED STATES V. REGUEIRO (2/6/2001, NO. 99-14192)<BR></A><BR> Regueiro and Perez established more than 100 nursing groups whose ostensible purpose was to provide home health care services to qualified patients. Regueiro and Perez used the nursing groups to bill Medicare for thousands of services that were never performed. Or that were performed on patients who were not eligible to receive Medicare benefits. Both of them were extensively involved in all aspects of the scheme. Regueiro's total offense level was 28. The district court had notified the parties that it was considering imposing an upward departure on Regueiro because her conduct had significantly disrupted a governmental function. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="626"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/00opinions/00-5109a.html">MONMOUTH MEDICAL CENTER V. TOMMY G. THOMPSON<BR></A><BR> Argued the cause for appellee.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6AA2DACB7759D17488256DB7005BBA85/$file/0235158.pdf?openelement">OPINION/ORDER</A><BR> Who was awarded both the overtime wages and an equal amount in liquidated damages. Because this case was decided on summary judgment. We are required. As was the district court. Black was interested in the purchase of Alternative because she sought to obtain certain state issued. Which were otherwise difficult to obtain. Alternative was behind in its taxes. The other problem was that Alternative. Was not yet certified as a Medicare provider. This second complication was remedied when Alternative's Medicare certification became effective on February 22. Alternative alone would have had difficulty passing the survey because Alternative had very few </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/00a0145p-06.pdf">OPINION/ORDER</A><BR> Defendants argue that this court can affirm the district court's opinion on summary judgment grounds or on the grounds that the plaintiffs have failed to state a claim 26 Helwig. When defendants chose to speak they have a duty to provide complete and non misleading information regarding those statements. The effect of the Court's decision seems to be that no statements about the future prospects ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19956781.OPA.pdf">OPINION/ORDER</A><BR> The sole issue in this appeal is the meaning of the word </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/034163p.pdf">OPINION/ORDER</A><BR> Irwin has consistently denied liability for any false Medicare claims and further contends that Paranich is not a proper relator in a qui tam action because the allegations he now asserts had been publicly disclosed before his suit and because he is not an original source as defined by the FCA.1 On Irwin's motion for summary judgment. We will affirm its dismissal because we conclude that Paranich is not a proper relator under the FCA because his allegations were based on public disclosures and he does not qualify as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcU1VNXDA0LTMxMDlfc28ucGRm/04-3109_so.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/01/021244P.pdf">OPINION/ORDER</A><BR> KMS was a licensed Medicare provider of ambulance services and contracted with Arkansas Blue Cross and Blue Shield. The Medicare program would compensate KMS if the transportation of the Medicare beneficiary is medically necessary (i.e. The claims submitted by KMS for transportation of dialysis patients were false because those claims represented that these trips were medically necessary. That thirteen out of the fourteen dialysis patients transported by KMS were not compensable. Murray further testified that Barfoot showed him an anonymous note advising Medicare that KMS was transporting dialysis patients. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/981954.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. Blue Cross/Blue Shield's decision was affirmed and the reimbursement disallowed. I. The facts of the case are not disputed. The CON was an important acquisition because under Maryland law Gundry/Glass could not operate without it. 000 was allocated to the hospital's tangible assets. The remainder of the purchase price was assigned to intangibles such as goodwill. Although no specific value was assigned to the CON. Gundry/Glass's CEO stated that the CON's value had increased because Maryland was no longer issuing new CON's since </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200414458.pdf">OPINION/ORDER</A><BR> Circuit Judge: The question in this interlocutory appeal is whether a violation of the AntiKickback Statute can form the basis for a qui tam action under the False Claims Act. Because it is undisputed that a violator of the Anti Kickback Statute is disqualified from participating in a Medicare program. When it alleged that the Burlesons had submitted claims for Medicare reimbursement with knowledge that they were ineligible for that reimbursement. The government alleged that Medicare providers are required to enter a provider agreement with the government. The Medicare provider certifies that it will comply with all laws and regulations concerning proper practices for Medicare providers. One of the laws included in this certification is the AntiKickback Statute. 42 U.S.C. § 1320a 7b(b). The government alleged that a Medicare </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200705/05-3212b.pdf">OPINION/ORDER</A><BR> Was on the brief for appellant. Jr. were on the brief for appellee. The Government explained that this amount was calculated based on four investigative sources: (1) the false claims filed by Bryson on behalf of the seven patients named in the plea documents. Which revealed information that was inconsistent with Bryson's representations to Medicare. The Government also took pains to ensure that a patient included in multiple components was not double counted. A patient who indicated on a survey that he had received no treatment and who also was not mentioned in any notes in the patient's file was counted only once. The proper figure was $20. This was allegedly an estimate that a prior prosecutor had suggested to Bryson at some earlier date. He clarified that the four component approach initially described by the Government was in fact a three component approach: The first component (fraudulent claims in connection with the seven patients named in the plea documents) was actually just a subset of the fourth component (interviews and surveys of all patients). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="613"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/03a0452p-06.pdf">OPINION/ORDER</A><BR> The district court held that the Secretary's interpretation of the governing statute and regulations was unreasonable and granted summary judgment to ACMC. Which cautions that agency decisions may only be set aside if they are </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="600"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/001409.P.pdf">OPINION/ORDER</A><BR> We are presented with two questions: (1) whether the Hospital is entitled to judicial review and (2) whether. If judicial review is available. We conclude that the Hospital is entitled to judicial review. I. The Hospital is a Medicare provider. (The appeal document was a request for a hearing before the Board. The letter said that preliminary position papers were due by November 1. The failure was due to internal confusion at the Hospital in the wake of a corporate acquisition. Which occurred after the appeal was filed but before the position papers were due. Was initially responsible for handling the appeal. The Board concluded that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="600"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CC9E6FCE60171BBD88256FB80059D3AB/$file/0335612.pdf?openelement">OPINION/ORDER</A><BR> Only expenditures made under an approved state plan are eligible for matching federal payments. States have considerable </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="600"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/98opinions/98-5455a.html">USA V. KRIZEK GEORGE<BR></A><BR> Were on the briefs.</P> <P> Jeffrey Bossert Clark argued the cause for appellees/cross </P> <P>appellants. With him on the briefs was Karen N. Because it was impossible to identify </P> <P>precisely which claims were fraudulent. His wife Blanka functioned as his secretary and was </P> <P>responsible for his billing. Krizek could not have spent the </P> <P>requisite time providing services.... </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-6.gif" ALT="600"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=93-1832.01A">OPINION/ORDER</A><BR> With whom Chapman & Chapman was on brief. Was on brief. Appellant was the president and sole shareholder of O'Brien Ambulance. Or thing of value of the United States or of any department or agency thereof </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="585"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/96/08/952820P.pdf">OPINION/ORDER</A><BR> That is. The government's key witnesses were two former administrators of Dr. Jain was then a North Hills Hospital ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="585"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200510/04-5276a.pdf">OPINION/ORDER</A><BR> O:\Slip\WP\2005\04 5276 Palisades5a.odl.wpd
585 OPINION/ORDER
With him on the brief were David W. Attorney at the time the brief was filed. Circuit Judge: Plaintiff appellants Monmouth Medical Center and Staten Island University Hospital are acute care facilities that receive payments under Medicare Part A for services to Medicare beneficiaries. Are eligible for
585 OPINION/ORDER
With him on the briefs were Roscoe C. With him on the briefs was Margaret S. With him on the briefs were John Townsend Rich. Including with respect to coal operators who were not parties in the Eleventh Circuit litigation. Appellant Commissioner contends that the agency's nation wide implementation of the revised interpretation of
585 UNITED STATES V. TARKOFF (2/20/2001, NO. 99-13223)

Who was a target of a grand jury investigation of a scheme in which Arnaiz and his business partner. Were not necessary. Tarkoff did not claim that Arnaiz was not guilty of Medicare fraud. Merely argued that the $20 $40 million dollar figure was too high and that Arnaiz caused losses to Medicare of only $6 million (the dollar amount was relevant to sentencing Arnaiz). Testified that Tarkoff acknowledged to her that Arnaiz was involved in Medicare fraud.

585 MICHAEL H. HOLLAND V. NATIONAL MINING ASSN

Argued the cause for federal appellant.
585 OPINION/ORDER
Finding that three of these allegations were
585 NATIONAL COAL ASSOC. V. CHATER

This document was created from RTF source by rtftohtml version 2.7.5 > National Coal Assoc. v. The sole issue in this appeal is the meaning of the word </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="585"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//feb2001/99-13223.man.html">UNITED STATES V. TARKOFF (2/20/2001, NO. 99-13223)<BR></A><BR> Who was a target of a grand jury investigation of a scheme in which Arnaiz and his business partner. Were not necessary. Tarkoff did not claim that Arnaiz was not guilty of Medicare fraud. Merely argued that the $20 $40 million dollar figure was too high and that Arnaiz caused losses to Medicare of only $6 million (the dollar amount was relevant to sentencing Arnaiz). Testified that Tarkoff acknowledged to her that Arnaiz was involved in Medicare fraud.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="585"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/apr96/95-6781.opa.html">NATIONAL COAL ASSOC. V. CHATER<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>National Coal Assoc. v. The sole issue in this appeal is the meaning of the word </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="585"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-1933.01A">OPINION/ORDER</A><BR> P.C.</SPAN> were on brief for appellant.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/012012.P.pdf">OPINION/ORDER</A><BR> BethEnergy Mines is corrected to begin </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Sep2004/Sep21/03-20376-CV0.wpd.pdf">OPINION/ORDER</A><BR> Holding that the suit was barred by the Act's jurisdictional bar (31 U.S.C. § 3730(e)(4)(A)) and. I The University Park Hospital ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199910/98-5455a.txt">OPINION/ORDER</A><BR> Were on the briefs. With him on the briefs was Karen N. Because it was impossible to identify precisely which claims were fraudulent. His wife Blanka functioned as his secretary and was responsible for his billing. Krizek could not have spent the requisite time providing services.... </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/12/00-1405a.htm">00-1405A -- ALLCARE HOME HEALTH, INC. V. SHALALA -- 12/14/2001<BR></A><BR> The motion is granted. <p> The order and judgment filed on December 14. Shall be published. <p> The published opinion is attached to this order. <p> Entered for the Court <p> <hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/00opinions/00-5141a.html">LAKE MEDICAL CENTER V. TOMMY THOMPSON<BR></A><BR> Argued the cause for appellee.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1952.01A">OPINION/ORDER</A><BR> With whom <SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/07/993680P.pdf">OPINION/ORDER</A><BR> Each of the appellants was convicted of one count of conspiracy to commit an offense against the United States. Was president of American. Ruth Ferguson was a regional manager who became the director of operations of American. Cheryl Peterson was a regional manager of American. Frank Martin was an X ray technician who became a regional manager of American. Medicare was to pay a single transportation fee. United States District Judge for the Eastern District of Arkansas. 3 1 were repeatedly instructed that every trip's transportation fee should be prorated among the patients receiving services. The defendants' method of overbilling was quite simple. The information on the forms was used by billing clerk Vicki Lueck and later by American's billing agents to prepare the standard Medicare claim forms sent to BC/BS for payment. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200312838.pdf">OPINION/ORDER</A><BR> Defendant Bracciale was employed by Kraft Foods ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=06-1417_015.pdf">OPINION/ORDER</A><BR> Was convicted by a jury of mail fraud and sentenced to 22 months of imprisonment. Charging Shelia with two counts of mail fraud in violation of 18 U.S.C. § 1341 and one count of obstruction of justice in violation of 18 U.S.C. § 1505.1 The latter charge was later dismissed. The indictment alleged that Shelia and her husband were participants in a scheme to defraud Medicare by submitting fraudulent claims for reimbursement. The government's theory was that the Swans sought reimbursement for compensation allegedly paid to three family members. She also testified that Shelia sent her the checks and told her that the checks were to pay off a loan to Greentree Financial to purchase a mobile home in Benton. The address listed for Starling on the W 2 form was a Chicago address with which Starling was not familiar. Starling testified that she was under financial strain and asked Shelia for a loan. In an 1 Since we will also be referring to the defendant's husband and co defendant. We will refer to both the defendant and her husband by their first names to avoid any confusion. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0239p-06.pdf">OPINION/ORDER</A><BR> Davis asserts that the trial court erred in (1) excluding evidence that oxygen received by certain miners named in the indictment was medically necessary. Davis was instrumental in the founding of the Kentucky Black Lung Association (hereinafter </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="570"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/FE43AF4A2D2DFB9888256DFF00007467/$file/0235912.pdf?openelement">OPINION/ORDER</A><BR> We hold that 42 C.F.R. § 413.30(e) is ambiguous. Because the Secretary's interpretation that Providence is not entitled to a new provider exemption due to its acquisition of pre existing bed rights from Summitview Manor (Summitview) is reasonable. It is therefore entitled to deference. Washington closely monitors geographical planning areas in the state in order to determine which areas are </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/11/001959P.pdf">OPINION/ORDER</A><BR> United States District Judge for the District of Minnesota. 1 reimbursement for charges covering in home physical therapy services in excess of the cost limits created by the Secretary on the grounds that the cost limits were outdated and thus contrary to the Secretary's regulations. Jurisdiction Jurisdiction in the district court was based upon 42 U.S.C. § 1395oo(f)(1). Jurisdiction on appeal is based upon 28 U.S.C. § 1291. The notice of appeal was timely filed pursuant to Fed. 42 C.F.R. § 413.20(b).3 A provider is entitled to recover the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200502/04-5092a.pdf">OPINION/ORDER</A><BR> With him on the briefs was Robert D. With him on the briefs were Peter D. Elizabeth's was not entitled to an exemption from limitations on Medicare reimbursements to a new skilled nursing facility ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=94-1611.01A">OPINION/ORDER</A><BR> Leonard Friedman is appealing the district court's decision dismissing his case for mootness. Friedman's period of exclusion was to end when either Massachusetts or New York reinstated his license. 2 At Friedman's request. Friedman says that HHS is reasonably likely to exclude him again since California revoked his medical license in 1990 and that any future exclusion by HHS would likely evade judicial review because it would lapse before the court could render a decision. Friedman argues that his exclusion has continuing collateral consequences that will 2. Because his motion was filed within the time limit for filing motions under Fed. Challenged the legal correctness of the court's decision that his action was moot. That the dismissal of his action for mootness is properly before us. Other arguments he makes are without merit. Friedman claims that his request for declaratory relief is not moot. It does not seem at all likely that HHS will exclude Friedman on the basis of California's revocation of his medical license. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/09/983141P.pdf">OPINION/ORDER</A><BR> The Secretary argues that under 42 U.S.C. § 1395x(v)(5)(A)3 the Secretary may limit reimbursements to home health agencies for physical therapy services provided by physical therapists who are bona fide employees of the provider but who are paid on a per visit basis. The district court found that the Secretary's interpretation of 42 U.S.C. § 1395x(v)(5)(A) was contrary to the language of the statute and granted In Home's motion to declare unlawful and set aside the Secretary's decision. Reimbursement under the Medicare Act In Home is a provider of services under the Medicare program. Reasonable costs are defined as actual costs less costs that are </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/06/99-3344a.htm">99-3344A -- U.S. V. LAHUE -- 06/18/2001<BR></A><BR> Circuit Judges. <p> <strong><hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=99-1085.01A">OPINION/ORDER</A><BR> Abbott</U> were on brief. Were on brief. <U>Circuit Judge</U></STRONG></FONT><FONT FACE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/03/03-50201.0.wpd.pdf">OPINION/ORDER</A><BR> The Court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. We hold that the effective date determination was supported by substantial evidence and that the DAB applied the appropriate regulations. legal standard under the relevant statutes and We further hold that an evidentiary hearing would We therefore AFFIRM the summary judgment. I have been futile. Which is administered by the Centers for Medicare and Medicaid Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/12/00-1405.htm">00-1405 -- ALLCARE HOME HEALTH, INC. V. SHALALA -- 12/14/2001<BR></A><BR> Inc. is a for profit home health agency that provides home health services to Medicare beneficiaries and others in the greater Denver area. HCFA contracts with private insurance companies known as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199712/96-3172a.txt">OPINION/ORDER</A><BR> Was on brief. Were on brief. She was sentenced to twenty seven months' imprisonment and three years' supervised release and was ordered to pay $100. Claiming that it was improperly enhanced under sections 2F1.1(b)(2)(A) (more than minimal planning) and 3B1.1(c) (aggravating role) of the United States Sentencing Guidelines (Guidelines) and that she was erroneously ordered to pay restitution without regard to her ability to pay.1 We affirm. I. BACKGROUND Bapack was the co owner of Urgent Home Health Care Services. She was responsible for billing Medicaid for the services the Corpora tion provided. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/00opinions/00-7210a.html">OPINION/ORDER</A><BR> DeMarcay III argued the cause for appellant Gene Taylor.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0434n-06.pdf">OPINION/ORDER</A><BR> That the district court erred when it permitted the government to introduce evidence establishing the high profit margin that the Defendant received on selling power wheelchairs because the evidence was either irrelevant to any issue in the case. Was overly prejudicial. Amr was indicted on November 2. Charging for standard accessories which were already included in the wheelchairs. The vast majority of the durable medical equipment that USMS sold were power wheelchairs. Part of this profit USMS earned on each chair it sold was obtained by charging Medicare for more expensive products than that which it actually provided the patient (a fraudulent practice known as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="555"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200312185.pdf">OPINION/ORDER</A><BR> Jose Arias (who was charged in the initial indictment. These recruited </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//july97/94-5112.man.html">UNITED STATES V. DAVIS<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>United States v. Were convicted in a complex Medicare fraud scheme. Valdes was found guilty on Counts 4. 896.73 in restitution.<p> ISSUE<p> <p> The issue is whether the district court committed plain error in ordering appellants Davis. A defendant is liable for the foreseeable acts of co conspirators. While indigence is a consideration. It is. The government contends that the district court was not required to make explicit factual findings on the restitution issue.<p> DISCUSSION<p> <p> In this appeal. The appellants were obligated to preserve this issue for appeal. Effective appellate review is hindered when the asserted error has not been brought to the district court's attention. We will review the restitution orders for plain error. <i>See United States v. This court will not entertain an appeal of a restitution order if the defendant failed to raise an objection to the district court). </i> this court held that a district court may order a defendant to pay restitution for losses </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/06/99-3344.htm">99-3344 -- U.S. V. LAHUE -- 06/18/2001<BR></A><BR> Ronald LaHue were convicted by a jury for violations of the Medicare Antikickback Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/july97/94-5112.man.html">UNITED STATES V. DAVIS<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>United States v. Were convicted in a complex Medicare fraud scheme. Valdes was found guilty on Counts 4. 896.73 in restitution.<p> ISSUE<p> <p> The issue is whether the district court committed plain error in ordering appellants Davis. A defendant is liable for the foreseeable acts of co conspirators. While indigence is a consideration. It is. The government contends that the district court was not required to make explicit factual findings on the restitution issue.<p> DISCUSSION<p> <p> In this appeal. The appellants were obligated to preserve this issue for appeal. Effective appellate review is hindered when the asserted error has not been brought to the district court's attention. We will review the restitution orders for plain error. <i>See United States v. This court will not entertain an appeal of a restitution order if the defendant failed to raise an objection to the district court). </i> this court held that a district court may order a defendant to pay restitution for losses </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0397p-06.pdf">OPINION/ORDER</A><BR> This decision was originally issued as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/054594p.pdf">OPINION/ORDER</A><BR> At issue is a regulation that would exempt from the Age Discrimination in Employment Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0243n-06.pdf">OPINION/ORDER</A><BR> Dep't of Health & Human Servs. have been substantially noncompliant with the standards of care in the Medicare regulations. Arguing that the Department's immediate jeopardy findings were not supported by substantial evidence. BNH is a skilled nursing facility participating in the federal Medicare and Medicaid programs. Assesses compliance through surveys that are typically conducted by state agencies.1 In June 2001. The scope and severity of each deficiency is determined in accordance with the factors set forth in 42 C.F.R. § 488.404(b): the severity determination ranges from </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/031401.P.pdf">OPINION/ORDER</A><BR> A special reimbursement that is available under the Medicare program to hospitals providing inpatient acute care to a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/04/97-6226.htm">97-6226 -- DEBOARD V. SUNSHINE MINING AND REFINING CO. -- 04/05/2000<BR></A><BR> Plaintiffs have filed two cross appeals challenging various aspects of the district court's judgment. Knox Van Hoy are former employees of Woods Petroleum Corporation (Woods). As part of the merger (which was described in the record as more akin to a hostile takeover). 1985. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200208/00-7210a.txt">OPINION/ORDER</A><BR> With him on the briefs was George J. With him on the brief was Jan W. Circuit Judge: After publishing an offer to pay one million dollars to the first person who could demonstrate that a statement about Republican plans for Medicare spend ing was false. Two of those claims are now before this court. The ad is reproduced at the end of this opinion. Prominently fea tured at the top of the ad is a photograph of Haley Barbour. The fact is Republicans are increasing Medicare spend ing by more than half. Haley </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/03/02-8096.htm">02-8096 -- HIGH COUNTRY HOME HEALTH INC. V. THOMPSON -- 03/03/2004<BR></A><BR> Circuit Judge. <p> <strong><hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/08/01-3185.htm">01-3185 -- STERNBERG V. DEPARTMENT OF HEALTH AND HUMAN SERVICES -- 08/13/2002<BR></A><BR> We have jurisdiction under 28 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="537"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2003/04/01-9013.htm">01-9013 -- IHC HEALTH PLAN, INC V. COMMISSIONER OF INTERNAL REVENUE -- 04/09/2003<BR></A><BR> Will &. We have jurisdiction to review the Tax Court's decision under 26 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200507/04-5203a.pdf">OPINION/ORDER</A><BR> With her on the briefs were Peter D. With him on the brief were John M. Hospitals unhappy with their fiscal intermediary's award have 180 days to appeal to the Provider Reimbursement Review Board ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/07/031584P.pdf">OPINION/ORDER</A><BR> Julia Bazazzadegan were charged with various counts involving a home health care fraud scheme. Dupont pled guilty and seeks to have his plea set aside for failure of consideration. Claiming improper joinder and that her motion for acquittal should have been granted. Physicians are required to certify that certain individuals are considered homebound and require home health care. Were alleged to have conspired with the doctors to fraudulently certify patients as requiring home health care. Patients are assessed by case managers who visit residential care facilities. The government alleged defendants submitted false applications for payment for services on dates when the patients were in the hospital and therefore not receiving the personal care services. Jr. was charged with ten counts. Dupont's counsel also believed dismissal 3 of all charges against Liveoak was a term of the agreement. B. Kelley Liveoak Appellant Kelley Liveoak was charged in Counts One and Nine. Trobaugh was charged in Counts Two. When they were allegedly not homebound. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-1514.01A">OPINION/ORDER</A><BR> Monospace </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/EF88382F4953FE1788256E740074C257/$file/0256611.pdf?openelement">OPINION/ORDER</A><BR> The plaintiffs are seventy nine hospitals and two healthcare corporations (collectively. Hospitals) who contend that the Secretary of the United States Department of Health and Human Services (the Secretary) acted in an arbitrary and capricious fashion in setting the thresholds for socalled </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/964813.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. He would not have found probable cause and issued the warrants. The government appeals contending (1) that the district court's findings of fact were clearly erroneous. The warrants were supported by probable cause. Because we find no clear error in fact finding and agree with the magistrate judge who originally issued the warrants that as redacted they are not supported by probable cause. Both of whom were part of a joint statefederal task force. Was also identified in the Master Affidavit as having participated in the investigation. The Master Affidavit asserted that there was probable cause to believe that criminal fraud had been committed at the eight Home Health locations. Which were executed on January 19. Approximately 5 million documents were seized. The Master Affidavit was unsealed and examined by Home Health and its attorneys. The motion was assigned to Magistrate Judge Denson. Arguing that Home Health had not established that the Master Affidavit would be insufficient to show probable cause if the alleged falsehoods and omissions were corrected. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-1614.01A">OPINION/ORDER</A><BR> Were on brief for appellant.</FONT> <P><FONT FACE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/02/02/004056P.pdf">OPINION/ORDER</A><BR> I. BACKGROUND This case is a qui tam action brought on behalf of the government under the FCA. 31 U.S.C. § 3730(b). Madonna Towers is a non profit corporation that operates a combined residential and skilled nursing facility for the elderly. The CCA provided that if Quirk was ever transferred from her residential apartment into the skilled nursing facility. A Resident is entitled to the nursing care and housekeeping services provided for occupants of the Infirmary. Quirk fell ill and was transferred from her residential unit to the skilled nursing facility. Appellant argues that it was illegal for Madonna Towers to submit those claims for payment because Medicare law provides. Appellant contends that under the terms of the CCA Quirk was under no legal obligation to pay for the first ninety days of her stay in the skilled nursing unit. Therefore it was fraudulent for Madonna Towers to submit claims for payment to Medicare. Quirk was legally obligated to pay for the first ninety days of her stay in the skilled nursing facility. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/05/97-6226.htm">97-6226 -- DEBOARD V. SUNSHINE MINING AND REFINING CO. -- 05/02/2000<BR></A><BR> Circuit Judges. <p> <hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-2235_015.pdf">OPINION/ORDER</A><BR> Our review is de novo. Gear is a graduate of Midwestern University's emergency medicine program and during the relevant time was fulfilling his residency requirements at three Chicago area hospitals: St. Residents are medical school graduates who gain experience by working in hospitals. Residents' services are not reimbursable by Medicare. Who are licensed doctors. Are reimbursable by Medicare. Senior residents are then properly allowed to moonlight as attending physicians. 42 C.F.R. § 415.208. Their services are also reimbursed by Medicare. It is also true that senior residents cannot work as attending physicians during residency hours. The problem Gear highlights is that the two defendants double billed Medicare for the work of residents in their capacity as attending physicians but performed during residency hours. Which provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/july96/95-3298.wpd.html">CHIPMAN V. SHALALA<BR></A><BR> We may overturn the Secretary's decision only </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200512/04-5411a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Peter J. With him on the brief were Peter D. Circuit Judge: The first issue in this appeal from the district court's order granting summary judgment in favor of the Secretary of Health and Human Services is whether the American Chiropractic Association has prudential standing to pursue its claims under the Medicare Act. The second issue is whether the district court had jurisdiction over each of the Association's remaining claims. With Medicare paying costs that are covered. The focus of the case is on these organizations and on a particular type of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-5.gif" ALT="518"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/F61C87D5903EA3A28825731300564F27/$file/0556341.pdf?openelement">OPINION/ORDER</A><BR> Is one of statutory interpretation. The question is whether the Provider Reimbursement Review Board has jurisdiction over a Medicare provider's appeal of a cost that was allowable under the Medicare regulations. Which have decided it. Indicating that providers who bypass an exhaustion requirement or fail to request reimbursement for all costs to which they are entitled under applicable rules may stand on different ground). 2 Compare St. Board . . . if (1) such provider (A)(i) is dissatisfied with a final determination of . . . its fiscal intermediary . . . as to the amount of total program reimbursement due the provider . . . the amount in controversy is $10. It has discretion under § 1395oo(d)4 to decide whether to order reimbursement of a cost or expense that was incurred within the period for which the cost report was filed. Even though that particular expense was not expressly claimed or explicitly considered by the intermediary. As well as on Loma Linda's cross appeal which in the main raises issues on which federal jurisdiction is lacking. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-1536.01A">OPINION/ORDER</A><BR> Special Assistant United States Attorney were on brief. Moore & Jones were on brief. The district court found that the Information was insufficient to sustain the charges and dismissed it.1 For the reasons that follow. The court was bound to accept the lower court's 2 nom. 1082 are reviewed de novo. Concise and An information is sufficient if it </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/03/03-1745.PDF">OPINION/ORDER</A><BR> After extended proceedings that it is unnecessary 2 No. 03 1745 to recount. All obligations were offset. Claims an entitlement to interest on the $6.4 million between January 1989 and the time the (net) payment of about $2.4 million was made. It is distinct from Edgewater Operating Co. The Administrator of the Health Care Financing Administration (part of the Department of Health and Human Services) made the final administrative decision and determined that the Foundation and the Operating Company are jointly and severally liable for reimbursements of all overpayments. Because the Medicare program is entitled to treat a single hospital as one </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/07/991672P.pdf">OPINION/ORDER</A><BR> Hammond argues that summary judgment was improper because there was a genuine issue of material fact as to whether she was entitled to damages or other relief under the False Claims Act. Jurisdiction Jurisdiction in the district court was proper based upon 28 U.S.C. §§ 1331 and 1367. Jurisdiction in the court of appeals is proper based upon 28 U.S.C. § 1291. The notice of appeal was timely filed pursuant to Fed. Background The following statement of facts is drawn from the district court order and the record on appeal. Was employed as Medical Director of Northland from October 1994 to September 1996. Hammond became concerned that Northland was improperly billing day Hammond also argues that the district court abused its discretion in denying her leave to amend her complaint to include a claim for punitive damages. Even if this matter were properly on appeal before this court. Northland's billing practices were not corrected. After purportedly conducting her own inquiries into the billing practices of other local mental health facilities to determine if Northland's billings were in compliance with Medicare requirements. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=04-4329_040.pdf">OPINION/ORDER</A><BR> OE This opinion was originally issued as an unpublished order on November 17. The panel has determined that this decision should now issue as a published opinion. 2 No. 04 4329 Phillips and Fernandos Johnson were charged with health care fraud. After Phillips was indicted. To whom the case was assigned for trial. Over which our jurisdiction is established. The allegations of the superseding indictment are that Phillips owned and operated Health Care Creations (HCC). Defendant Johnson was employed by HCC as a therapist even though he was not licensed to conduct psychotherapy services. Medicare reimbursement checks were sent through the mail to HCC at an address in Bolingbrook. Through this scheme it is alleged in the superseding indictment Phillips defrauded Medicare to the tune of some $1. Five specific counts of fraud based on specific checks are set out. It is because the latter specific counts in the indictment allege fraud in the amount of $47. 947.87 that Phillips No. 04 4329 3 argues she is entitled to the release of property in excess of that amount. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200103/00-5141a.txt">OPINION/ORDER</A><BR> With her on the brief were Harriet S. Circuit Judge: At issue is the valuation of hospital assets for purposes of reimbursement under the Medicare statute. Medicare providers such as Nu Med are entitled with certain limitations not relevant here to compensation for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/041258np.pdf">OPINION/ORDER</A><BR> We will affirm. I. Appellant is a unit of Mercer Street Friends Center. Inc. is a non profit corporation that manages appellant's endowment. Inc. ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/06/023494U.pdf">OPINION/ORDER</A><BR> Goli) was charged with nineteen counts of mail fraud. Goli was charged with devising and executing a scheme to defraud private individuals. Medicaid </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="498"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/061972np.pdf">OPINION/ORDER</A><BR> We will affirm the judgment of the District Court. I. The Court recognizes that the parties are well versed in the facts and procedural history of this matter. Therefore only those facts necessary to our analysis are set forth below. His Several other physicians were initially named in the cause of action. Were granted summary judgment. Booth were voluntarily dismissed. The issues tried were reduced to medical malpractice. Battery. 2 1 foot became discolored and his pulse was not palpable. The action was heard in the Eastern District of Pennsylvania before the Honorable Eduardo C. This motion was unopposed by Plaintiffs and granted by Judge Robreno. Plaintiffs also alleged to have obtained newly discovered evidence that Defendants were committing medical fraud as a result of Booth having withheld information of a pending investigation for Medicare fraud when he was deposed in the malpractice case. Plaintiffs' counsel agreed that the fraud claims in this action were in fact the same exact claims previously alleged and argued in Plaintiffs' June 12. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200302/01-5265a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0107p-06.pdf">OPINION/ORDER</A><BR> Page 2 BACKGROUND This Tennessee breach of contract suit was previously before this Court. The overall goal of the TRICARE program is to improve the quality. One aspect of the new TRICARE program was the establishment of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0455n-06.pdf">OPINION/ORDER</A><BR> She argues that she was discriminated against on the basis of her race. That she was retaliated against for engaging in protected activity. That she was subjected to a hostile work environment. I. BACKGROUND Bush is an African American female who worked for Gambro. Bush was using Gambro's computers for personal use. Bush must show that: (1) she is a member of a protected class. (2) she applied for and was qualified for a promotion. (3) she was considered for and denied the promotion. (4) other employees of similar qualifications who were not members of the protected class received promotions at the time her request for promotion was denied. Gambro Healthcare While it is questionable whether Bush has satisfied the similarly situated prong. We will assume that she has made a prima facie showing. Gambro essentially stated that Stepanek was more qualified than Bush for the position. The burden then shifted to Bush to establish that Gambro's reasons were a pretext designed to mask discrimination. Her unsupported allegations are not enough to establish that Gambro's reasons were pretextual. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/01/01-4088.PDF">OPINION/ORDER</A><BR> Fairfax Nursing Home is a skilled nursing facility participating in Medicare and Medicaid. Fairfax was assessed a civil monetary penalty ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6E7BC5466800808488256E5A00707AF3/$file/9917123.pdf?openelement">OPINION/ORDER</A><BR> Changes in the hospital's case mix index that would otherwise have subjected the provider to a TEFRA penalty. The Secretary's decision to deny it an incentive payment is arbitrary and capricious in violation of the Administrative Procedure Act (APA). We have jurisdiction pursuant to 42 U.S.C. § 1251. Payment to providers of services is commonly carried out by fiscal intermediaries pursuant to contracts with the Secretary. The fiscal intermediary is Blue Cross of California. Reimbursement for hospital services to Medicare beneficiaries was based on the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTI1NzAtY3Zfb3BuLnBkZg==/05-2570-cv_opn.pdf">OPINION/ORDER</A><BR> The district court held that enforcement of section 211 a is preempted by the National Labor Relations Act. We reverse the grant of summary judgment because we conclude that there are disputed issues of fact. The legislature hereby finds and declares that sound fiscal management requires vigilance to ensure that funds appropriated by the legislature for the purchase of goods and provision of needed services are ultimately expended solely for the purpose for which they were appropriated. The legislature finds and declares that when public funds are appropriated for the purchase of specific goods and/or the provision of needed services. Those funds are instead used to encourage or discourage union organization. The proprietary interests of this state are adversely affected. Which should be utilized solely for the public purpose for which they were appropriated. 2. Or (c) hire employees or pay the salary and other compensation of employees whose principal job duties are to encourage or discourage union organization. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTI5NTEtY3Zfb3BuLnBkZg==/05-2951-cv_opn.pdf">OPINION/ORDER</A><BR> We reverse in part and remand to the district court with instructions that the remaining claims be dismissed on the ground that they are time barred. See id. § The appellant hospitals (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar99/97-3472.opn.html">UNITED STATES V. VAGHELA (3/12/1999, NO. 97-3472)<BR></A><BR> Vaghela raises three arguments in this appeal: (1) that there was insufficient evidence to support his conviction for conspiracy to obstruct justice. (2) that the district court erred in assessing the restitution owed at the total amount for which the United States Department of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19975812.OPN.pdf">OPINION/ORDER</A><BR> Which is more formally known as the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The plaintiffs are a class of aliens who do not fit within any of the eligible categories. Because no members of the plaintiff class are illegal aliens. We will for convenience use the term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19975812.MAN.pdf">OPINION/ORDER</A><BR> Which is more formally known as the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The plaintiffs are a class of aliens who do not fit within any of the eligible categories. Because no members of the plaintiff class are illegal aliens. We will for convenience use the term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar99/97-5812.man.html">RODRIGUEZ V. UNITED STATES (3/15/1999, NO. 97-5812)<BR></A><BR> Which is more formally known as the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The plaintiffs are a class of aliens who do not fit within any of the eligible categories. THE WELFARE REFORM ACT'S PROVISIONS AFFECTING THE ELIGIBILITY OF ALIENS</CENTER> FOR SSI AND FOOD STAMP WELFARE BENEFITS</P> <P> The federal government provides SSI benefits to impoverished individuals who are elderly. Aliens were eligible for both SSI and food stamp benefits on the same basis as citizens. The Act provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=00-2029.01A">OPINION/ORDER</A><BR> Hafetz</SPAN> were on brief. Kornspan</SPAN> were on brief. Were on brief. They argue that there was a constructive amendment of the indictment. That there was insufficient evidence to convict them. That the jury instructions were defective. We affirm.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/19CAD28B9CF44F6188256A32005AD97B/$file/9917123.pdf?openelement">OPINION/ORDER</A><BR> Changes in the hospital's case mix index that would otherwise have subjected the provider to a TEFRA penalty. The Secretary's decision to deny it an incentive payment is arbitrary and capricious in violation of the Administrative Procedure Act (APA). We have jurisdiction pursuant to 42 U.S.C. § 1251. Payment to providers of services is commonly carried out by fiscal intermediaries pursuant to contracts with the Secretary. The fiscal intermediary is Blue Cross of California. Reimbursement for hospital services to Medicare beneficiaries was based on the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/11/011201P.pdf">OPINION/ORDER</A><BR> Callantine filed this action alleging she was wrongfully terminated in violation of public policy for failure to commit the illegal act of signing a backdated Medicare Form 485. The action was tried to a jury. Is wholly owned by Staff Builders. Callantine is a registered nurse who worked as a field nurse for the Cabool office from October 1996 until March 25. When she was terminated. Are required by Medicare to fill out Form 485 for patients who use Medicare as their primary insurance. The doctor's determination that a patient is homebound and requires home health care for a certain length of time. Recertification is required to continue home health care after the time period originally prescribed. The doctor who prescribes the home health care and the nurse who provides the home health care are both required to sign the form. Were terminated. Sander was terminated on March 13. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar99/97-3472.opn.html">UNITED STATES V. VAGHELA (3/12/1999, NO. 97-3472)<BR></A><BR> Vaghela raises three arguments in this appeal: (1) that there was insufficient evidence to support his conviction for conspiracy to obstruct justice. (2) that the district court erred in assessing the restitution owed at the total amount for which the United States Department of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar99/97-5812.man.html">RODRIGUEZ V. UNITED STATES (3/15/1999, NO. 97-5812)<BR></A><BR> Which is more formally known as the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The plaintiffs are a class of aliens who do not fit within any of the eligible categories. THE WELFARE REFORM ACT'S PROVISIONS AFFECTING THE ELIGIBILITY OF ALIENS</CENTER> FOR SSI AND FOOD STAMP WELFARE BENEFITS</P> <P> The federal government provides SSI benefits to impoverished individuals who are elderly. Aliens were eligible for both SSI and food stamp benefits on the same basis as citizens. The Act provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/01/013995P.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="475"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0580n-06.pdf">OPINION/ORDER</A><BR> Norwest Bank appeals from an order in which the district court concluded that it was responsible for the 2003 real estate taxes covering a nursing home purchased by Extendicare Health Services. Inc. ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200216337.pdf">OPINION/ORDER</A><BR> The government argues that the district court lacked subject matter jurisdiction to issue the order because the motions were filed outside the time limits for post verdict motions prescribed in Rules 29 and 33 of the Federal Rules of Criminal Procedure. That the district court's order was wrong on the merits as well. I The relevant facts and procedural history of this case are straightforward. So called </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/09/98-6364.htm">98-6364 -- HOME CARE ASSOCIATION OF AMERICA, INC. V. U.S. -- 09/13/2000<BR></A><BR> Plaintiffs argue summarily (in a single paragraph) that <u>Illinois Council</u> is distinguishable in that the plaintiffs in <u>Illinois Council</u> challenged Medicare regulations. Whereas plaintiffs here challenge </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/04/982677P.pdf">OPINION/ORDER</A><BR> Both physician anesthesiologists and nurse anesthetists are licensed in Minnesota to administer anesthesia during surgeries. Concluding that these contracts are not properly analyzed as boycotts. That plaintiffs have totally failed to demonstrate either market power or </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=91-1827.01A">OPINION/ORDER</A><BR> Were on brief for appellee Health and Human Services. Appellants1 are suppliers of DME located in Puerto Rico. Because the material facts were not in dispute. The case was submitted on cross motions for summary judgment. That: (1) the regulations issued by the Secretary and his agents for determining the amount of payments for DME were interpretive rules. Appellants have appealed these district court rulings. Appellants are: La Casa del Convaleciente. The Medicare program is divided into two major components. Part B is a federally subsidized. Payments for DME purchases or leases were calculated based upon lump sum purchases. The carrier was delegated the task of determining which of the three reimbursement methods would be more economical and practical. The payment basis is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/05/02-6313.htm">02-6313 -- U.S. V. PAPA -- 05/13/2004<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Defendant appellant Ronald Todd Papa appeals the district court's decision denying him collateral relief from the sentence he received for conspiring to defraud the United States.<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/022076.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. That was certified to receive Medicare and Medicaid funds. All such facilities are subject to annual state surveys to determine if they comply with the Medicare and Medicaid participation requirements. 42 U.S.C. § 1395i 3(g). HHS notified Hermina that the facility was out of compliance with the Medicare and Medicaid participation requirements at the immediate jeopardy level. The date the survey was completed. Immediate jeopardy is the most serious violation category. 42 C.F.R. § 488.408. The ALJ found that there was no evidence to show that Hermina had made such efforts. That is. Or is likely to cause. Sea Island contends that HHS is bound by its own internal policy set out in its State Operations Manual § 3010. HHS maintains that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200416167.pdf">OPINION/ORDER</A><BR> Circuit Judge: This is a qui tam action brought in the United States District Court for the Northern District of Alabama by a physician. The questions lying at the heart of this appeal are whether the complaint's allegations of fraud have been made with the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Mar2000/993570.txt">OPINION/ORDER</A><BR> Who are individually named plaintiffs in a suit seeking to require Freedom Forge to continue funding the health benefits plan currently in place for retirees and spouses. The gravamen of the plaintiffs' claim is that Freedom Forge induced them into early retirement with oral assurances that their health insurance benefits would continue essentially unmodified until death. This suit was prompted by Freedom Forge's announcement that it would be switching from a self insured benefits program with no premiums to a managed care system in which retirees would be able to choose among plans. Asserting that they were reasonably likely to succeed on the merits. Faced with a large group of plaintiffs whom the court determines are reasonably likely to succeed on the merits. May grant a preliminary injunction to the entire group of plaintiffs if there is evidence that some. Of the plaintiffs will suffer irreparable harm. While none of the other plaintiffs presented evidence that they were threatened with irreparable harm or were similarly situated to those who testified. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-2256.01A">OPINION/ORDER</A><BR> PSC</SPAN> was on brief. With whom <SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug1998/98a1952p.txt">OPINION/ORDER</A><BR> Was not negligent in providing medical services to plaintiff in the course of three surgical operations and did not breach his duty of informed consent. Appeals from 2 the district court's final judgment entered against her on her derivative claim for loss of consortium.1 We will affirm the district court in all respects. Clifford's preliminary assessment was that plaintiff had diverticulitis. He was discharged from the hospital on July 27. All evidence and inferences therefrom are taken in the light most favorable to defendant. Plaintiff was hospitalized for more than one month. Dwyer concluded that the stoma was constricting and additional surgery would be necessary. Plaintiff claimed that he suffered serious physical and psychological injuries and was left with an undesired. Defendant opposed this motion on the grounds that disclosure of this information was prohibited under the Peer Review Improvement Act of 1982 (the Act). Dwyer was the subject of a PRO inquiry after Dwyer's colleague. The magistrate judge held that the documents requested were </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="449"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/10/99-3105.htm">99-3105 -- U.S. V. COASTAL HEALTHCARE GROUP -- 10/26/2000<BR></A><BR> To bring actions against individuals or entities who have allegedly presented false or fraudulent claims to the federal government. Prohibiting <em>qui tam</em> suits based on publicly disclosed information unless the person suing is an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1999/09/98-3209.htm">98-3209 -- U.S. V. SPECTRUM EMERGENCY CARE INC. -- 09/07/1999<BR></A><BR> The Act also contains jurisdictional limits on those who may bring <em>qui tam</em> actions and it specifically bars all <em>qui tam</em> suits based upon publicly disclosed information unless the person bringing the action is an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1997/12/96-1314.htm">96-1314 -- U.S. V. MARONEY -- 12/03/1997<BR></A><BR> Defendant was sentenced to twenty one months imprisonment. Was convicted of overbilling the Colorado workers' compensation authority by improperly seeking reimbursements for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0298p-06.pdf">OPINION/ORDER</A><BR> Have risen and fallen many times over the last 50 years. We have consolidated the appeals and now affirm. Not just those who had retired after each new collective bargaining agreement was made. Their spouses and dependents which is to say 472. These benefits are not inexpensive. No participant in this case whether that party agrees with the settlement or not offers any reason to believe these healthcare benefits will become cheaper over time. The car companies' capacity to pay them will become less burdensome in the future or the differential between what these American car companies pay in healthcare costs per vehicle and what their rivals from Japan (which has universal healthcare) pay will change any time soon. Making these obligations increasingly more difficult to meet are a growing ratio of retirees to active employees (four to one at GM in 2006 and two to one at Ford in 2005) and rapidly increasing healthcare costs. GM's accumulated obligations were expected to increase 22% between 2005 and 2009). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/09/033012P.pdf">OPINION/ORDER</A><BR> Those hospitals which serve an unusually high number of Medicaid patients are entitled to a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0161p-06.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/12/994324P.pdf">OPINION/ORDER</A><BR> After it was bought by Deerbrook Pavilion. That doing so was a violation of due process. We must assume all of the facts alleged in the complaint to be true and affirm only if it is clear that no relief can be granted based on those allegations. The facility had numerous violations of basic sanitary standards and was also cited for neglect to the residents' basic needs. The facility was brought into substantial compliance. There were $419. That corporation was dissolved. Deerbrook then filed a complaint in district court asserting that HCFA did not have the authority to impose successor liability and that collection of CMPs against it would violate due process. The federal defendants responded that unpaid CMPs Deerbrook represents that it is a separate entity from the original operator of the nursing home that accrued the CMPs. For purposes of a motion to dismiss we must take the allegations of Deerbrook's complaint to be true. 31 </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//jan98/96-9459.man.html">UNITED STATES V. GILLIARD (1/21/1998, NO. 96-9459)<BR></A><BR> Circuit Judge:</P> <P> The sole issue in this appeal is whether the district court erred when it excluded evidence of a polygraph examination offered into evidence by Appellant Fred Emerson Gilliard. While he was chief executive officer of Penn Teck Diagnostics. Honts is an associate professor of psychology at Boise State University whose training is in psychophysiology. While you were employed by Penn Teck. When the incorrect billings were filed with Medicare or Medicaid. Did you know that they were incorrect?</P> <P> 3. While you were employed by Penn Teck. Were the incorrect billings to Medicare and Medicaid made unintentionally?</P> <P>Gilliard denied any wrongdoing. Concluded that the results indicated that Gilliard was not being deceptive when he answered the relevant questions. Polygraph evidence is no longer per se inadmissible. </EM> the district court sustained the Government's objection and held that the Honts Polygraph evidence was inadmissible under Fed.R.Evid. 702. </EM> polygraph evidence was per se inadmissible in this Circuit. <EM>Piccinonna. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/05/022193P.pdf">OPINION/ORDER</A><BR> This is an appeal from a dismissal of a second qui tam action brought on behalf of the United States by James Kinney pursuant to the False Claims Act. Brings an action on behalf of the United States alleging fraudulent claims were submitted to the government. 31 U.S.C. § 3730(b)(4). In the process defrauded the United States by billing Medicare for ambulance runs that should not have been billed as necessary. The runs Kinney claimed as fraudulent were termed </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-1498.wpd">OPINION/ORDER</A><BR> Was admitted to Porter Adventist Hospital in Denver. This determination was based on the Medicare review program's assessment that acute hospital care was no longer medically necessary. Lego sought reconsideration of the decision and it was denied. Lego testified that he did not know why a hearing was being held as it was his understanding that there was a zero balance on the account and that no collection actions had been undertaken. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0957n-06.pdf">OPINION/ORDER</A><BR> I. BACKGROUND Petitioner is a skilled nursing facility located in Vandalia. Its participation in Medicare is governed by sections 1819 and 1866 of the Social Security Act and by federal regulations at 42 C.F.R. To insure that the facility is in compliance with program requirements. At which time Petitioner was found not to be in substantial compliance with several of the federal requirements for nursing homes. At the heart of this appeal are several allegations by three different residents of sexual abuse by members of Petitioner's staff. No such report was ever located. Resident 6 was not examined by her physician. The authorities were not notified. Although an internal incident report was generated. Resident 6 was finally examined by her physician and a pediatric gynecologist on March 29 and 30. Resident 124 was a 37 year old woman diagnosed with. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2003/08/01-4228.htm">01-4228 -- LEFLER V. UNITED HEALTHCARE OF UTAH, INC. -- 08/14/2003<BR></A><BR> We affirm. <p> <strong><em>Factual Background</em></strong> <p> United is licensed in Utah. Employees contributed to the premiums.<strong> </strong> United was a fiduciary<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug95/94-2683.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1997/10/96-8108.htm">96-8108 -- YEAROUS V. NIOBRARA COUNTY MEMORIAL HOSPITAL -- 10/21/1997<BR></A><BR> Chintamani Frahm are registered nurses. Plaintiff Sarah Yearous is a licensed practical nurse. All are former employees of Defendant Niobrara County Memorial Hospital. Defendant appeals the district court's denial of its motion for judgment as a matter of law claiming the evidence was insufficient to support the jury's finding of constructive discharge. <u>See</u> Fed. Because we conclude that the record is devoid of any evidence upon which a reasonable jury could return a verdict for Plaintiffs under the controlling law. The standards governing our review are well established. We will reverse the denial of a Rule 50 motion only if the evidence points but one way and is susceptible to no reasonable inferences supporting the nonmoving party. <u>Haines v. We must enter judgment as a matter of law in favor of the moving party if there is no legally sufficient evidentiary basis with respect to a claim . . . under the controlling law. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6C97098ADF8099AB88256C910059D128/$file/0136089.pdf?openelement">OPINION/ORDER</A><BR> This flaw is fatal to a qui tam1 action under the False Claims Act. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/jan98/96-9459.man.html">UNITED STATES V. GILLIARD (1/21/1998, NO. 96-9459)<BR></A><BR> Circuit Judge:</P> <P> The sole issue in this appeal is whether the district court erred when it excluded evidence of a polygraph examination offered into evidence by Appellant Fred Emerson Gilliard. While he was chief executive officer of Penn Teck Diagnostics. Honts is an associate professor of psychology at Boise State University whose training is in psychophysiology. While you were employed by Penn Teck. When the incorrect billings were filed with Medicare or Medicaid. Did you know that they were incorrect?</P> <P> 3. While you were employed by Penn Teck. Were the incorrect billings to Medicare and Medicaid made unintentionally?</P> <P>Gilliard denied any wrongdoing. Concluded that the results indicated that Gilliard was not being deceptive when he answered the relevant questions. Polygraph evidence is no longer per se inadmissible. </EM> the district court sustained the Government's objection and held that the Honts Polygraph evidence was inadmissible under Fed.R.Evid. 702. </EM> polygraph evidence was per se inadmissible in this Circuit. <EM>Piccinonna. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-3502_025.pdf">OPINION/ORDER</A><BR> The creditors' committee all agreed the settlement was in the 2 No. 05 3502 best interest of the estate. The bankruptcy court held the settlement was in the best interest of the estate and approved it. I. Background Desnick was the owner and sole shareholder of Doctors Hospital and a number of other entities. Because the loan was. It was secured by the Hospital's equipment and (like the Daiwa loan) by the Hospital's accounts receivable. The proceeds some $48.5 million after administrative fees were deposited into an No. 05 3502 3 account bearing the name of Desnick and his wife. Twelve of the other defendants were Desnick controlled entities2 and four were former corporate officers or directors3 of the Hospital whom Desnick had effectively agreed to indemnify for their losses.4 The gist of the complaint was that Desnick and the other officers and directors caused the Hospital's bankruptcy through mismanagement and a series of fraudulent transactions to the tune of about $34 million which benefitted Desnick. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0286n-06.pdf">OPINION/ORDER</A><BR> Batavia Nursing & Convalescent Center is a nursing home facility that was assessed a civil monetary penalty by the Centers for Medicare and Medicaid Services. Which is the federal agency within the Department of Health and Human Services charged with enforcing Medicare/Medicaid participation standards. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/02/02-21247.0.wpd.pdf">OPINION/ORDER</A><BR> The Court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5th Cir. FACTUAL AND PROCEDURAL BACKGROUND Parsons was indicted on twenty three counts of health care fraud. The Government showed that Parsons submitted numerous Medicare and Medicaid claims for office visits that never occurred and for echocardiogram services that were never performed. Parsons restated his objection and an amended motion in limine was granted. That she did not have heart problems and she did not remember Parsons performing an echocardiogram on her. Parsons took the stand and testified that the Medicare bills were mistakes or accidents. The Government introduced evidence that Parsons had been warned by the Medical Board in 1994 to adequately supervise his employees and that his files were substandard. II. 404(b) EVIDENCE Parsons argues that the admission of evidence involving his prior dealings with the Medical Board was an abuse of discretion because the evidence was more prejudicial than probative. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/044124p.pdf">OPINION/ORDER</A><BR> We have an appeal by an employer from an adverse verdict in favor of an employee (here independent contractor) on his claim of unlawful termination in retaliation for speech protected by the First Amendment. Our task is to review the law applied by the District Court on a plenary basis and ascertain whether there is sufficient evidence to support the jury verdict. 2 I. Gregg Sylvester was the Secretary of DHSS from October. Was an independent contractor at the DPC from July 1. These were introduced into evidence at trial as Plaintiff's Exhibits PX 1 through 5. We summarize them below but because they are central to the issues before us they are included verbatim in the Appendix to this opinion. The memorandum charges that there was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/199912243.MAN.pdf">OPINION/ORDER</A><BR> His appeal presents the issue of whether a bank is the only legally possible victim of bank fraud. We hold that bank fraud may have more than one victim for U.S.S.G. § 3B1.3 purposes. We take the district court's facts as true unless they are clearly erroneous. To forge checks that were cashed and converted to personal use. Who also had access to Linville also argues that the evidence was insufficient to support his convictions. We conclude that there was sufficient evidence to support Linville's convictions. We are not required to accept such a concession when the law and record do not justify it. The court also found that Raulerson was a victim of the offense because it footed the bill in the end. An abuse of trust enhancement is appropriate whenever the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//sept2000/99-12243.opn.html">UNITED STATES V. LINVILLE (9/29/2000, NO. 99-12243)<BR></A><BR> His appeal presents the issue of whether a bank is the only legally possible victim of bank fraud. We hold that bank fraud may have more than one victim for U.S.S.G. § 3B1.3 purposes. We take the district court's facts as true unless they are clearly erroneous. To forge checks that were cashed and converted to personal use. The court also found that Raulerson was a victim of the offense because it footed the bill in the end. 000 in restitution. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/June2002/003516u.pdf">OPINION/ORDER</A><BR> A committee of unsecured creditors is challenging the District Court's order allowing Charter to assume and assign certain executory contracts involving Medicare and the sale of some of Charter's hospitals. The parties are familiar with the facts of this case. We will provide only a brief summary of those facts at the outset and will incorporate additional facts as they are relevant to our discussion of the issues. These sales were conditioned upon the assumption and assignment. The Settlement Agreement was approved by the District Court. The $7 million was paid to HHS. The Medicare Provider Agreements were assumed and assigned. Whether the District Court erred when it approved a settlement agreement between the Debtors and the United States because it did not have sufficient information to make an independent determination about the settlement. Claiming that this appeal is moot under 11 U.S.C. 363(m) and the doctrine of equitable. We do not reach Appellant's issues because this appeal is statutorily moot under 11 U.S.C. 363(m). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/sept2000/99-12243.opn.html">UNITED STATES V. LINVILLE (9/29/2000, NO. 99-12243)<BR></A><BR> His appeal presents the issue of whether a bank is the only legally possible victim of bank fraud. We hold that bank fraud may have more than one victim for U.S.S.G. § 3B1.3 purposes. We take the district court's facts as true unless they are clearly erroneous. To forge checks that were cashed and converted to personal use. The court also found that Raulerson was a victim of the offense because it footed the bill in the end. 000 in restitution. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug95/94-2683.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//may2002/01-13312.opn.html">UNITED STATES V. LAB. CORP. OF AM., INC. (5/9/2002, NO. 01-13312)<BR></A><BR> LabCorp is an Atlanta based company that performs medical testing services nationwide and specializes in providing testing on a contract basis to long term care facilities ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/03/03-30294.0.wpd.pdf">OPINION/ORDER</A><BR> The Court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. The CMHCs first contend that the CMS's mistaken classification of the CMHCs as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/may2002/01-13312.opn.html">UNITED STATES V. LAB. CORP. OF AM., INC. (5/9/2002, NO. 01-13312)<BR></A><BR> LabCorp is an Atlanta based company that performs medical testing services nationwide and specializes in providing testing on a contract basis to long term care facilities ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0861n-06.pdf">OPINION/ORDER</A><BR> The record is replete with specific evidence supporting each care deficiency finding upheld by the ALJ and DAB. Ivy Woods points to F Tag 164 where a surveyor observed that Ivy Woods failed to cover a resident receiving personal care while the door was open. The surveyor testified that the resident's head is supposed to be placed on the bottom end. The resident complained they were placing her on the bed incorrectly. Resident 40 told the aides her broken leg hurt and cried until the shower was over. The aides ignored Resident 40's complaints and complained they had urine on their uniforms from Resident 40's leaking catheter as if Resident 40 were not in the room. It would need to violate </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Feb2004/032391np.pdf">OPINION/ORDER</A><BR> We find that critical findings of the hearings officer were not supported by substantial evidence and that the hypothetical question posed to the vocational expert by the hearings officer did not incorporate all of Robinson's limitations. We will reverse and remand with instructions that an order granting a period of disability and early Medicare coverage be entered. Thereafter he applied for and was awarded an occupational disability annuity under section 2(a)(1)(iv) of the Railroad Retirement Act. Had completed twenty years of service and was found unable to perform his regular railroad occupation. His application for an occupational disability annuity was also an application for a period of disability and early Medicare coverage under the Social Security Act. This application was denied on March 12. His application was denied at the various administrative stages. A telephone hearing was held at which a vocational expert testified in response to hypothetical questions which the hearings officer posed and in response to questions which Robinson's attorney posed. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/oct97/96-8108.wpd.html">YEAROUS V. NIOBRARA COUNTY MEM'L HOSP.<BR></A><BR> Chintamani Frahm are registered nurses. Plaintiff Sarah Yearous is a licensed practical nurse. All are former employees of Defendant Niobrara County Memorial Hospital. Defendant appeals the district court's denial of its motion for judgment as a matter of law claiming the evidence was insufficient to support the jury's finding of constructive discharge. Because we conclude that the record is devoid of any evidence upon which a reasonable jury could return a verdict for Plaintiffs under the controlling law. The standards governing our review are well established. We will reverse the denial of a Rule 50 motion only if the evidence points but one way and is susceptible to no reasonable inferences supporting the nonmoving party. We must enter judgment as a matter of law in favor of the moving party if there is no legally sufficient evidentiary basis with respect to a claim . . . under the controlling law. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-4.gif" ALT="420"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/199912243.OPN.pdf">OPINION/ORDER</A><BR> His appeal presents the issue of whether a bank is the only legally possible victim of bank fraud. We hold that bank fraud may have more than one victim for U.S.S.G. § 3B1.3 purposes. We take the district court's facts as true unless they are clearly erroneous. Linville also argues that the evidence was insufficient to support his convictions. We conclude that there was sufficient evidence to support Linville's convictions. We are not required to accept such a concession when the law and record do not justify it. To forge checks that were cashed and converted to personal use. The court also found that Raulerson was a victim of the offense because it footed the bill in the end. An abuse of trust enhancement is appropriate whenever the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-1186o.pdf">OPINION/ORDER</A><BR> Of counsel on the petition was Thomas J. With him on the opposition were Jeffrey J. With him on the brief was Roy H. With him on the brief were John D. ORDER A combined petition for panel rehearing and rehearing en banc was filed by the Appellant. A response thereto was invited by the court and filed by the Appellee.1 The petition for rehearing was referred first to the merits panel that heard the appeal. The amici curiae briefs were referred to the circuit judges who are authorized to request a poll whether to rehear the appeal en banc. A poll was requested. IT IS ORDERED THAT: (1) The petition for panel rehearing is denied. 1 Amicus curiae briefs were filed by: 1 The Federal Trade Commission. 2 The Generic Pharmaceutical Association. 3 Ivax Pharmaceuticals. Schumer. (2) The petition for rehearing en banc is denied. (3) The mandate of the court will issue on April 11. This is a critical issue under the Hatch Waxman Act.1 The failure of this court by en banc action to correct the Teva court's decision. The Teva court's reasonable apprehension analysis is the wrong test for a concrete. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/06/99-3274.htm">99-3274 -- U.S. V. MCCLATCHEY -- 06/13/2000<BR></A><BR> The district court concluded there was insufficient evidence from which a reasonable jury could find McClatchey had a specific intent to violate the Act. That the district court improperly instructed the jury it could convict McClatchey if remuneration was paid </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/07/00-3266.htm">00-3266 -- GLOVER V. NMC HOMECARE INC. -- 07/18/2001<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/04/01-7092.htm">01-7092 -- U.S. V. JONES -- 04/24/2002<BR></A><BR> We discern three points of error that Jones raises in his appeal: (1) that the investigation was not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec1996/96a1479p.txt">OPINION/ORDER</A><BR> Appellant John Cocivera and six corporations that he established were convicted by a jury of various crimes arising out of a scheme to defraud Medicare. I. Cocivera was the chief executive officer and fifty percent owner of six Pennsylvania corporations that were created in August 1989 to provide medical equipment to Medicare beneficiaries through a national telemarketing operation. Cocivera and the corporations were indicted in September 1994 in the United States District Court for the Eastern District of Pennsylvania on one hundred forty four (144) counts of mail fraud in violation of 18 U.S.C. § 1341. Were found guilty of all 205 counts by a jury in May 1995. Each of the other corporations was convicted. Cocivera was sentenced to a 78 month prison term. We have jurisdiction under 28 U.S.C. § 1291. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2003/01/01-3327.htm">01-3327 -- U.S. V. MCCLATCHEY -- 01/16/2003<BR></A><BR> We have jurisdiction under 18 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Sept1996/96a1413p.txt">OPINION/ORDER</A><BR> Rehkop alleged that he was discharged from his position as a Certified Registered Nurse Anesthetist in retaliation for refusing to complete what he contends were fraudulent Medicare. Rehkop is not precluded from alleging a RICO conspiracy under section 1962(d). Thus we will reverse the district court's dismissal of the conspiracy count and remand also for reinstatement of the pendent state law claims. Rehkop was hired as a Certified Registered Nurse Anesthetist by the Berwick Healthcare Corporation to provide services at the Berwick Hospital Center. Medicaid and Medical Assistance as these programs are established and administered by the United States of America and the Commonwealth of Pennsylvania. Was hired to provide the anesthesia services. Alex Keris was the Chief Nurse Anesthetist and Manager of the Anesthesia Department. Keris was Rehkop's direct supervisor. To which they were not entitled. Rehkop further alleges that he was required to complete claim forms. When he learned that the claims were fraudulent. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/01/03-1162.htm">03-1162 -- SOSKIN V. REINERTSON -- 01/12/2004<BR></A><BR> Circuit Judge. <p> <hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug97/95-9493.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/994814.P.pdf">OPINION/ORDER</A><BR> The Boldens were indicted in December of 1997 by a grand jury in Asheville. A superseding indictment was returned in October of 1998.1 The indictment alleged that. On which the Boldens were tried. This fraud scheme was carried out through their operation of Emerald Health CareTaylorsville ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/991979.P.pdf">OPINION/ORDER</A><BR> Asset freezing injunction on the United States' allegations that the defendant oncology service providers defrauded the Medicare and CHAMPUS1 programs and thereafter were engaging in complex reorganizations and transfers of assets to insulate themselves from liability. Concluding that because both money damages and equitable relief are sought in this case. The controlling authority is not Grupo Mexicano but Deckert v. Doctors Colkitt and Derdel are physicians specializing in radiation oncology. The United States alleges that the defendants claimed reimbursement on bills for radiation oncology services that were not provided or ordered by the physician and on bills for unnecessary radiation oncology services. Count V 8 alleges that payments were made to defendants under a mistake of fact. Count VI alleges that all actions of the defendants were actions of Colkitt under an alter ego theory. Profits </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-4252.wpd">OPINION/ORDER</A><BR> The case is therefore ordered submitted without oral argument. Appellant Larry Stoddard pled guilty to executing a scheme or artifice to (1) This order and judgment is not binding precedent except under the doctrines of law of the case. Stoddard was licensed to practice medicine and prescribe controlled substances in Utah where he operated Utah Hyperbaric Oxygen Therapy.(1) He also qualified as an approved health care provider entitled to payments from the Medicare program for services provided to qualified beneficiaries. Determining: 1) his base offense level was 6. Because the loss was at least $70. Stoddard did not dispute the facts represented in the presentence report or that the advisory Guidelines range was twelve to eighteen months imprisonment. Government counsel argued incarceration of twelve to eighteen months was warranted. Stating it was appropriate for the purpose of deterring Dr. He also twice participated in substance abuse programs for prescription pain medication use in order to retain his medical license and is currently on various medications for pain. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/oct98/96-3117.man.html">UNITED STATES V. STARKS (10/9/1998, NO. 96-3117)<BR></A><BR> Starks and Siegel contend that the Anti Kickback statute is unconstitutionally vague. The government cross appeals Siegel's sentence on the grounds that the district court should not have reduced his offense level for acceptance of responsibility. That the district court should have applied the guideline for bribery of a public official rather than the guideline for fraud and deceit. Andrew Siegel was both the president and the sole shareholder of Future Steps. Angela Starks and Barbara Henry had just become community health aids in the employ of the State of Florida Department of Health and Rehabilitative Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//oct98/96-3117.man.html">UNITED STATES V. STARKS (10/9/1998, NO. 96-3117)<BR></A><BR> Starks and Siegel contend that the Anti Kickback statute is unconstitutionally vague. The government cross appeals Siegel's sentence on the grounds that the district court should not have reduced his offense level for acceptance of responsibility. That the district court should have applied the guideline for bribery of a public official rather than the guideline for fraud and deceit. Andrew Siegel was both the president and the sole shareholder of Future Steps. Angela Starks and Barbara Henry had just become community health aids in the employ of the State of Florida Department of Health and Rehabilitative Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/07/063263P.pdf">OPINION/ORDER</A><BR> We have observed that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug97/95-9493.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/03/052445P.pdf">OPINION/ORDER</A><BR> Joshi asserts </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=93-1024.01A">OPINION/ORDER</A><BR> Wishart and Jackman & Roth were on brief for plaintiffs. Shea and Peabody & Brown were on brief for defendants. Was entitled to three years' continuation coverage under COBRA. I I BACKGROUND BACKGROUND David Gaskell was a longtime employee of the Harvard Cooperative Society ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/042589np.pdf">OPINION/ORDER</A><BR> Teaching hospitals are entitled to reimbursement for the indirect cost of operating a medical residency program. This </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/02/02/011970P.pdf">OPINION/ORDER</A><BR> They argue that the district court's grant of summary judgment was erroneous because 3M provided vested benefits. Hughes were employed by 3M until they both retired at age 66 Ed retiring in 1991 and Dorothy in 1993. Were members of Local 6 75 of Oil. The resulting agreement was distributed to the active employees. A document called </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/051292np.pdf">OPINION/ORDER</A><BR> We will affirm. Who are familiar with this case. I. Briston's first contention is that the government failed to prove the jurisdictional element contained in 18 U.S.C. § 666(a)(1)(A)(i). The government claims this argument was waived because Briston did not move for a judgement of acquittal at the close of evidence. 000 threshold contained in the statute is jurisdictional. Defects in subject matter jurisdiction require correction regardless of whether the error was raised in district court. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/053409p.pdf">OPINION/ORDER</A><BR> Before us are cross appeals arising from the reduction of a $30 million punitive damages verdict to $2 million. The District Court ordered the reduction on the ground that the verdict was constitutionally excessive. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0107p-06.pdf">OPINION/ORDER</A><BR> Waiving review of all other violations for which civil penalties were imposed. Which was sustained by an administrative law judge for the HHS Departmental Appeals Board and then upheld by an appellate panel of the Appeals Board. 2004* This decision was originally issued as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDAzLTE1NDZfb3BuLnBkZg==/03-1546_opn.pdf">OPINION/ORDER</A><BR> Singh was convicted of health care fraud. Structure of the Practice Singh was a physician. The Practice was located on the first floor of Albany Memorial Hospital ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0284n-06.pdf">OPINION/ORDER</A><BR> Is said to be the product of an improper shifting of the burden of proof. Windsor was found not to have * Michael O. Is substituted for outgoing Secretary Tommy Thompson as defendant in this case. This determination was based primarily on two accidents. The Centers for Medicare & Medicaid Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=06-3521_012.pdf">OPINION/ORDER</A><BR> We have jurisdiction because. We would have had jurisdiction of that review proceeding. 42 U.S.C. § 1320a 7a(e). 2 No. 06 3521 The first subsection of section 504(a) provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-3476_021.pdf">OPINION/ORDER</A><BR> One for breach of contract and one for violating the Illinois (continued...) 2 No. 05 3476 mined that Caremark was not an ERISA fiduciary and therefore granted Caremark's motion to dismiss. One of the benefits provided is prescription drug coverage which entitles the union members to obtain brand name or generic prescription drugs for a small copayment. One of the nation's largest Pharmaceutical Benefit Management ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0662n-06.pdf">OPINION/ORDER</A><BR> Factual background Clermont is a nursing home located in Milford. Clermont is required by law to comply with all 1 No. 04 3949 Clermont Nursing & Convalescent Ctr. v. This survey found that Clermont was not in compliance with 23 federal regulations for nursing homes participating in the Medicare and Medicaid programs. 2 are at issue in this appeal. The first point of contention involves the surveyors' finding that Clermont was not in compliance with 42 C.F.R. § 483.25(c). Which mandates that a facility ensure that a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0837n-06.pdf">OPINION/ORDER</A><BR> We conclude that the proper legal standards were employed and that there was substantial evidence to support the decision to impose a civil monetary penalty under 42 C.F.R. § 483.20(k)(3)(i) (2001). Omni Manor is a long term care facility in Ohio that participates in the federal Medicare and Medicaid programs under a provider agreement with the Secretary of Health and Human Services. 42 U.S.C. § 1395cc (2001). Facilities that contract with the Secretary of Health and Human Services are periodically inspected by state health agencies to ensure compliance with federal regulations. 42 U.S.C. §§ 1395aa. The Ohio Department of Health ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/08/97-2031.htm">97-2031 -- U.S. V. MEYEROWITZ -- 08/17/1998<BR></A><BR> </strong> <a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200401/02-5350a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="388"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1997/10/96-5168.htm">96-5168 -- SMITH V. ROGERS GALVANIZING CO. -- 10/28/1997<BR></A><BR> We affirm.<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-2079.01A">OPINION/ORDER</A><BR> Were on brief for appellants. Were on brief for appellee. FACTS FACTS As the facts relevant to the merits of this case are set forth fully in the district court opinion. We will recount only those facts pertinent to the issue of appellate jurisdiction. Plaintiffs claimed that they were denied coverage for durable medical equipment under Medicare Part B in violation of statutory and constitutional law.2 The complaint indicated plaintiffs' intent to seek class certification. The Department of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/03/03-2111.PDF">OPINION/ORDER</A><BR> We conclude that its grant of summary judgment was premature. I As is common with FCA cases. CMC is a nonprofit corporation established to provide information technology (IT) consulting services to small and medium sized manufacturing enterprises in the Chicago area. CMC is sponsored by the Manufacturing Extension Plan (MEP). She was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199810/97-5262a.txt">OPINION/ORDER</A><BR> With him on the briefs was Ronald N. With her on the brief were Frank W. It would have qualified for reclassification as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=99-1085ORD.01A">OPINION/ORDER</A><BR> 2000</CENTER> </P> <BR WP= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcU1VNXDA1LTEyNTdfc28ucGRm/05-1257_so.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/001118.P.pdf">OPINION/ORDER</A><BR> Circuit Judge: We are presented with the question of whether the Federal Tort Claims Act. Asserting that he was suffering from a medical emergency. Federal employees operating the hospital refused to treat White or to refill his oxygen tank because he was not Indian. He was in extreme respiratory distress. The complaint alleges that White's death was caused by the Cherokee Indian Hospital's </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0019p-06.pdf">OPINION/ORDER</A><BR> WILL & EMERY. WILL & EMERY. The plaintiffs in these four consolidated appeals are retirees or surviving spouses of the J.I. The underlying issue is whether the retirement health care benefits vested for life. We conclude that the district court did not abuse its discretion in determining that the plaintiffs are likely to succeed on their claim that their health care benefits are fully vested for life. The defendants are El Paso Tennessee Pipeline Company and CNH America. Was established in 1842 and became a wholly owned subsidiary of Tenneco (now El Paso) in 1970. Included was all of the JI Case business (defined as the farm and construction equipment business of Tenneco) except for Tenneco's JI Case stock. Case Equipment was then spun off on July 1. Is now known as CNH America.2 In 1996. Tenneco merged with a subsidiary of El Paso Natural Gas Company and is now known as El Paso Tennessee Pipeline Company. At times the opinion will refer to CNH America by its previous names. Page 3 forward contain the following language in Section 4A with respect to the Group Insurance Plans: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug97/97-2229.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/01/01-3806.PDF">OPINION/ORDER</A><BR> The district court concluded that it lacked subject matter jurisdiction because the information upon which Feingold based his suit was publicly disclosed and he was not the original source of that information. Inc. are companies that contracted with the Healthcare Financing Administration (HCFA) to approve or disapprove healthcare equipment providers' claims for reimbursement under Medicare. Appellant Richard Feingold is familiar with the approval process because he recently worked for a medical supply company and was involved in two other successful qui tam suits involving improper Medicare reimbursements. Adult diapers were an item for which Medicare would not provide reimbursement. Feingold suspected that Appellees recklessly approved claims for diapers that were disguised as being for other. The district court determined that the five categories of documents were publicly disclosed and that Appellees were entitled to summary judgment because Feingold ran afoul of the FCA's prohibition of suits based on publicly disclosed </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=00-2446.01A">OPINION/ORDER</A><BR> Were on brief. Were on brief. The district court issued a preliminary injunction preventing the implementation of the statute on the ground that it is preempted by the Supremacy Clause and violates the dormant Commerce Clause. Which establishes the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/july99/98-3447.man.html">UNITED STATES V. DBB, INC. (7/14/1999, NO. 98-3447)<BR></A><BR> Circuit Judge:</P> <P> The United States and various defendants separately appeal from a district court order granting a preliminary injunction pursuant to 18 U.S.C. § 1345(a)(2) freezing the defendants' assets that were traceable to their fraudulent activities. Procedural History and Background</EM></CENTER> </P> <P> This action was originally filed by Gary E. The individual defendants are directors and officers of various companies that provide Durable Medical Equipment ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/03/03-30064.0.wpd.pdf">OPINION/ORDER</A><BR> The court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/09/99-9535.htm">99-9535 -- SOUTH VALLEY HEALTH CARE CENTER V. HEALTH CARE FINANCING ADMINISTRATION -- 09/11/2000<BR></A><BR> The penalty was levied by the Health Care Financing Administration (Administration) pursuant to 42 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0095p-06.pdf">OPINION/ORDER</A><BR> Sitting by designation. ** This decision was originally issued as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//july99/98-8870.man.html">UNITED STATES V. PEDRICK (7/22/1999, NO. 98-8870)<BR></A><BR> BACKGROUND</CENTER> </P> <P> Pedrick was tried jointly with co defendant Andrew Shankman. Pedrick and Shankman were charged jointly with one count of conspiracy to defraud Medicare. Shankman alone was subject to ten counts of unlawfully dispensing controlled substances in violation of 21 U.S.C. § 841(a)(1) (Counts 91 to 100) and twenty five counts of money laundering to promote the scheme to defraud in violation of 18 U.S.C. §§ 2 and 1956(a)(1)(A)(i) (Counts 101 to 125).</P> <P> Shankman was a psychiatrist who owned and operated Shankman/Davidson Psychiatric Management. Along with co defendant Thomas Davidson.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0650n-06.pdf">OPINION/ORDER</A><BR> It is unnecessary to consider whether the ALJ. Because the evidence is not in equipoise in this case. Hillman is not dispositive of the result here. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0539n-06.pdf">OPINION/ORDER</A><BR> The state agency performed a revisit survey and determined that Harmony Court was in substantial compliance as of December 10. The agency cited Harmony Court for 29 violations that the agency was unwilling to waive. She concluded that the facility had failed to comply with 12 participation requirements with at least 1 violation per survey cycle and that the civil penalty was reasonable. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/12/971015P.pdf">OPINION/ORDER</A><BR> Most of whom were eligible for Medicare. During the course of the audit it was revealed that the Mayers had submitted false invoices totaling $253. 000 expense for computer equipment that was never purchased. Kerry Mayer was sentenced to 2 twelve months and one day of imprisonment. Was ordered to pay an identical amount of restitution jointly and severally with his wife. The government contends the two level increase is not reviewable because Eleni's twenty one month sentence would still be within the guideline range she seeks. It must be </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/B97D5C369DDFA424882573480056ED67/$file/0536065.pdf?openelement">OPINION/ORDER</A><BR> Leavitt is substituted for his predecessor. Circuit Judge: As we are often called to do. Appeal the adverse grant of summary judgment in their challenge to the Secretary of Health and Human Services's ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-5101.pdf">OPINION/ORDER</A><BR> On counsel were W. With him on the brief were Peter D. Of counsel on the brief were Walter F. This is a post award bid protest case. PGBA filed suit in the United States Court of Federal Claims seeking to have the award of the contract to WPS set aside. Rule that PGBA was entitled to recover its reasonable bid preparation and proposal costs. TRICARE is a military health care benefits program that provides health care benefits to dependents of active duty service members and to retired service members and their dependents. TRICARE is administered within the Department of Defense by TMA. The TRICARE system was divided into eleven geographical PGBA filed its first motion for reconsideration after the court issued its original order under seal. TMA will consolidate the MCS contracts from seven contracts covering eleven regions to three contracts covering three regions. This new contract is called the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//july99/98-3447.man.html">UNITED STATES V. DBB, INC. (7/14/1999, NO. 98-3447)<BR></A><BR> Circuit Judge:</P> <P> The United States and various defendants separately appeal from a district court order granting a preliminary injunction pursuant to 18 U.S.C. § 1345(a)(2) freezing the defendants' assets that were traceable to their fraudulent activities. Procedural History and Background</EM></CENTER> </P> <P> This action was originally filed by Gary E. The individual defendants are directors and officers of various companies that provide Durable Medical Equipment ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/04/983110P.pdf">OPINION/ORDER</A><BR> I. Appellant James Darst is a former Administrative Law Judge in the Social Security Administration (SSA) Office of Hearing and Appeals in Creve Coeur. Darst stated that he was born on June 17. The SSA advised Darst that his application was denied because he did not submit proof that he was at least sixty two years of age. Stating that the decision was incorrect and that he had no other proof to offer. This Request was denied on December 13. Darst was advised that upon an independent review. The SSA found their first decision was correct. This investigation was conducted by Mr. Eventually the information he developed was forwarded to Chief Administrative Law Judge Boyer. Boyer issued letters counseling Darst and Mills about the appearance of impropriety of holding Darst's hearing the same day it was requested and of giving Darst's claim priority over other claimants. The SSA asserts that these letters were not placed in the official personnel files of Darst or Mills. That no action was taken on the basis of these letters. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=95-1167.01A">OPINION/ORDER</A><BR> THE FACTS We are guided through the thicket of conflicting testimony and the chasmal gaps in the direct evidence by the rule that. See id. at 35 36. 2 The evidence is conflicted as to whom she saw and what that person was told about her condition. Angel testified that he implored the receptionist to have someone </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=91-1396.01A">OPINION/ORDER</A><BR> Inc. was on brieffor appellants. The question in thiscase is when the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca5.uscourts.gov/opinions%5Cpub%5C03/03-60801-CV0.wpd.pdf">OPINION/ORDER</A><BR> FACTS AND PROCEEDINGS BELOW Plaintiffs were selling agents for Commonwealth National Life Insurance Company ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=04-2989_032.pdf">OPINION/ORDER</A><BR> The practice of favoring close family members or friends with lucrative government contracts is hardly a new one. It is usually forbidden. Which in turn was receiving federal monies from the Department of Housing and Urban Development (HUD). Moore argues primarily that she had no duty to disclose the fact that she was her mother's daughter to the City (and hence to the federal government). WH was a non profit organization that Cameron established to carry out neighborhood social programs. It was largely funded by HUD block grants awarded by the City of Milwaukee. Cameron ran for and was elected to be an alderwoman on Milwaukee's Common Council. Although the City is responsible for awarding and administering particular grants. After a block grant is awarded to an organization. If all is in order. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0826n-06.pdf">OPINION/ORDER</A><BR> The Sanctuary at Whispering Meadows is a nursing facility that participates in the Medicare and Medicaid programs. A survey conducted on behalf of the Centers for Medicare & Medicaid Services (CMS) determined that Whispering Meadows was not in substantial compliance with Medicare regulations regarding the prevention and treatment of pressure sores. Who concluded that the facility was not in compliance with the regulations and that the amount of the penalty was Whispering Meadows v. The Departmental Appeals Board (DAB) of the Department of Health and Human Services (HHS) affirmed the judgment of the ALJ in a thorough and well reasoned opinion that was supported by substantial evidence. To ensure that they are in substantial compliance with all federal requirements for skilled nursing facilities. These surveys are generally conducted by the health departments of the various states on behalf of CMS. Whispering Meadows was found to be out of compliance with 42 C.F.R. § 483.25(c)(1). Which requires participating facilities to ensure that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcU1VNXDA1LTQxMjhfc28ucGRm/05-4128_so.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/09/983619P.pdf">OPINION/ORDER</A><BR> Knew or should have known of the improprieties. Palmisano was The HONORABLE JOHN B. I. The Defamation Claim Allina is a nonprofit health care corporation. An Allina staff attorney conducted the internal investigation and completed his final report on the day Palmisano was forced to resign. Mishek also noted that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CE08057BF6F39DF3882571E0004AA906/$file/0416247.pdf?openelement">OPINION/ORDER</A><BR> Relators have raised allegations that the University of Phoenix knowingly made false statements. One of these requirements is a ban on incentive compensation: a ban on the institution's paying recruiters on a per student basis. This requirement is meant to curb the risk that recruiters will </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Oct2004/Oct28/03-60801-CV0.wpd.pdf">OPINION/ORDER</A><BR> FACTS AND PROCEEDINGS BELOW Plaintiffs were selling agents for Commonwealth National Life Insurance Company ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/DE0F7B78D1C92CBA88256A22005C0E0A/$file/9856557.pdf?openelement">OPINION/ORDER</A><BR> We reverse the district court's decision to dismiss Lee's case with prejudice because we conclude that Lee should have been granted leave to amend his federal FCA and federal </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/E3AF839F8EFD31ED88256E5A00707ACC/$file/9856557.pdf?openelement">OPINION/ORDER</A><BR> We reverse the district court's decision to dismiss Lee's case with prejudice because we conclude that Lee should have been granted leave to amend his federal FCA and federal </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA0LTUwOTctY3Zfb3BuLnBkZg==/04-5097-cv_opn.pdf">OPINION/ORDER</A><BR> That Murray and Gould had never actually worked for him and that they were threats to national security. We will continue to refer to the INS. 2 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 BACKGROUND In 1998. Who are responsible for general oversight and enforcement of the IPPCTP provisions. The PA is responsible for monitoring participants' compliance with program requirements. The PA is required to terminate from the program Id. § 139.4. NGIT was selected as the any participant who is fired for cause. The PA is obligated to report to the DOS and INS on certain aspects of the program. After they were approved to participate in the IPPCTP. They began to have concerns about Smith's conduct. did not pay them and told them that business was too slow. That both of them were working for many different employers. That Murray was getting his pilot's license. That they were both working for others in the Las Vegas area. That Murray was getting his pilot's license in order to open a business in Yemen. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA2LTM2NDQtY3Zfb3BuLnBkZg==/06-3644-cv_opn.pdf">OPINION/ORDER</A><BR> For Respondent PER CURIAM: We are called upon to address a matter of human tragedy. We are compelled to conclude that the statute which guides this Court's review denies Collier Social Security Disability Insurance (SSDI) and Medicare benefits because she does not have the required recent work history. Recognizing that we have no license to alter the legislative scheme. Collier was diagnosed with ALS. Since then Collier and her family 2 have expended more than $500. As that is the prerequisite for Medicare eligibility for those under 65. 42 U.S.C. § 426(b). The statute requires that an applicant above the age of 31 must have worked twenty of the previous forty quarters (i.e. It is undisputed that Collier did not have a recent work history as she left the paid workforce in 1994. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200706/06-5133a.pdf">OPINION/ORDER</A><BR> With him on the briefs was E. Green was on the brief for amici curiae American Medical Association et al. in support of appellant. With her on the brief were Jeffrey S. Circuit Judge: The issue in this case is standing to challenge a regulatory safe harbor where the direct cause of injury is the independent action of a third party. The same issue was before this court in National Wrestling Coaches Ass'n v. Though the factual context there was very different. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/12/043788U.pdf">OPINION/ORDER</A><BR> This action for review of an administrative claim for Medicare benefits was brought by Maxine King (King). Anderson argues this appeal from the district court's1 adverse judgment is not moot. Rather seeks to challenge (1) the finding that King was not entitled to coverage under the Medicare Act for skilled nursing care during some period in the past. Both issues were mooted by King's death. . . . there must be a reasonable expectation that the same complaining party will be subjected to the same action again. 631 (1979)) ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/044081.P.pdf">OPINION/ORDER</A><BR> Requesting that it be given what it contends is the necessary evidentiary latitude to prove its case. Have been indicted for a conspiracy in Northern Virginia from 1996 to 2003 to defraud the United States and private insurance plans of funds for medical reimbursement by submitting to Medicare and the private plans false claims for services allegedly performed by Dr. Janati have been indicted in 61 additional counts alleging overt acts. It explained that the charts and witnesses would condense the evidence necessary to present to the jury approximately 1300 individual reimbursement claims that were made in furtherance of the conspiracy and in support of the specific overt acts alleged in Counts 2 62 of the indictment. It could not refer in those charts or in testimony to any of the 1300 transactions within the scope of the conspiracy that were not alleged as overt acts: UNITED STATES v. JANATI 3 [T]he charts in their case in chief could not contain any reference to those additional items that are not permitted in their case in chief [to prove the 61 overt acts]. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/july99/98-8870.man.html">UNITED STATES V. PEDRICK (7/22/1999, NO. 98-8870)<BR></A><BR> BACKGROUND</CENTER> </P> <P> Pedrick was tried jointly with co defendant Andrew Shankman. Pedrick and Shankman were charged jointly with one count of conspiracy to defraud Medicare. Shankman alone was subject to ten counts of unlawfully dispensing controlled substances in violation of 21 U.S.C. § 841(a)(1) (Counts 91 to 100) and twenty five counts of money laundering to promote the scheme to defraud in violation of 18 U.S.C. §§ 2 and 1956(a)(1)(A)(i) (Counts 101 to 125).</P> <P> Shankman was a psychiatrist who owned and operated Shankman/Davidson Psychiatric Management. Along with co defendant Thomas Davidson.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1499.01A">OPINION/ORDER</A><BR> Mudd</SPAN> was on the brief. Ones Rivera</SPAN> were on the brief. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/jan2002/00-16345.opn.html">VENCOR HOSPITALS, INC. V. STANDARD LIFE AND ACCIDENT INS. CO. (1/24/2002, NO. 00-16345)<BR></A><BR> The motion for reconsideration was denied by the district court. The district court determined relief was precluded based on the 1991 amendment adopting Federal Rule of Appellate Procedure 4(a)(6). A Florida resident to whom Appellee had issued an insurance policy providing benefits supplementing her Medicare coverage. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/042255p.pdf">OPINION/ORDER</A><BR> A house leased and used by CSG to provide caretaker services to three mentally retarded women residing there on the basis that the house was a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/04/041691U.pdf">N:\DOCS\PATTY\04-1691 VOLKERT V. LEAVITT1.WPD<BR></A><BR> Is substituted as appellee pursuant to Federal Rule of Appellate Procedure 43(c). Jurisdiction to review Volkert's related due process argument is also lacking. Because it is inextricably intertwined with. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/031675.P.pdf">OPINION/ORDER</A><BR> 1 were engaged in an anticompetitive conspiracy with medical doctors and medical associations whose purpose was to harm chiropractors. Claiming that Trigon and the medical doctors and associations were engaged in a conspiracy that used Trigon's reimbursement policies and treatment guidelines to limit severely the flow of insurance dollars to chiropractors and steer those monies toward medical doctors. Trigon Healthcare was recently purchased by Anthem Healthcare. Trigon is a for profit. These healthcare benefit plans list the benefits and services covered by Trigon under the plan and describe any services that are excluded from the plan or are the subject of coverage limitations. Trigon creates this network of healthcare providers by entering into contracts with providers who are willing to abide by Trigon's terms and conditions. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//jan2002/00-16345.opn.html">VENCOR HOSPITALS, INC. V. STANDARD LIFE AND ACCIDENT INS. CO. (1/24/2002, NO. 00-16345)<BR></A><BR> The motion for reconsideration was denied by the district court. The district court determined relief was precluded based on the 1991 amendment adopting Federal Rule of Appellate Procedure 4(a)(6). A Florida resident to whom Appellee had issued an insurance policy providing benefits supplementing her Medicare coverage. </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug97/97-2229.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-3.gif" ALT="347"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/oct96/95-2159.wpd.html">UNITED STATES V. JARAMILLO<BR></A><BR> Jaramillo moved for a new trial on the ground that there were exhibits in the jury room during deliberations that had not been admitted into evidence. The trial court found that the loss to the government was $12. BACKGROUND Jaramillo was a psychiatrist licensed in Albuquerque. Jaramillo was also a staff psychiatrist and part owner of Memorial Hospital. He was not licensed to practice medicine in the United States because he had failed the foreign medical graduates examination more than twenty times. CHAMPUS are federally funded health insurance programs. Jaramillo was permitted to submit claims to these programs because he. Was an authorized provider of services. Who was not licensed to practice medicine. Was not an authorized provider. The regulations did not permit Jaramillo to bill for services provided by Meyerowitz if Jaramillo was absent from his office or the hospital. Jaramillo was not in Albuquerque. (4) the use of videotapes in English which were shown to Spanish speaking patients. The government argued that this evidence was directly relevant to the conspiracy count and to Jaramillo's knowledge and intent on all counts under Federal Rule of Evidence 401. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200705/06-5232a.pdf">OPINION/ORDER</A><BR> With her on the briefs were Adina H. Martha Jane Perkins was on the brief for amici curiae Representatives Henry R. With her on the brief were Peter D. Walker were on the brief for amicus curiae CTIA The Wireless Association in support of appellee. Is invalid because the bill that was presented to the President did not first pass both chambers of Congress in the exact same form. Because the version of the legislation that was presented to the House contained a clerk's error with respect to one term. Public Citizen asserts that it is irrelevant that the Speaker of the House and the President pro tempore of the Senate both signed a version of the proposed legislation identical to the version signed by the President. The District Court held that Public Citizen's bicameralism claim is foreclosed by the Supreme Court's decision in Marshall Field & Co. v. Through their presiding officers </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/99a0408p-06.pdf">OPINION/ORDER</A><BR> At the time that this first CBA was negotiated. Aircraft was a division of Loral and as a consequence. Employees of both entities were covered by the In its January 1996 Order. The NLRB determined not only that Loral and Aircraft had violated Section 8(a)(5) and (1) as a result of their unilateral changes in health care plans but also found that Aircraft was guilty of separate violations of Section 8(a)(5) and (1) arising out of its failure/refusal to arbitrate certain grievances. The failure to arbitrate portion of the NLRB's Order is not challenged by Aircraft. That portion of the Order will be summarily enforced. Cir. 1997) (Board's findings that are not challenged on appeal are entitled to summary enforcement). 1 4 Loral Defense Systems. Aircraft was severed from Loral and became an independent corporate entity. The 1988 collective bargaining agreement covering Loral and Aircraft employees was to expire by its own terms on August 10. The Board issued an order determining that the single collective bargaining unit was no longer appropriate in light of the new organizational structure of the companies and. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/09/00-6158.htm">00-6158 -- U.S. V. HILLCREST HEALTH CENTER INC. -- 09/07/2001<BR></A><BR> The <em>qui tam</em> provisions of the Act permit private individuals to sue on behalf of the United States those persons or entities who allegedly have presented false or fraudulent claims to the federal government.<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0912n-06.pdf">OPINION/ORDER</A><BR> Belluardo and Middleton contend that they are participants in Cox Enterprises' pension plan and are entitled to benefits under the plan. They claim they are entitled to amounts that Dayton Newspapers should have paid the federal and state governments on their behalf as Social Security and Medicare taxes. Belluardo and Middleton were newspaper carriers for Dayton Newspapers. That Dayton Newspapers had misclassified them as independent contractors when they were actually common law employees. The defendants are Dayton Newspapers. Holding that the plaintiffs were independent contractors because they had the right to control the means of selling the papers. Observing that although it agreed that plaintiffs were independent contractors. The real issue before it was whether the plaintiffs were permitted to buy and sell the newspapers. So there was no misrepresentation by Dayton Newspapers. While their state suit was pending. Pension Plan contending that they were covered employees entitled to benefits under the pension plan. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/09/042352P.pdf">OPINION/ORDER</A><BR> I. Reaves is a disabled person and a client of the Division. Is charged with providing vocational rehabilitation services for individuals with disabilities in the State. 29 U.S.C. §§ 720. The Division is organized as part of the Department. Of which King is the appointed Commissioner. Reaves requested support from the Division in her pursuit of a career as what is known as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Jun2004/Jun15/03-20840-CR0.wpd.pdf">OPINION/ORDER</A><BR> PER CURIAM: The defendant was convicted of 32 counts of mail fraud by a jury. This court reversed her conviction on the first three counts of the first indictment and remanded for resentencing. court erred In this appeal the defendant asserts the district in (1) enhancing her sentence under U.S.S.G. § 2F1.1(b)(8)(B) because an insurance company is not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-6186.wpd">OPINION/ORDER</A><BR> It had neither paid the taxes it was disputing nor sought administrative relief before the Internal Revenue Service. Arguing that the judgment is void because the jurisdictional defect that existed when the suit began was incurable. Whether a district court had subject matter jurisdiction is a question of law that we review de novo. Were the only children of S. One of their businesses was Primco Management Company. An Oklahoma corporation whose stock was held equally by the brothers' revocable living trusts. Primco was the nerve center for the Goldmans' other businesses: it performed administrative services such as bookkeeping. The complaint and stipulation were amended as follows: 1. Goldman for the tax (1) The district court said that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/12/041017P.pdf">OPINION/ORDER</A><BR> Is a retired public school employee and a participant in the teacher retirement program administered by the Arkansas State and Public School Life and Health Insurance Board (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/12/033710P.pdf">OPINION/ORDER</A><BR> Many of the bills prepared by Appellants were submitted for payment to various federal entities including Medicare and Medicaid. If the file data was incomplete. Central to Appellants' concern was that the University was billing federally funded programs for surgical procedures and other medical services as if they were performed by teaching physicians when the procedures and services were 2 actually performed by residents. She told her advisors that she thought it was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/004879.U.pdf">OPINION/ORDER</A><BR> NORTON Unpublished opinions are not binding precedent in this circuit. Charles Fugate were indicted for their involvement in Medicare kickback schemes. Rule 402 of the Federal Rules of Evidence provides that all relevant evidence is admissible. Rule 401 defines relevant evidence as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/04/013888P.pdf">OPINION/ORDER</A><BR> Hays was fired by St. A qui tam action is one in which a private plaintiff sues on behalf of the government under a statute that awards part of any penalty recovered to the plaintiff and the remainder to the government. 2 1 Defendants appeal the qui tam portion of the judgment. We conclude that the DHS audit reports were relevant public disclosures of the allegations underlying the qui tam claims. That Hays was an original source of only one of those disclosures. The public disclosure bar at issue was part of the 1986 FCA amendments. These extensive amendments were intended to encourage private enforcement suits by legitimate whistleblowers while barring suits by opportunistic qui tam plaintiffs who base their claims on matters that have been publicly disclosed by others. Defense counsel suggested that the appeal includes the question whether defendants are entitled to a new trial on the retaliation claims. That question was not included in their statement of the issues. Nor was it argued in their briefs. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/03/023613P.pdf">OPINION/ORDER</A><BR> PTS was under investigation for submitting fraudulent Medicare and Medicaid claims. Wallace was PTS's office manager. Nine federal agents were dressed in business suits and carried their weapons concealed. Wallace was in the business office she shared with four other employees. The employees were told not to leave until they were interviewed or talked to someone. Seventeen employees were found in the building and interviewed. Employees were allowed to use the restrooms without permission. Wallace and other employees were able to move freely between the front office and the business office. At which time they were paged back to the offices. Because she was also the evidence custodian. Agent Dawkins and Wallace were alone in the lounge during the 2 interview. Wallace told Agent Dawkins she was upset by the initial entry of the other agents. Wallace seemed fine and was calm. Wallace explained she was familiar with Medicare billing. Wallace testified </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-2447.01A">OPINION/ORDER</A><BR> Shall reimburse the appropriate\ Trust Fund for any payment made by the Secretary under\ this subchapter with respect to an item or service if it\ is demonstrated that such primary plan has or had a\ responsibility to make payment with respect to such item\ or service. Or\ release (whether or not there is a determination or\ admission of liability) of payment for items or services\ included in a claim against the primary plan or the\ primary plan\'s insured. The United States may\ bring an action against any or all entities that are or\ were required or responsible (directly. S direct MSP reimbursement collection\ action against the major tobacco companies was dismissed in a\ related federal district court lawsuit. 100 Stat. 3153 (1986). </span></p>\ </span>' var WPFootnote7 = '<span class= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/apr96/95-6781.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//nov99/99-11177.man.html">FLORIDA ASS'N OF MED. EQUIP. DEALERS V. APFEL (11/5/1999, NO. 99-11177)<BR></A><BR> Those who wished to sell such items to the government were required to compete by submitting bids. Suppliers whose bids failed to meet competitive price and quality standards were precluded from providing these items under Medicare. Was convened. The NTEP met three times for this purpose and was not expected to. FAMED claimed that the NTEP was an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=95-2175.01A">OPINION/ORDER</A><BR> Egbert was on brief. Were on brief. Stoller caused it to make loans to several real estate trusts with which he was affiliated. The order prevents Stoller (who is an attorney) from serving as an officer or director of. This appeal followed. 1This statute and the criminal statutes underpinning the later indictment are reprinted in the appendix. 3 II. Federal appellate courts have jurisdiction only over final orders and judgments of district courts. Emphasizing that the Double Jeopardy Clause is a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTE5ODEtY3Zfb3BuLnBkZg==/05-1981-cv_opn.pdf">OPINION/ORDER</A><BR> Circuit Judge: Plaintiffs appellants are a proposed class of patients who received treatment from defendant appellees New YorkPresbyterian Hospital and New York Presbyterian Health Care System. Inc. and were uninsured at the time of their treatment. Arguing that the district court should not have exercised supplemental jurisdiction over these state law claims after all 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 claims supporting original jurisdiction had been dismissed at a very early stage in the proceedings. Plaintiffs argue in the alternative that even if the district court was correct to reach the merits of their state law claims. We need not reach plaintiffs' alternative arguments because we agree that this case is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=96-1203.01A">OPINION/ORDER</A><BR> Hanson & DeTroy were on briefs for appellant. Was on brief for the United States. Are drawn from the presentence report. Gill was employed part time at the Bethel Area Health Center in Bethel. That he possessed a doctoral degree in psychology and was licensed as a psychologist or counselor under Maine law. Gill was not licensed and had never received an advanced degree in either psychology or counseling. The total value of the payments claimed from these entities was over $37. All charges were consolidated for sentencing. It is these two adjustments that are the sole subjects of Gill's appeal from his sentence. Gill was sentenced under the November 1995 edition of the guidelines. References are to that version unless otherwise specified. The standard of review in such a case is simple. In the standard formulation: the district court's factual findings are respected unless clearly erroneous. The determinations of law are reviewed de novo. The application of a legal standard to undisputed facts is also an issue of law. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0809n-06.pdf">OPINION/ORDER</A><BR> Petitioner Lakeridge Villa Health Center ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/98opinions/98-5233a.html">PRESBY MED CTR V. SHALALA DONNA E.<BR></A><BR> With <p> her on the briefs was <i>L. With him on the brief were <p> <p> <p> <i>Frank W. <p> the information on which it is based. The parties agree that this <p> documentation policy is an interpretive rule. <i>See</i> 5 U.S.C. <p> 553(b)(A).<p> <p> The interpretive rule provides the following </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/02/992331P.pdf">OPINION/ORDER</A><BR> Shaver was formerly employed by Lucas. Shaver alleged that Lucas knew that those medical bills it was responsible for but refused to pay would be submitted to the Social Security Administration (SSA) and Medicare. The district court concluded that setting aside the default was proper because Lucas had not intentionally delayed in responding to the complaint. 783 84 (8th Cir. 1998) (motion to set aside clerk's entry of default is subject to even more lenient </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Jun2004/Jun15/03-20839-CR0.wpd.pdf">OPINION/ORDER</A><BR> PER CURIAM: The defendant was convicted of 32 counts of mail fraud by a jury. This court reversed her conviction on the first three counts of the first indictment and remanded for resentencing. court erred In this appeal the defendant asserts the district in (1) enhancing her sentence under U.S.S.G. § 2F1.1(b)(8)(B) because an insurance company is not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1763.01A">OPINION/ORDER</A><BR> Will &. Alvarez LLP</U> were on brief for appellee.</FONT></P></UL> <P> <TABLE> <TR> <TD VALIGN= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/00a0100p-06.pdf">OPINION/ORDER</A><BR> This case requires that we determine whether the Attorney General's consent is required before a private plaintiff may settle or otherwise dismiss an action under the qui tam provisions of the False Claims Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=12&date=01&year=01">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Mar2002/011793.txt">OPINION/ORDER</A><BR> The contracts were funded by a grant from the United States Department of the Interior to the GVI for capital improvement projects. At issue here is Gumbs's submission to the GVI of requests for payment of $92. Gumbs was indicted on two counts of willfully causing a false claim to be made or presented to a federal department in violation of 18 U.S.C. Gumbs was also indicted on two counts of making false statements in a matter within the jurisdiction of a federal department in violation of 18 U.S.C. These counts were dismissed before trial. 2 Gumbs moved for judgment of acquittal at the close of the government's case pursuant to Rule 29(a) of the Federal Rules of Criminal Procedure. Gumbs submits that there was insufficient evidence that he knew that the contracts in question were federally funded. That such knowledge is required before a defendant may be convicted under S 2(b) and S 287. The government responds that S 2(b) and S 287 do not require a defendant to know that he is causing a false claim to be presented to a federal department. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=09&date=01&year=99">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Jun2004/Jun24/03-20840-CR0.wpd.pdf">OPINION/ORDER</A><BR> PER CURIAM: The defendant was convicted of 32 counts of health care fraud by a jury. This court reversed her conviction on the first three counts of the first indictment and remanded for resentencing. court erred In this appeal the defendant asserts the district in (1) enhancing her sentence under U.S.S.G. § 2F1.1(b)(8)(B) because an insurance company is not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/3730AAA6B048E0DD88256E5A00707CC4/$file/9917539.pdf?openelement">OPINION/ORDER</A><BR> Appellants filed this qui tam action alleging that Appellees defrauded the United States by receiving payments from Medicare and Medicaid for care which was not given. We have jurisdiction over this appeal pursuant to 28 U.S.C. § 1291.1 We review the district court's findings of fact relevant to its determination of subject matter jurisdiction for clear error. Is a mixed question of law and fact that we review de novo. The False Claims Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//apr96/95-6781.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/3F91B4230881B4C68825731A00823BCA/$file/0416963.pdf?openelement">OPINION/ORDER</A><BR> Developmentally disabled Medicaid beneficiaries ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Jan2003/014424.pdf">OPINION/ORDER</A><BR> Are brothers who owned and operated a construction business. The purpose of which was to file false personal income tax returns and to aid and assist certain of their employees and subcontractors in doing the same. Although there are other Gambone defendants in this case. We sometimes refer to Jack and Tony exclusively as the Gambones as they are the only appellants. The first and most common method was to pay the employees </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0196p-06.pdf">OPINION/ORDER</A><BR> Believing that the written record was sufficient to adjudicate the matter. It was thus improper not to hold an in person evidentiary hearing. Is periodically surveyed by the CMS in order to assure compliance with Medicare and Medicaid regulations. Were observed lying on their beds without these protectors. Crestview failed to ensure that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA1LTE5ODEtY3YgdyBFcnJhdGFfb3BuLnBkZg==/05-1981-cv%20w%20Errata_opn.pdf">OPINION/ORDER</A><BR> Circuit Judge: Plaintiffs appellants are a proposed class of patients who received treatment from defendant appellees New YorkPresbyterian Hospital and New York Presbyterian Health Care System. Inc. and were uninsured at the time of their treatment. Arguing that the district court should not have exercised supplemental jurisdiction over these state law claims after all 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 claims supporting original jurisdiction had been dismissed at a very early stage in the proceedings. Plaintiffs argue in the alternative that even if the district court was correct to reach the merits of their state law claims. We need not reach plaintiffs' alternative arguments because we agree that this case is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0372p-06.pdf">OPINION/ORDER</A><BR> This decision was originally issued as an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200016345.opn.pdf">OPINION/ORDER</A><BR> The motion for reconsideration was denied by the district court. The district court determined relief was precluded based on the 1991 amendment adopting Federal Rule of Appellate Procedure 4(a)(6). At issue was whether the terms of the insurance policy limited reimbursement to the discounted rates accepted by the hospital from Medicare. The district court concluded relief from judgment ­ almost a year after its entry ­ was not available under Rule 60(b). Was denied. 2000 motion was a recent opinion from the United States Court of Appeals for the District of Columbia. This was the first notice received by Appellant indicating its motion for reconsideration had been denied. 3 1 A district court's interpretation of federal procedural rules is subject to de novo review. 1279 (11th Cir. 2000) (holding a district court's interpretation of the Federal Rules of Civil Procedure is a question of law subject to de novo review). Relief from Judgment Based on Lack of Actual Notice Appellant also contends the district court should have granted its motion for relief from judgment based on a change in the law set forth in Vencor. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0238p-06.pdf">OPINION/ORDER</A><BR> The taxes at issue in the instant cases are payroll taxes withheld from employees' paychecks and held in trust by the employer until payments are made to the government. The total current liability (including interest and penalties) is approximately $450. Collection due process hearings were conducted by phone in March 2002 (Living Care II. Notice of Determination letters denying Living Care's claims were mailed June 2002 and March 2003. Which were heard by different judges. Judicial Review of Collection Due Process Proceedings Collection due process hearings were created by the Internal Revenue Service Restructuring and Reform Act of 1998. 112 Stat. 685 ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0386n-06.pdf">OPINION/ORDER</A><BR> I. Heartland is a skilled nursing facility located in Dearborn Heights. She applied for the position of nurse supervisor and stated on her employment application that her salary expectation was negotiable. Her base pay rate at the time was $27.25 per hour. She was also paid an additional $2.00 per hour shift differential. Morse was hired at a base pay rate of $29.50 per hour. Heard did not have management experience at a skilled nursing facility prior to her employment at Heartland. She was hired at a base pay rate of $27.50 per hour. Both employees were suspended from work without pay. Heartland was in a period of transition to a more </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Dec2002/021112.pdf">OPINION/ORDER</A><BR> S 669 is thus unconstitutional as applied to the facts of her case. We note that we are the first court to address the constitutionality of this statute as an exercise of Congress' power under the Commerce Clause. Will affirm. I. The relevant facts are not in dispute and may be briefly recounted. Whited was responsible for receiving payment from Center patients. It was common practice for patients to pay by endorsing a check from their insurance provider. Whited was charged by indictment of one count of theft or embezzlement in connection with health care. The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0104p-06.pdf">OPINION/ORDER</A><BR> Confers a private right on individuals enforceable under § 1983 and (2) the State's single source contract violates the freedom of choice provision because incontinence products are not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/199904/98-5233a.txt">OPINION/ORDER</A><BR> With her on the briefs was L. With him on the brief were Frank W. The information on which it is based. The parties agree that this documentation policy is an interpretive rule. We are allowing providers to furnish documentation from cost reporting periods subse quent to the base period in support of the allocation of physician compensation costs in the GME based peri od.... It is only in the absence of base period docu mentation that subsequent documentation should be con sidered as a proxy for base period documentation.... 55 Fed. If such records are also unavailable. The interpretive rule states as follows: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/817B02275C9E3BC2882572E20057D770/$file/0435746.pdf?openelement">OPINION/ORDER</A><BR> Circuit Judge: We deal with what federal Medicaid restrictions apply to a state program providing medical benefits to persons who are not eligible for Medicaid. States do not have to participate in the federal Medicaid program. If a state chooses to expand coverage to needy people who are not eligible for Medicaid. Then the needy people who are not eligible for Medicaid are neverthe 5922 SPRY v. THOMPSON less regarded as though they were. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Jun2004/Jun24/03-20839-CR0.wpd.pdf">OPINION/ORDER</A><BR> PER CURIAM: The defendant was convicted of 32 counts of health care fraud by a jury. This court reversed her conviction on the first three counts of the first indictment and remanded for resentencing. court erred In this appeal the defendant asserts the district in (1) enhancing her sentence under U.S.S.G. § 2F1.1(b)(8)(B) because an insurance company is not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/89E9077C28AC645B88256AC60013283D/$file/9917539.pdf?openelement">OPINION/ORDER</A><BR> Appellants filed this qui tam action alleging that Appellees defrauded the United States by receiving payments from Medicare and Medicaid for care which was not given. We have jurisdiction over this appeal pursuant to 28 U.S.C. § 1291.1 We review the district court's findings of fact relevant to its determination of subject matter jurisdiction for clear error. Is a mixed question of law and fact that we review de novo. The False Claims Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/01/01-3625.PDF">OPINION/ORDER</A><BR> Placing an elderly parent in a nursing home is a trying experience under the best of circumstances. The industry is highly regulated and the customers are often anxious and unhappy about the need for nursing home services. When a customer believes he has been defrauded and the proprietors of the establishment have been accused not just of fraud but racketeering. No such luck here: the parties and their attorneys have chosen the scorched earth model of litigation. The briefs on appeal do little to untangle the mess the parties have made of the case. This is the second time we have reviewed a district court's grant of summary judgment against the plaintiff in this civil RICO action. We affirm the district court's grant of summary judgment because the plaintiff is still unable to produce enough evidence to demonstrate a viable RICO claim against the defendants here. The defendants have cross appealed. Nos. 01 3625 & 01 3642 I. 3 We will assume familiarity with our first opinion in this matter and repeat only what is necessary to the resolution of this appeal. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA0LTQxMDctY3Zfb3BuLnBkZg==/04-4107-cv_opn.pdf">OPINION/ORDER</A><BR> Introduction This is an appeal from a grant of summary judgment by the United States District Court 11 for the District of Connecticut (Underhill. Morenz is an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec2000/993979.txt">OPINION/ORDER</A><BR> Was not sufficient to convict Dr. Because it proved only that his patient care may have fallen below acceptable medical standards. Gomez failed to adhere to accepted medical practices and standards was irrelevant to the issue of whether he knowingly and willfully participated in fraudulent billings. Also [was] unduly prejudicial. So that it was improperly admitted under Federal Rules of Evidence 402 and 403. 2 III. Gomez his constitutional right to a defense when it refused to allow him to present evidence proving that the general practice of Aquahab was to exclude its doctors fr om billing matters. Never told him that what he said might be used against him or that he did not have to answer if he did not want to. We have reviewed this matter car efully and have concluded that the appeal is clearly without merit and accordingly we will affirm without discussion except on the Fifth Amendment issue that Gomez raises in point IV . He actually is referring to the actions of the assistant United States attor ney before the grand jury. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/9A9CE57C4219AEB988256E5A00707AF8/$file/9817152.pdf?openelement">OPINION/ORDER</A><BR> Schug noted that Jackson was reporting hallucination. That he was taking Anafranil and Ativan.1 Dr. Diagnosed Jackson as suffering from an emergency medical (as opposed to a psychological or psychiatric) condition. 1 Anafranil is an antidepressant. Ativan is an anti anxiety agent. 4921 Redbud did not offer psychiatric care to its patients. The unwritten policy of the Redbud emergency room was that when a patient presented to the emergency room with psychiatric complaints. The patient would be examined to determine if there were any medical components to his problem. If a medical problem was found. If no medical problem was found. Where he was evaluated by Dennis Skinner. Such as the Anafranil Jackson was known to be taking. His condition to have stabilized. Ollada observed that Jackson was very agitated. Ollada that she believed that her husband was suicidal. Ollada determined that Jackson was suffering from a psychological disorder which caused his agitation. That he was not suffering from any physical disorders. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-4742_014.pdf">OPINION/ORDER</A><BR> The reductions were as follows: the $2 deductible was limited to generic drugs. For brand name drugs the deductible was raised to $35 or (for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-4193_019.pdf">OPINION/ORDER</A><BR> Facts Memorial is a hospital located in Belleville. It is licensed to provide health care services. The Medicaid program is a program jointly funded by the states and the federal government. It provides medical assistance to individuals and families whose resources are insufficient to meet the costs of necessary medical services. Ark. 2002) (noting that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-3682_011.pdf">OPINION/ORDER</A><BR> I. Background The plaintiffs appellants are retired hourly employees of a manufacturing facility located in Auburn. The employees (now </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/96opinions/96-5013.html">TOTAL MANAGEMENT V. U.S.<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec1995/95a1237p.txt">OPINION/ORDER</A><BR> We have jurisdiction pursuant to 28 U.S.C. § 1292(a)(1). The Parties NJHA is a non profit association representing seventy one of the eighty four hospitals in New Jersey that receive Medicaid reimbursement from the State of New Jersey. The defendants in this action are William Waldman. The defendants have been sued in their official capacities. DHS is the state agency responsible for New Jersey's Medicaid Program. The Division of Medical Assistance and Health Services is the office within DHS that administers the program. The defendants will be referred to as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/01/00-6456.htm">00-6456 -- U.S. V. VANMETER -- 01/29/2002<BR></A><BR> VanMeter asserts the following: (1) the trial court should have suppressed wiretap communications obtained pursuant to a court order that included unlawful references to offenses not subject to wiretap investigation. (4) there was insufficient evidence the bribe in question was related to Oklahoma State Department of Health official business to sustain a conviction. Was responsible for overseeing Oklahoma's nursing homes. Were unable to discover the full extent of corruption. VanMeter was soliciting bribes. Judges may only authorize wiretaps where statutory requirements are met. Including a showing the wiretap is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200511868.pdf">OPINION/ORDER</A><BR> Is whether a former sales employee of multiple defendants pleaded fraud with particularity. Because the complaint failed to provide any factual support that false claims were actually submitted to the government and a third amendment of the complaint more than five years after the commencement of this action would have been futile. Corsello alleged 2 that while he was employed by two of the defendants. The district court granted Corsello's motion to file an amended complaint but warned Corsello that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CD710642EE1C289388256A33005ADA63/$file/9817152.pdf?openelement">OPINION/ORDER</A><BR> Schug noted that Jackson was reporting hallucination. That he was taking Anafranil and Ativan.1 Dr. Diagnosed Jackson as suffering from an emergency medical (as opposed to a psychological or psychiatric) condition. 1 Anafranil is an antidepressant. Ativan is an anti anxiety agent. 4921 Redbud did not offer psychiatric care to its patients. The unwritten policy of the Redbud emergency room was that when a patient presented to the emergency room with psychiatric complaints. The patient would be examined to determine if there were any medical components to his problem. If a medical problem was found. If no medical problem was found. Where he was evaluated by Dennis Skinner. Such as the Anafranil Jackson was known to be taking. His condition to have stabilized. Ollada observed that Jackson was very agitated. Ollada that she believed that her husband was suicidal. Ollada determined that Jackson was suffering from a psychological disorder which caused his agitation. That he was not suffering from any physical disorders. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/04/031015P.pdf">OPINION/ORDER</A><BR> United States District Judge for the Eastern District of Arkansas. 3 1 We affirm the district court's ruling that ADHS may not alter the CHMS program until it conducts an impact study to ensure that the changes are consistent with the principles of economy. The federal Centers for Medicare & Medicaid Services (CMS) was not a party to the suit below. The district court ordered it to continue to subsidize the services that ADHS was providing. BACKGROUND Much of the historical background to this case was detailed in our prior decision. While participation in Medicaid is voluntary. That such services were currently provided under the CHMS program. Our court agreed that children are entitled to day treatment under the Medicaid Act. It was sufficient that ADHS continue to provide CHMS like services when prescribed by a physician. Since ADHS had done nothing to 3 42 U.S.C §§ 1396 1396v. 5 determine the effect that terminating elements of the CHMS program would have on these principles. ADHS notes that this issue was not remanded to the district court. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=93-2026.01A">OPINION/ORDER</A><BR> Palou & Miranda were on brief for respondents. Were on brief for petitioner. This is a difficult labor law case made even more difficult because the pertinent doctrines have confusing labels. San Rafael was in poor financial shape. In mid 1978 the Puerto Rico health authorities said that the hospital would have to remedy problems in its physical plant or lose its eligibility to treat Medicare patients. It was conceived that a new corporation would be established. In addition the new 2 2 hospital was expected to be more than a local hospital and to draw patients from the Caribbean basin. Centro Medico was created in August 1978 to operate the proposed new hospital under the name Hospital Interamericano de Medicina Avanzada ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="299"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov99/99-11177.man.html">FLORIDA ASS'N OF MED. EQUIP. DEALERS V. APFEL (11/5/1999, NO. 99-11177)<BR></A><BR> Those who wished to sell such items to the government were required to compete by submitting bids. Suppliers whose bids failed to meet competitive price and quality standards were precluded from providing these items under Medicare. Was convened. The NTEP met three times for this purpose and was not expected to. FAMED claimed that the NTEP was an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Aug2004/Aug11/03-50507-CV0.wpd.pdf">OPINION/ORDER</A><BR> Circuit Judge: This is a qui tam action under the False Claims Act. Who are both medical professionals. Consultants from both Deloitte and Medicaid Solutions alerted local school districts to the opportunity to gain reimbursement through Medicaid for health services that the districts were already providing. The district court concluded that any action arising out of NHIC's role as a Medicaid fiscal intermediary is barred by Texas's Eleventh Amendment immunity. Tangipahoa Parish Council Presidential Gov't.2 In order to determine whether the district court properly concluded that NHIC is an arm of the state and thus entitled to sovereign immunity from this damages action. Whether the entity is concerned primarily with local as opposed to statewide. City of New Orleans.3 This Clark test seeks to determine </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/95opinions/95-5137.html">BLACK V. SHHS<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/93opinions/93-3326.html">BALIK V. OPM<BR></A><BR> With him on the brief were <u>Frank W. The Office of Personnel Management's reconsideration decision that Balick had underreported income resulting in disability annuity payments to which he was not entitled. His disability annuity was subject to the statutory condition that he continue to be medically disabled and that his income from wages and self employment in any one year not exceed 80 percent of the then current pay of his former position<a NAME= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/01opinions/01-5146.html">JOHN MCBRYDE V. U.S.<BR></A><BR> Argued for plaintiff appellant.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/00opinions/00-5099.html">VEREDA, LTDA V. U.S.<BR></A><BR> Argued for defendant appellant.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/93opinions/93-1652a.html">AMER SCHLST TV PGRM V. FCC<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/sept2002/02-10151.opn.html">PHARM. RESEARCH V. MEADOWS (9/6/2002, NO. 02-10151)<BR></A><BR> If a drug is not on the preferred list. The pharmacist informs the doctor of the availability of other drugs (usually on the preferred drug list) that allegedly have comparable therapeutic value but are less expensive. Approval of the prescribing doctor's first choice drug is guaranteed in 100 percent of all cases. Approximately 55 percent of all these calls have resulted in a change of the prescription to a drug on the preferred drug list. It is not favored by the pharmaceutical manufacturers that brought this lawsuit.</P> <P> The prior authorization program gives the state of Florida considerable leverage in negotiating with pharmaceutical companies. Companies that have agreed to pay a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar97/95-5398.man_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/feb2002/01-15848.opn.html">VENCOR HOSPITALS V. BLUE CROSS BLUE SHIELD(2/26/2002, NO. 01-15848)<BR></A><BR> We held that an issue of fact existed as to whether Vencor was entitled to payment based on its ordinary charges. Because we were uncertain as to precisely what documents constituted the two contracts of insurance Blue Cross issued (to Butler and Esposito) that is. Whether state law required that an Outline of Coverage and a promotional brochure are part of the contracts we remanded the case and instructed the district to make that determination. Vencor challenges the district court's determination (1) that the Outline of Coverage and the promotional brochure are not part of the insurance contracts. The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/dec98/96-8787.man.html">JOHNSON V. UNIV. HEALTH SERVICES, INC. (12/3/1998, NO. 96-8787)<BR></A><BR> Is a perinatologist. Which is an obstetrician who specializes in high risk pregnancies. She was recruited in May 1992 by Hossam E. Fadel is a member of the obstetrics department of University Hospital in Augusta. Which is run by the non profit University Health Services (UHS).</P> <P> Only a few months into her employment. Her primary dissatisfaction was based on the low number of new patients that Dr. It was important that she admit a large number of new patients in order to become a board certified perinatologist. Fadel was not permitting her to admit patients in sufficient numbers to allow her to qualify for certification as quickly as she would have liked. Johnson claims to have been promised an $800. Fadel that she was considering other alternatives before it would provide any assistance.</P> <P> Dr. Johnson claimed that UHS was estopped from refusing to provide her with financial assistance under the doctrine of promissory estoppel. We conclude that they are without merit. Johnson's first two causes of action are antitrust claims. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug98/97-6023.opn.html">STEANS V. COMBINED INS. CO. OF AM. (8/4/1998, NO. 97-6023)<BR></A><BR> Order prohibiting future punitive damages awards was not binding on Aldridge and Williams and that Aldridge and Williams did not have a full and fair opportunity to litigate the orders enjoining their state court claims for punitive damages. The aggregate amount of the settlements agreed to be paid is four and a half times Combined's entire statutory profits earned during the whole of the ten year period between 1985 and 1994 in the State of Alabama. . . . The ratio of punitive damages to compensatory damages paid in these settlements is more than 125 to 1. . . . The payment by Combined of the amounts it has either paid or agreed to pay is sufficient to punish Combined for the alleged Misconduct and to deter Combined and others from similar Misconduct in the future. . . . This Court will retain jurisdiction of this case for purposes of enforcing this Order and the settlement of this case. Evidence relating to Combined's operation in the entire state of Alabama.</P> <P><U>Id.</U> at 7.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/aug2001/97-8597.opn.html">O'NEAL. V. GARRISON (8/29/2001, NO. 97-8597)<BR></A><BR> Circuit Judge:</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/apr95/94-2050.opa.html">HILLSBOROUGH COUNTY HOSP. AUTH. V. SHALALA<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Hillsborough County Hosp. Appeal the district court's grant of summary judgment in favor of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/apr2000/99-10114.man.html">SHANDS TEACHING HOSP. V. BEECH ST. CORP. (4/13/2000, NO. 99-10114)<BR></A><BR> The district court concluded that although the State of Florida was not named as a defendant in the suit. A judgment granting the relief sought by Shands would have to be satisfied from the state coffers. Thus the suit is barred by the Eleventh Amendment. Is a self insured plan funded by annual appropriations from the state legislature and premium payments by enrollees. The Department of Management Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//sept2002/02-10151.opn.html">PHARM. RESEARCH V. MEADOWS (9/6/2002, NO. 02-10151)<BR></A><BR> If a drug is not on the preferred list. The pharmacist informs the doctor of the availability of other drugs (usually on the preferred drug list) that allegedly have comparable therapeutic value but are less expensive. Approval of the prescribing doctor's first choice drug is guaranteed in 100 percent of all cases. Approximately 55 percent of all these calls have resulted in a change of the prescription to a drug on the preferred drug list. It is not favored by the pharmaceutical manufacturers that brought this lawsuit.</P> <P> The prior authorization program gives the state of Florida considerable leverage in negotiating with pharmaceutical companies. Companies that have agreed to pay a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//mar97/95-5398.man_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//feb2002/01-15848.opn.html">VENCOR HOSPITALS V. BLUE CROSS BLUE SHIELD(2/26/2002, NO. 01-15848)<BR></A><BR> We held that an issue of fact existed as to whether Vencor was entitled to payment based on its ordinary charges. Because we were uncertain as to precisely what documents constituted the two contracts of insurance Blue Cross issued (to Butler and Esposito) that is. Whether state law required that an Outline of Coverage and a promotional brochure are part of the contracts we remanded the case and instructed the district to make that determination. Vencor challenges the district court's determination (1) that the Outline of Coverage and the promotional brochure are not part of the insurance contracts. The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//dec98/96-8787.man.html">JOHNSON V. UNIV. HEALTH SERVICES, INC. (12/3/1998, NO. 96-8787)<BR></A><BR> Is a perinatologist. Which is an obstetrician who specializes in high risk pregnancies. She was recruited in May 1992 by Hossam E. Fadel is a member of the obstetrics department of University Hospital in Augusta. Which is run by the non profit University Health Services (UHS).</P> <P> Only a few months into her employment. Her primary dissatisfaction was based on the low number of new patients that Dr. It was important that she admit a large number of new patients in order to become a board certified perinatologist. Fadel was not permitting her to admit patients in sufficient numbers to allow her to qualify for certification as quickly as she would have liked. Johnson claims to have been promised an $800. Fadel that she was considering other alternatives before it would provide any assistance.</P> <P> Dr. Johnson claimed that UHS was estopped from refusing to provide her with financial assistance under the doctrine of promissory estoppel. We conclude that they are without merit. Johnson's first two causes of action are antitrust claims. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug98/97-6023.opn.html">STEANS V. COMBINED INS. CO. OF AM. (8/4/1998, NO. 97-6023)<BR></A><BR> Order prohibiting future punitive damages awards was not binding on Aldridge and Williams and that Aldridge and Williams did not have a full and fair opportunity to litigate the orders enjoining their state court claims for punitive damages. The aggregate amount of the settlements agreed to be paid is four and a half times Combined's entire statutory profits earned during the whole of the ten year period between 1985 and 1994 in the State of Alabama. . . . The ratio of punitive damages to compensatory damages paid in these settlements is more than 125 to 1. . . . The payment by Combined of the amounts it has either paid or agreed to pay is sufficient to punish Combined for the alleged Misconduct and to deter Combined and others from similar Misconduct in the future. . . . This Court will retain jurisdiction of this case for purposes of enforcing this Order and the settlement of this case. Evidence relating to Combined's operation in the entire state of Alabama.</P> <P><U>Id.</U> at 7.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//aug2001/97-8597.opn.html">O'NEAL. V. GARRISON (8/29/2001, NO. 97-8597)<BR></A><BR> Circuit Judge:</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//apr95/94-2050.opa.html">HILLSBOROUGH COUNTY HOSP. AUTH. V. SHALALA<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Hillsborough County Hosp. Appeal the district court's grant of summary judgment in favor of the Secretary of Health and Human Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit//apr2000/99-10114.man.html">SHANDS TEACHING HOSP. V. BEECH ST. CORP. (4/13/2000, NO. 99-10114)<BR></A><BR> The district court concluded that although the State of Florida was not named as a defendant in the suit. A judgment granting the relief sought by Shands would have to be satisfied from the state coffers. Thus the suit is barred by the Eleventh Amendment. Is a self insured plan funded by annual appropriations from the state legislature and premium payments by enrollees. The Department of Management Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/08/00-9529.htm">00-9529 -- ST. ANTHONY HOSPITAL V. U.S. DEPT. OF HEALTH AND HUMAN SERVICE -- 08/28/2002<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/07/99-2278.htm">99-2278 -- CORDOBA V. MASSANARI -- 07/20/2001<BR></A><BR> The SSA is authorized to pay an attorney his fees directly from the past due benefits due a claimant. <u>See</u> 46 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/06/99-1448.htm">99-1448 -- LAWRENCE V. PETERS -- 06/09/2000<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Thomas R. We have carefully reviewed the district court's order. Lawrence at a hearing that his criminal trial was the proper forum in which to litigate the allegations in the indictment. Lawrence's complaint simply prematurely alleged a malicious prosecution case before he had established in his criminal trial that the allegations were unfounded. <em>See Taylor v. App. 1990) (setting forth essential elements of malicious prosecution claim in Colorado: (1) defendant was a party to or assisted in a criminal or civil proceeding against the plaintiff. (2) the proceeding was resolved in favor of plaintiff. (3) there was no probable cause for the proceeding. (4) the defendant was actuated by malice in instituting the proceedings. (5) the plaintiff was damaged thereby). The district court did not take the position that a prosecuting attorney </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/05/97-6265.htm">97-6265 -- SHAW V. AAA ENGINEERING & DRAFTING INC. -- 05/18/2000<BR></A><BR> INTRODUCTION</strong> <p> One of these consolidated cases is a <em>qui tam</em> . Plaintiff Debra Shaw is the relator. Shaw asserted she was terminated in retaliation for reporting Defendants' fraudulent activities to U.S. government officials at TAFB. <p> Defendants AAA Engineering &. 2) whether the district court erroneously denied Defendants' Rule 50 motions on Shaw's FCA claim that she was terminated for her actions in furtherance of the FCA. Defendant AAA was awarded a government contract (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/04/99-6167.htm">99-6167 -- NORRIS V. APFEL -- 04/28/2000<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Claimant Don L. We have jurisdiction under 28 . Reverse and remand the case for further proceedings. <p> <center><u>The Claim for Benefits</u></center> <p> Claimant was born on October 30. Until he was fired on June . His attempts to work since then have been brief and unsuccessful. He claims that he ends up in pain after a few days and is unable to continue working. <u>See</u> Appellant's App. at 120. He explained that the pain is on the right side of his lower back and in his right hip and leg. He testified that he was also depressed. <u>See</u> <u>id.</u> at 202. <p> <center><u>The ALJ's Decision</u></center> <p> The ALJ denied the claim at step four on the basis that claimant retained the RFC to return to any of four specific past jobs. <u>See</u> <u>id.</u> at 32. The agency requires the ALJ to have made specific findings concerning: (1) claimant's RFC. (3) claimant's ability to return to these past jobs with the RFC the ALJ determined the claimant to have. <u>See</u> Social Security Ruling 82 62. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/09/96-2180.htm">96-2180 -- PUBLIC EMPLOYEES' RETIREMENT BOAD V. SHALALA -- 09/02/1998<BR></A><BR> The sole issue here is whether contributions to a retirement plan for New Mexico State employees. Can be said to be contributions made pursuant to a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1997/12/97-9501.htm">97-9501 -- RUSSELL V. RAILROAD RETIREMENT BOARD -- 12/05/1997<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Plaintiff filed an application for disability annuity with the Railroad Retirement Board (Board). A Hearing Officer found that plaintiff was entitled to an occupational disability. That he was not entitled to a period of disability and early Medicare coverage. It affirmed and adopted the decision of the Hearing Officer denying plaintiff's application for a period of disability under the Social Security Act. <p> The affirmance by the Board is a final decision within the meaning of 45 . Is therefore appealable to this court under 45 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/05-3326.pdf">OPINION/ORDER</A><BR> This disposition is not citable as precedent. It is a public record. The grievance was the subject of a teleconference. Uliano [were] present by phone. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/C11DC3F7D1025AA388256E7400744671/$file/0116124.pdf?openelement">OPINION/ORDER</A><BR> Circuit Judge: What happens when a party to an arbitration is unable to pay its pro rata share of the arbitration fees? Is a Florida based company that purchases diabetic products from manufacturers and resells them across the country to customers. Lifescan stopped shipping because it became convinced that Premier was selling to non Medicare customers. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/BD56EB1FEB830BA6882570650056DD30/$file/0317082.pdf?openelement">OPINION/ORDER</A><BR> Circuit Judge: The False Claims Act provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6370802B473DC4D6882572A6008183A3/$file/0655559.pdf?openelement">OPINION/ORDER</A><BR> We have jurisdiction to review the district court's order The class also includes children at imminent risk of foster care placement. 1 3392 KATIE A. v. A class of children who were in Los Angeles County foster care or at risk of being placed into foster care (Katie A. The complaint alleged that the class was entitled to and had not received </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/20ADC1B137F0613D882571EF0077D396/$file/0355166.pdf?openelement">OPINION/ORDER</A><BR> Circuit Judge: The question before us is whether a state's exercise of its sovereign power to control the use of its funds conflicts with national labor policy as expressed in the National Labor Relations Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/07/983123P.pdf">OPINION/ORDER</A><BR> I. BACKGROUND Poplar Bluff is a city of 17. It is located in Butler County. It is the largest city in several counties and has numerous major employers and manufacturing operations. 000 are forty and sixty miles away from Poplar Bluff. The population in the area surrounding Poplar Bluff is concentrated in Scott and Stoddard Counties. Poplar Bluff is within a few hours' drive of several large metropolitan centers including St. Lucy Lee is a general acute care hospital that provides primary and secondary care services.2 Lucy Lee has 201 licensed beds. 185 of which are staffed. Its average daily census was 75 in 1994. Doctors' Regional Medical Center in Poplar Bluff is presently owned by a group of physicians. It is also a general acute care hospital providing primary and secondary care services. Of which 187 are staffed. Its average census in 1994 was 106. In 1995 was 99. In 1996 was 95 and in 1997 was 77. Both hospitals are underutilized and have had problems attracting specialists to the area. Secondary care is somewhat more complex. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/10/971798U.pdf">OPINION/ORDER</A><BR> Is too remote. The government is under no obligation to show that Jenkins wore expensive clothing or spent large amounts of money to make its case. Giving the district 3 court the discretion to which it is entitled under Whitfield. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/08/964043P.pdf">OPINION/ORDER</A><BR> The remaining equity in the company was owned by Mary Beth's then husband Steven and by trusts benefitting their children. Who were beginning divorce proceedings. Judy Breeding (who was also a director of CHCC). Who was well known in Missouri as a successful manager of nursing homes. Gourley explained to the Userys that his assets were tied up because of continuing litigation relating to his divorce. The Userys and Breeding (who is not a party to this case) assured Gourley that. Even though 1988 financial results were not yet available. The homes' cash flow in 1988 was substantially the same as the 1987 cash flow. He was told that they totaled about $75. 000 and were current. The resulting drain on cash was exacerbated by Mary Beth's insistence. The Userys also represented that all of the long term debt that Gourley agreed to assume was business related debt. As the deal was structured. The amount of the note was to be adjusted after the closing to account for the difference between payables and Medicaid receivables. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/05/963651U.pdf">OPINION/ORDER</A><BR> Ulrich discovered that Minnesota hospitals were not being properly reimbursed for patients eligible for benefits under both Medicare and Medicaid insurance programs. The state to resolve potential outstanding claims offered to pay defendants a portion of what they were owed. They were unjustly enriched by his efforts. Are bound by the decisions of the Minnesota courts. As he has made no allegation that defendants' acceptance of payments to which they were entitled was fraudulent or illegal in any way. He has stated no facts to support an allegation that defendants' actions were morally wrong. Ulrich is not entitled to compensation from defendants merely because his efforts in representing his clients may have incidentally conferred a benefit upon defendants. The judgment is affirmed. Ulrich's attorney's fees and costs is denied. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/03/961414P.pdf">OPINION/ORDER</A><BR> A jury convicted Brown on two counts Anti kickback The district court granted Brown's post verdict motion for a new trial based on its findings that the jury was exposed to prejudicial extrinsic information and that certain members of the jury engaged in misconduct. court. The government contends that Brown waived any claim We affirm the order of the district to a new trial that he might have had. A home health care company that was the exclusive home health distributor of an expensive growth hormone called Protropin. In exchange for Brown's referral of patients for whom he prescribed Protropin and who were participants in the Medicaid program.2 On June 20. Approximately one month before the trial was set to begin. Three of Brown's co defendants were executives at Caremark. While the fourth co defendant was an executive at Genentech. Both the government and Brown's counsel asked the court to conduct an individual voir dire of the jurors based on their belief that the jurors may have witnessed Brown's co defendants celebrating in the hallway following their acquittals on October 3 and that the jurors may have been exposed to ensuing news accounts that referred to the codefendants' acquittals and Caremark's previous guilty plea and agreement to pay a $161 million fine. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/96/08/951468P.pdf">OPINION/ORDER</A><BR> The case arises under the Emergency Medical Treatment and Active Labor Act of 1986 Summers claims that he was not appropriately The District Court1 granted Baptist's screened for treatment when he was brought in to Baptist's emergency room after a deer hunting accident. motion for summary The Hon. Summers said he </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/05/062965P.pdf">OPINION/ORDER</A><BR> Goldsmith was charged with twelve felony counts of failing to pay over to the IRS the money he withheld from his employees. Four days before trial was set to begin and without any agreement with the government. Preferred to spend money on himself and was willing to steal it from his employees and the government. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/12/054489P.pdf">OPINION/ORDER</A><BR> Sick leave to other employees who have a medical condition preventing them from working and exhaust all paid leave. 2 Qualified employees may receive up to 1. (3) successfully have completed the initial six month probation. The city's Administrative Specialist informed the Personnel Board: I have the following concerns about restrictions included in Paragraph 1 of the Proposed Leave Donation Program. If the employee will only be off for a few months. Regular retirement age is young. Hopkins was hospitalized and diagnosed with ventricular tachycardia. Hopkins's physician determined that he was unable to drive for six months following any episode of VT. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/06/053587P.pdf">OPINION/ORDER</A><BR> Except for recipients who are blind. Unless they fall within one of the statutory groups. 2 Plaintiffs have never challenged the statute's elimination of the DME program. Are not limited to: Prosthetics. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/07/043238P.pdf">OPINION/ORDER</A><BR> United States District Judge for the District of Minnesota. 1 was not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/07/043141P.pdf">OPINION/ORDER</A><BR> Plaintiffs do not have an absolute or automatic right to amend. Futility is a valid basis for denying leave to amend. Lee argues that the district court abused its discretion by denying her motion for leave to amend as futile because she could have amended the complaint to include an allegation that Fairview's athletic trainers were not properly supervised and. That Fairview's Medicare and Medicaid claims were falsely made. Lee first requested leave to amend in her opposition to Fairview's motion to dismiss so that she could </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/01/023292U.pdf">OPINION/ORDER</A><BR> Because he was able to defraud Medicare by certifying that in his professional judgment treatment was medically necessary and had been provided. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/09/011518U.pdf">OPINION/ORDER</A><BR> Allen Lee Paris was convicted of conspiracy to defraud Medicare and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) in violation of 18 U.S.C. § 371. That is. Separately billing for individual chemical tests that are routinely run. 654.66 in restitution imposed by the district court.* Paris contends the evidence was insufficient to show there was a conspiracy to defraud the government. There was sufficient evidence of a continuing conspiracy to permit a jury reasonably to find Paris guilty beyond a reasonable doubt. Paris was not deprived of a fair trial by the prosecutor's single mistaken comment in closing argument that Paris could conspire with his wholly owned corporation. Having concluded that the district court's finding of the amount of loss attributed to Paris's fraudulent billing practices is not clearly erroneous. We reject Paris's contention that his sentence is incorrect. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/05/993262P.pdf">OPINION/ORDER</A><BR> Was born with the physiology of a female. Equates with what is popularly known as transsexualism. Has determined that sex reassignment surgery (essentially a transition from female to male physical features) is the necessary treatment for Smith. Which is a phalloplasty. We will refer to Smith. C. The disturbance is not concurrent with a physical intersex condition. That surgical procedures are not covered. That were medically necessary for diagnosed conditions other than his gender identity disorder. Medicaid is a federal state program through which the federal government provides funds for the provision of health care services to needy individuals through the participation of the states. States are not required to participate in the Medicaid program. It does require that state Medicaid plans establish `reasonable standards . . . for determining . . . the extent of medical assistance under the plan which . . . are consistent with the objectives of [the Medicaid Act].' </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/09/994183P.pdf">OPINION/ORDER</A><BR> The Administration is entitled to recover the money unless the recipient of the check was without fault and recovery would subvert the purpose of social security or be against equity and good conscience. Thought the check was a back payment for medical expenses because he canceled his Medicare. He did not have the resources to immediately repay the money already spent. Asserting he was without fault and that recovery would subvert the purpose of social security or be against equity and good conscience. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=11&date=01&year=99">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=10&date=01&year=97">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=07&date=01&year=00">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=04&date=01&year=96">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=01&date=01&year=03">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/02/02-2092.PDF">OPINION/ORDER</A><BR> The initial venture was launched by Pat Ballinger and two other individuals in 1995 under the names </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/07a0097p-06.pdf">OPINION/ORDER</A><BR> Caremark specifically challenges the district court's declaration that the Bureau of TennCare's third party claims for Medicaid reimbursement are not subject to certain </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0322p-06.pdf">OPINION/ORDER</A><BR> The principal question in this appeal is whether the Public Service Commission of Kentucky (the PSC) correctly applied a superseded Federal Communications Commission (FCC) regulation on the ground that application of the current regulation to a pending case would be impermissibly retroactive. Underlying the dispute is a complex statutory and regulatory scheme. Who are referred to as competing local exchange carriers. One of the key obligations imposed by the Act is the requirement that ILECs make </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0300p-06.pdf">OPINION/ORDER</A><BR> Who was a member of the panel. This case presents the question of whether a change in a rule governing the adjudication of social security disability benefits claims that is applied as of its effective date to all pending cases has an impermissibly retroactive effect. Have their primary effect on claimants' applications when the claimants appear before the agency to have their claims decided on the merits. The change in the rule is thus not impermissibly retroactive. When Combs' claim was administratively adjudicated. It was not impermissibly retroactive in its effect. The district court correctly concluded that the Agency's determination in this case is supported by substantial evidence. The five steps are as follows: In step one. The SSA identifies claimants who </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0523n-06.pdf">OPINION/ORDER</A><BR> The defendant was sentenced to imprisonment for 41 months. Sitting by designation. * No. 04 5310 Page 2 court's allegedly erroneous evidentiary rulings was to deprive the defendant of a fair trial. (4) whether there was sufficient evidence to support the defendant's convictions for making false statements. We are not persuaded that the district court committed any error requiring reversal of the conviction. The enhancement of the defendant's sentence was plainly erroneous and requires a remand for resentencing. Is an orthopedic surgeon. Was $3. Arguing that the evidence was insufficient to support the jury's verdict. Arguing that the verdict was against the weight of the evidence and that several of the district court's evidentiary rulings were erroneous. The motions were denied. The result was a 13 level increase in Dr. He is free on bond pending the completion of the appellate process. Canon were trigger point injections and not nerve blocks. The parties were permitted to ask follow up questions. This court has held that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0260p-06.pdf">OPINION/ORDER</A><BR> Anna Marie Bowling Irrevocable Trust Page 2 The district court found that Spectrum's lien on the proceeds of a malpractice settlement was valid and enforceable. Therefore is invalid. Spectrum argues that the issue of the validity of the lien is precluded by two prior state court judgments approving the malpractice settlement. We conclude that the issue is not precluded by either of the state court judgments. That the lien on the settlement is prohibited by federal and state Medicaid law. I. BACKGROUND The material facts in this case are undisputed. Bowling has little or no control of her limbs and is unable to speak. Spectrum is the parent company of a group of providers of sub acute rehabilitation and nursing services. Bowling was admitted to GVHC in December 1998. The total customary cost of Spectrum's services provided to Bowling during the time she resided at GVHC was $639. The 1 It is unclear from the record how Bowling's co payments factor into the shortfall. Spectrum states that its total customary cost was $639. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/05a0132p-06.pdf">OPINION/ORDER</A><BR> Schott's claims are not at issue in this appeal. The state agencies now appeal the determination that they are required to provide direct reimbursement for allowable services received during the retroactivecoverage period. I. BACKGROUND Medicaid is a joint federal­state program that provides health insurance for low income individuals. State participation in Medicaid is optional. Her application was initially denied. In December of 1995 the Saginaw County Circuit Court determined that Levy was eligible for Medicaid benefits for the period from August 1 to December 31. Between the initial denial of her application and the time that she was declared eligible for benefits. The district court held that otherwise eligible Medicaid recipients were entitled to direct reimbursement for out of pocket payments made for Medicaid covered services provided during the retroactive coverage period. The court deferred a ruling on Levy's motion for summary judgment regarding the expenses that she incurred during this period because it was uncertain whether she was otherwise eligible for Medicaid at the time she made her payments. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0093p-06.pdf">OPINION/ORDER</A><BR> James Thomas McBride was convicted of (1) presenting a false claim against the IRS. (2) various obstruction of justice and bankruptcy fraud charges based upon certain financial transactions he initiated that were related to a tax evasion case against his girlfriend. McBride seeks to overturn his conviction on the basis that his waiver of counsel was ineffective and because the evidence against him was allegedly insufficient. We AFFIRM the district court's determination that McBride effectively waived his right to counsel at all stages of the proceedings and that there was sufficient evidence to convict him on Counts 2 6. REVERSE McBride's conviction on Count 1 because there was insufficient evidence to support the verdict on that charge. Factual background Katina Kefalos was convicted by a jury. Kefalos was McBride's girlfriend. Kefalos fired the two attorneys David Axelrod and Terry Sherman who were appointed to represent her. McBride knew that his check would </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/04a0006p-06.pdf">OPINION/ORDER</A><BR> Many employers are required to withhold various taxes from the wages of their employees. Which the employers hold in trust until the taxes are paid over to the federal government. 902.24 that was paid to satisfy an assessment made against the late Willard R. It is not disputed that Bell was the largest stockholder (51.5% of shares) and chief operating No. 02 3295 Bell v. Nor is it disclaimed that Bell essentially ran the company on a day to day basis. Dyac was responsible for withholding federal wage. Dyac was struggling financially at and following its acquisition by Bell. The issue of who controlled Dyac's funds is paramount. As the same are set forth on the Budget. The timing of Bank One's cessation of trust fund loan advances is in dispute. 000 in FICA trust fund taxes that were in arrears for most of January. Denied the request because Bank One had already lent Dyac money for payroll taxes in January and this additional request represented an overadvance that was not covered by the Forbearance Agreement. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/03a0416p-06.pdf">OPINION/ORDER</A><BR> I. JDHP is a qualified health maintenance organization. Each of these hospitals is a member of the Highland Wellmont Health Network. If policies and procedures are inconsistent with this provision. Which includes but is not limited to authorization of coverage for medical services and the determination of availability and extent of coverage for services provided to a particular Member. The question for the arbitrator will be whether the decision being arbitrated should be set aside because the decision was arbitrary and capricious. Each party will bear its own costs and attorney fees. The expenses associated with the arbitration will be shared equally by both parties. The arbitrator shall have no authority to award exemplary or punitive damages. The 2001 Contract was signed by Wellmont on January 24. The term of the 2001 Contract for Medicare + Choice Product (which includes the services subject to the billing dispute in this case) was made retroactive to October 23. Which JDHP believed was inappropriate because. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca3.uscourts.gov/opinarch/043872np.pdf">OPINION/ORDER</A><BR> SECRETARY OF HEALTH & HUMAN SERVICES* (*Michael Leavitt is substituted pursuant to Fed. Because the procedure was reasonably necessary. The Secretary argued that coverage was not available because the procedure. Was investigational and experimental in nature. The District Court concluded that there was substantial evidence to support the Secretary's conclusion that the procedure was investigational and experimental. Our review is limited to determining whether there is substantial evidence to support the Secretary's decision. Substantial evidence is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcU1VNXDA0LTU0ODVfc28ucGRm/04-5485_so.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcU1VNXDA0LTI1ODZfc28ucGRm/04-2586_so.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA2LTIzMjQtY3Zfb3BuLnBkZg==/06-2324-cv_opn.pdf">OPINION/ORDER</A><BR> The judgment of the District Court is AFFIRMED. The motion for a stay is DENIED as moot. Circuit Judge: The appeal in this class action asks us to determine the amount in controversy in an action for an accounting where there is no accompanying demand for damages or restitution. The amount in controversy is well over the $5 million jurisdictional requirement imposed by the Class Action Fairness Act of 2005. We hold that the Appellants have not met their burden of demonstrating that the amount incontroversy requirement has been met. It is unclear which funds Appellants calculate to total $40 million. 2 was filed . . . . We are not required to deny the appeal despite the fact that it was docketed more than 60 days prior to the time that a panel of this Court granted the petition to allow it. Dentists operating in various states who have agreed to treat patients eligible under Medicaid or Medicare. The pools consist of state and federal funds from which participating dentists are paid monthly on a pro rata basis. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200511556REH.pdf">OPINION/ORDER</A><BR> O R D E R: The Court having been polled at the request of one of the members of the Court and a majority of the Circuit Judges who are in regular active service not having voted in favor of it (Rule 35. The Suggestion of Rehearing En Banc is DENIED. /s/ J. Would have . . . the practical effect of diminishing the court's power to bring the litigation to a natural conclusion. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200115848.opn.pdf">OPINION/ORDER</A><BR> We held that an issue of fact existed as to whether Vencor was entitled to payment based on its ordinary charges. Because we were uncertain as to precisely what documents constituted the two contracts of insurance Blue Cross issued (to Butler and Esposito) ­ that is. Whether state law required that an Outline of Coverage and a promotional brochure are part of the contracts ­ we remanded the case and instructed the district to make that determination. Vencor challenges the district court's determination (1) that the Outline of Coverage and the promotional brochure are not part of the insurance contracts. The term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19978597.OPN.pdf">OPINION/ORDER</A><BR> Circuit Judge: This is a whistleblower suit brought by a corporate officer who was discharged and then sued his employer and individuals whom he alleges contributed to his termination. O'Neal was employed by Master Health Plan. The parties agree that he was an at will employee. MHP was wholly owned by Healthmaster. Garrison was president of both companies and controlled both. Plaintiff was not a target. O'Neal was 2 allowed to remove personal effects and told not to return to the office. The next day large quantities of documents in O'Neal's office were shredded by employees. The next day a letter signed by Garrison was delivered to plaintiff notifying him that he had been placed on administrative leave with pay. In succeeding weeks there was communication between plaintiff and Garrison and the attorney for MHP. The exact dates and sequence of which are disputed. Garrison encountered O'Neal at church and asked him whether he was ready to come back to work. One meeting was at O'Neal's home. At these meetings express or implied proposals were made to reinstate him if he would change his testimony. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=98-1594.01A">OPINION/ORDER</A><BR> With whom Harry Anduze Monta¤o was on brief. Montijo and Mirta Rodriguez Mora were on brief. We neither minimize the difficulty of the question nor pretend that the answer is transpiciously clear. We hold that EMTALA subsections (a) and (b) are to be read disjunctively. Hospital personnel brought her to the maternity ward where she was examined and admitted. The baby was admitted to the San Juan Pediatric Hospital that evening. Only the EMTALA claim is relevant here. L˘pez Soto posited that the Hospital violated EMTALA because her baby was born </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=93-1254.01A">OPINION/ORDER</A><BR> With whom Jack Comart and Pine Tree Legal Assistance were on brief. Were on brief. Were on brief for State of Maine. BACKGROUND AFDC is a voluntary. A dollar is subtracted from the family's basic AFDC grant for every dollar of supplemental income received. This phenomenon is known as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=91-1538.01A">OPINION/ORDER</A><BR> Were on brief for appellants. Were on brief for appellee. *Of the District of Massachusetts. The basic question in this appeal is whether or not the United States Department of Education ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-1696.01A">OPINION/ORDER</A><BR> P.C.</SPAN> was on brief for petitioner. Decof</SPAN> were on brief for claimant. Was employed on the M/V Reflections. The result was anoxic brain injury anoxic refers to the lack of oxygen so severe that his life was despaired of. </SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-1527.01A">OPINION/ORDER</A><BR> King</SPAN> were on brief for appellant.</SPAN> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1059.01A">OPINION/ORDER</A><BR> Inc.</SPAN> were on brief. Were on brief. Plaintiffs suffer from acquired brain disorders and have the option to receive medical care for that condition under the Medicaid program. The difficulty is that there are more people who want to be in the model program than there is room in the program.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-2553.01A">OPINION/ORDER</A><BR> P.C.</SPAN> were on brief for movants. Were on brief for defendants. Brewster</SPAN> were on brief for plaintiff. Were on brief for defendants. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-1410.01A">OPINION/ORDER</A><BR> Were on brief for appellant.</FONT></P> <BR WP= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Sept2001/993875.txt">OPINION/ORDER</A><BR> This proceeding is before us pursuant to 2 U.S.C.S 437h. The present challenge was filed in the District Court for the Middle District of Pennsylvania by Renato P. By making campaign contributions to a number of candidates for federal office through enlisting company employees and others to forward contributions to the candidates that were thereafter reimbursed by one of the companies. Individuals who have reached their federal direct contribution limits. Soft money is sometimes used to fund so called </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Jan2004/024372p.pdf">OPINION/ORDER</A><BR> We are obliged to interpret some of the contours of the tort of interference with contractual relations under Pennsylvania law. Jurisdiction in the District Court was based on 28 U.S.C. § 1332(a). We have jurisdiction pursuant to 28 U.S.C. § 1291. As this is an appeal from a final order of the District Court. We will affirm in part and reverse in part. The relevant facts are somewhat in dispute. Appellee is entitled to have all reasonable inferences drawn in its favor. Inc. ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Feb2004/013774p.pdf">OPINION/ORDER</A><BR> Sought and were denied M edicaid benefits because their assets exceed a level qualifying them for Medicaid eligibility. Whether plaintiffs are entitled to Medicaid benefits depends on how we view certain private trusts they established for the community spouse's benefit. Are designed to provide a stream of annuity payments to the community spouse for the duration of his or her life. New Jersey did not consider the corpus of these CSATs as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Dec2003/031020u.pdf">OPINION/ORDER</A><BR> Caroline Adesanya was convicted of bank fraud. Adesanya was sentenced to 24 months. She contends that the District Court should have granted her Rule 29 motion for judgment of acquittal because. The Government failed to produce sufficient evidence to support a finding that she knew the check was counterfeit beyond a reasonable doubt. We have jurisdiction pursuant to 28 U.S.C. § 1291. We will affirm. We will recite only those facts relevant to the issues before us. Was the president and a founding member of an agency that contracted to provide per diem nursing services for health care facilities. The business was earning very little money. Was a businessman who exported vehicles to Nigeria. She drove her boyfriend to the 2 airport where he was to embark on a business trip to Nigeria. The bank subsequently determined that the check Adesanya had deposited into the business account was counterfeit. Someone giving the name </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/May2000/993875.txt">OPINION/ORDER</A><BR> This proceeding is before us pursuant to 2 U.S.C.S 437h. The present challenge was filed in the District Court for the Middle District of Pennsylvania by Renato P. By making campaign contributions to a number of candidates for federal office through enlisting company employees and others to forward contributions to the candidates that were thereafter reimbursed by one of the companies. Individuals who have reached their federal direct contribution limits. Soft money is sometimes used to fund so called </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Jun2001/986248.txt">OPINION/ORDER</A><BR> The principal issue on appeal is whether the submission of fraudulent legal bills for approval to the United States Bankruptcy Court violates the False Claims Act. S 3730(h) requires proof that the employee engaged in </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec1995/95a1233p.txt">OPINION/ORDER</A><BR> The agents seized the items that are the subject of the three proceedings on appeal: $14. He was eventually convicted of conspiracy to distribute heroin and to possess heroin with the intent to distribute it. Who was incarcerated. McGlory's mother claimed not to remember receiving the notices but stated that she would have turned any such notices over to the attorney who was representing McGlory on the criminal charges. McGlory first argues that his due process rights were violated in that the government failed to provide him with adequate notice of the civil forfeiture proceedings against the $14K and the statues. Civil in rem forfeiture proceedings are governed by Rule C of the Supplemental Rules for Certain Admiralty and Maritime Claims. Publication alone is not sufficient when the government can reasonably ascertain the names and addresses of interested parties. The State knew that appellant was not at the address to which the notice was mailed and. Knew also that appellant could not get to that address since he was at that very time confined in . . . jail. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec1995/95a1227p.txt">OPINION/ORDER</A><BR> The sole issue we address in this appeal is whether the Federal Employee Health Benefits Act. HMO/NJ argues that the premium assessments under the Reform Act are preempted by FEHBA because they will increase the cost of individual health care benefits to federal employees. Benefits which are payable from the Federal Employee Health Benefits Fund. Will reverse the district court's order on the issue of FEHBA preemption. (Individual health care coverage is coverage offered by an insurance company or health maintenance organization directly to an individual and his or her family. Who often do not have the option of purchasing employer based or group health coverage). Carriers were required to start offering the five plans on August 1. The central component of the Reform Act is the requirement that all carriers in the state pay an </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug1995/95a1124p.txt">OPINION/ORDER</A><BR> We have before us a petition filed by one parent against the other under the Hague Convention on the Civil Aspects of International Child Abduction. Concluding that the United States was Evan's </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200403/03-5114a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/991893.P.pdf">OPINION/ORDER</A><BR> Detective Broderick was among those assigned to investigate the matter. Was able to obtain the tag number for the vehicle. The parking garage was also situated near the Fairfax Methadone Treatment Center ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/981037.P.pdf">OPINION/ORDER</A><BR> That WSRC falsely certified that there was no conflict of interest with the subcontractor. Or because the allegedly false statements were not made in connection with a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/022317.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. That its claim to those portions is superior to the claims of Pepper Hamilton and MLCA. Colkitt are siblings. Were insured. Colkitt was an officer and director of National Medical Financial Services. National Union agreed to provide his defense under a reserThe Rahman Agreement was one of four settlement agreements entered into by the United States. The other settlement agreements are not relevant to the issues on appeal. 2 10 UNITED STATES v. 2000 were not covered by the D&O policy and would not be paid. COLKITT 11 it would not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/022001.P.pdf">OPINION/ORDER</A><BR> Filed suit seeking to have declared unconstitutional several provisions of the Health Insurance Portability and Accountability Act of 1996 ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/012386.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. Essentially contending that the global settlement agreement failed to recognize DVI's security interests in assets that were disposed of by the agreement. Colkitt and Derdel were physicians specializing in radiation oncology. Was involuntarily placed into bankruptcy by its creditors. A trustee was appointed. Seeking to recover for the EquiMed estate losses that were allegedly caused by fraud. Those proceedings were consolidated with the EquiMed bankruptcy. COLKITT 15 were removed to federal court and transferred to the District of Maryland for consideration in the bankruptcy of EquiMed. Arguing that its security interest in various of EquiMed's assets were not recognized by the agreement. All of which were surrendered as part of the settlement agreement. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca4.uscourts.gov/opinion.pdf/001511.U.pdf">OPINION/ORDER</A><BR> Unpublished opinions are not binding precedent in this circuit. We have reviewed the record and find that Credit Recovery Systems had a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-9000.wpd">OPINION/ORDER</A><BR> The case is therefore ordered submitted without oral argument. <hr> Taxpayer Scanlon White. We have jurisdiction under 26 U.S.C. 7482(a)(1) and affirm. Show that there is no genuine issue as to any material fact and that a decision may be rendered as a matter of law. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-6021.wpd">OPINION/ORDER</A><BR> The case is therefore ordered submitted without oral argument. This order and judgment is not binding precedent. Was subsequently issued stock in the Firm. 8. McCutcheon was paid on all accounts receivable for which he had billings . . . The payment to McCutcheon was treated as ordinary income by the Firm. A W 2 form was issued with appropriate withholdings for state and federal taxes. Based on his assertion that such payments were capital gains and not subject to tax as ordinary income but the reduced capital gains tax. McCutcheon over the withholding dispute it would have a defense under 26 U.S.C. 3403. Might have arisen from the tax issues raised by the case. The exclusion is substantively coextensive with a provision in the Anti Injunction Act (AIA). Both provisions are fatal to the court's jurisdiction. The Firm reaffirmed that its objective in this action was a determination that it had </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=04-3192.wpd">OPINION/ORDER</A><BR> The case is therefore ordered submitted without oral argument. The underlying facts of Anderson's convictions are found in United States v. Was charged with various violations of the Medicare Anti Kickback statute. Anderson was convicted on April 5. Anderson's sentence was affirmed on direct appeal. The district court found Anderson's Apprendi claim to be without merit because he was sentenced below the statutory maximum. Had an undisclosed prior relationship with law enforcement which could have been used to impeach her testimony. A COA is a jurisdictional pre requisite to our review. The commission of which is the object of the conspiracy. Is a misdemeanor only. We are forbidden from giving full consideration to the factual or legal bases urged in support of the claims. Is not required to prove the merits of the case. The threshold of proof is higher than good faith or lack of frivolity. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=03-3288.wpd">OPINION/ORDER</A><BR> The District Court held that the Defendants are not entitled to assert qualified immunity because they are non governmental officials subject to the constraints of market forces. Under the provisions of (1) The Defendants also argue that we should grant them qualified immunity once we determine that they are entitled to assert it. Because we conclude that these Defendants are not entitled to assert qualified immunity. Which are private. Hammond was approached by parents and guardians of Sunflower's clients who apparently were dissatisfied with the service they were receiving. Hammond was asked if she would consider opening her own provider agency. Because Sunflower was also the area's CDDO. It was in charge of overseeing the distribution of funds to both Rosewood and itself. This potential conflict of interest is the root of the problems between Rosewood and Sunflower that are the basis of this suit. A CDDO that was not a service provider as well). That they were entitled to qualified immunity. Because the Defendants are private parties. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-2.gif" ALT="236"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/99opinions/99-7078.html">EDWARD T. SPLANE V. TOGO D. WEST, JR.<BR></A><BR> With her on the brief was <u>Michael P. On the brief were <u>David W. Of counsel on the brief were <u>Richard J. Petitioners seek to have VAOPGCPREC 14 98 declared invalid on the grounds that the opinion suffers from a number of procedural and substantive defects. We disagree with Petitioners that VAOPGCPREC 14 98 is procedurally defective under either the Administrative Procedure Act (". Because we agree that VAOPGCPREC 14 98 contains a statutory interpretation that is not in accordance with law. Which states that: </p> <dir> <dir> <p ALIGN= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca2.uscourts.gov:8080/isysnative/RDpcT3BpbnNcT1BOXDA0LTA0OTItcHIgdyAybmQgRXJyYXRhLnBkZg==/04-0492-pr%20w%202nd%20Errata.pdf">OPINION/ORDER</A><BR> This interlocutory appeal concerns (a) the procedural issue of whether a qualified immunity defense may be presented in a motion to dismiss under Rule 12(b)(6) of the Federal Rules of Civil Procedure and (b) the substantive issue of whether a qualified immunity defense is valid on such a motion in the context of a prisoner's claim for inadequate medical treatment for Hepatitis C Virus ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200610349.pdf">OPINION/ORDER</A><BR> Mosley's hip and back were injured when he fell from a tank. Mosley left Alcorn State because it was not offering a class he needed to graduate and because he believed his mother's health was deteriorating. He was unable to * Honorable John R. Sitting by designation. 2 complete the training or keep any of his jobs because he was depressed. Where he stayed for approximately one to two weeks and was diagnosed with anxiety and depression. Mosley is registered with the Georgia Department of Labor and has sought work through the labor pool since 2000 with little success. He worked at an airport for a short time but was unable to meet the physical demands of the job because his medication made him groggy and he cannot do heavy lifting. 000 and have been in default since 1996. Mosley's loans were transferred to Educational Credit. Mosley was the sole witness and testified before the bankruptcy court about his medical problems. He introduced Social Security and Medicare earnings statements showing that his annual taxable earnings between 1994 and 2004 have never exceeded $7. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0370p-06.pdf">OPINION/ORDER</A><BR> The Gilleys argue that the district court improperly concluded that Sheila Gilley was unjustly enriched when (1) a certificate of deposit that she posted as collateral for a $725. Was returned to her after the loan was released. 000 that she made to her husband's company was repaid. The government counters that the district court properly found that Sheila Gilley was unjustly enriched when the loans she made to her husband's insolvent company were repaid in full. The government further argues that the district court correctly found that the monthly payments made by George Gilley to his wife from 1993 to 1996 were fraudulent under two separate provisions of the FDCPA because they were not made for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0605n-06.pdf">OPINION/ORDER</A><BR> Which was covered by Unum Life Insurance. Disability income benefits for persons who are totally disabled as defined by the Plan. Nichols applied for disability benefits and was denied. Nichols was working as a nurse case manager at the Hospital when she applied for disability benefits in 2002. Her application for benefits was based largely on the diagnoses of her attending physician. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca6.uscourts.gov/opinions.pdf/06a0879n-06.pdf">OPINION/ORDER</A><BR> Were embodied in fraudulent documents including invoices. The superseding indictment alleged that inflating the records of his potato production during that period enabled Kuehnemund to make it appear that his </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200513006.pdf">OPINION/ORDER</A><BR> He argues that the district court was required to impose a sentence within the guidelines range based upon language in his plea agreement. He further argues that his consecutive statutory sentences on each count were unreasonable in light of Booker. Eldick was indicted on one count of fraudulently obtaining money from health care programs by filing claims falsely representing that he was a licensed physician in Florida and one count of dispensing hydrocodone. The District Court's discretion in sentencing is limited only by statutory provisions and the Sentencing Guidelines. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-1496_015.pdf">OPINION/ORDER</A><BR> In this case we are presented with the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200511628.pdf">OPINION/ORDER</A><BR> After that appeal was taken. A copy of that order is attached as an Appendix to this opinion. We now have before us the plaintiffs' appeal from the order denying that second motion for a temporary restraining order. 2 Our prior decision in this case brings into play the law of the case doctrine insofar as issues we addressed in our March 23. 2005 opinion are concerned. [the resolution of] an issue decided at one stage of a case is binding at later stages of the same case. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=99-1351.wpd">OPINION/ORDER</A><BR> This case is before us after the Supreme Court granted Rockwell International Corporation's petition for writ of certiorari and reversed the portion of our prior judgment in favor of plaintiff James S. ORDER AFTER LIMITED REMAND The disposition of the instant appeals by published opinion for a divided panel was suspended on petition for rehearing. Is reported. We will not attempt to summarize in this order the complex factual and legal background of this matter which is outlined in that opinion. At which all counsel agreed that the record was adequate to enable the judge to make the findings and conclusions necessary. Defendant avers that this point is (1) This order and judgment is not binding precedent. R. 36.3. (2) Judge Hartz has replaced the late Judge Politz on the panel. (1) See 31 U.S.C. 3730(e)(4). (2) These terms are explained in our published opinion. <hr> moot because the verdict for the time frame including this claim was in its favor. Stone had conceded that he did not make pre filing disclosure to the government of any knowledge he may have had underlying his claims with respect to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-2752_038.pdf">OPINION/ORDER</A><BR> The cross appeal is frivolous. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-3297_017.pdf">OPINION/ORDER</A><BR> After finding the amount of oxycodone attributable to Marty was greater than the quantity recommended by the parties in their plea agreement. The government agreed to recommend </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200415585.pdf">OPINION/ORDER</A><BR> Which was filed in 2001. Was consolidated with another case against the Monsanto Company filed in April 2002. Blair and Trussell's current law firms are Blair & Parsons. We refer to these parties collectively as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=05-4483_021.pdf">OPINION/ORDER</A><BR> This appeal presents the question whether a claim for fraudulent inducement of a contract is subject to the contract's forum selection clause. A misrepresentation made in the inducement of a contract is not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=06-1034_017.pdf">OPINION/ORDER</A><BR> Claiming that he was discriminated against because of his race in violation of 42 U.S.C. § 1981 and Title VI of the Civil Rights Act of 1964. Paul was born in India. Paul is not board certified by the American College of Surgeons in neurosurgery. Paul was a non board certified neurosurgeon. He was allowed to remain an active staff member after Theda Clark was designated a Level II Trauma Center in 1998. Paul was informed that his application for active status had been denied because as a non board certified neurosurgeon. The hearing committee stated that the denial was based solely on Dr. Paul filed a two count complaint in federal district court alleging that Theda Clark 1 (...continued) have been denied in 1999 and 2001. His status was mistakenly overlooked due to his inactivity at the hospital. Paul's patients were insured by Touchpoint. Care each physician is entitled to provide at Theda Clark. Staff membership is reflective of the level of patient involvement and administrative responsibilities of the physician. 4 No. 06 1034 discriminated against him by declining his application for active staff membership. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200412758.pdf">OPINION/ORDER</A><BR> Sitting by designation. * At issue in this case is the constitutionality of the City of Neptune Beach's sign code. I. Solantic is a business operating emergency medical care facilities in various locations. A videotape showing the sign was viewed by the district court and is part of the record. Solantic states that the EVMC sign </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/fdocs/docs.fwx?submit=showbr&shofile=06-3705_020.pdf">OPINION/ORDER</A><BR> Christopher Bertrand and Frank Patterson are developmentally disabled adults who want residential habilitation services under the Medicaid program in Illinois. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/02/02-3583.PDF">OPINION/ORDER</A><BR> However deplorable such behavior is. The question here is whether someone other than the perpetrator him or herself is responsible for the resulting injury. We must decide whether the United States is liable under the Federal Tort Claims Act (FTCA) for a mail carrier's sexual abuse of 2 No. 02 3583 a seven year old girl who lived in a home on his mail delivery route. The answer is yes only if the United States Postal Service (USPS or Postal Service) undertook a voluntary. Then filing a written request for reconsideration after his claim was denied. The facts set forth in LM's complaint were properly taken as true by the district court in deciding the government's motion to dismiss. LM is the father and guardian of KM. Alleging that she was sexually abused by Tucker when she was seven years old. Tucker was subsequently prosecuted by the state. Was still in prison at the time LM filed his complaint. LM further alleged that the USPS learned of Tucker's inappropriate and criminal conduct toward young girls both through numerous complaints from relatives of his various victims and through notice from the Richton Park police that Tucker was being investigated for sexually molesting a two year old girl and a four year old girl. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200312113.pdf">OPINION/ORDER</A><BR> The City of Day tona Be ach requ ested an e videntiar y hearing to determin e the mer its of Pau l Smalb ein's 42 U .S.C. § 1 983 claim s in orde r to establish w hether S malbein and M illis were e ligible for § 1988 (b) attorn ey's fees. Becaus e we fin d that Sm albein and Millis are prevailing parties under 42 U.S.C. § 1988. Were v iolated fo llowing his arrest in a night clu b parkin g lot. Sma lbein claim ed that he was de prived o f his due process rights. The compla int was la ter amen ded to allege eleven counts and named Claudia Smalbein and Edward Millis as plaintiffs after the death of Paul Smalbein.2 After mediation. All issues raised in the amended complaint were settled except for payment of attorney's fees and taxa ble costs. A nd the p arties jointly noticed th e district co urt of the ir 2 We note that Paul Smalbein's death was unrelated to the facts of this case. 3 agreement. Both the motion and the request for an evidentiary hearing were denied as premature because a final settlemen t had no t yet been r eached. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/03/03-3189.PDF">OPINION/ORDER</A><BR> Plaintiffs contend that the $43 price was the result of materially misleading projections on November 5. Was that during 2002 the business would yield revenue growth in the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200216640.pdf">OPINION/ORDER</A><BR> 1 physicians are suing many of this country's largest HMOs. The court held that certain claims were arbitrable. This order was slightly modified in In re Managed Care Litig. The district court certified a class in an order which is currently on appeal before this court. Whether the plaintiffs have adequately stated any claims. Or the merits of those claims An important point is that. It does not necessarily mean that arbitration of such a claim is prohibited or illegal. If this is done without the other party's consent. The result is a legal nullity. The first modification was in response to an inconsistency in its original opinion that the defendants pointed out. The second modification was made due to the subsequent history of 2 3 2 1 * procedural history leading up to them are not immediately relevant to this appeal. Are not being challenged here. The only claims remaining were those the court had ruled non arbitrable. The substance of these arbitration orders is not currently before us on appeal. The only important fact about the arbitration orders is that they designated some claims as arbitrable. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/03/03-3189A.PDF">OPINION/ORDER</A><BR> Plaintiffs contend that the $43 price was the result of materially misleading projections on November 5. Was that during 2002 the business would yield revenue growth in the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/200210018.opn.pdf">OPINION/ORDER</A><BR> He was entitled to a new trial. The petitioner would like to state that this is not a 28 U.S.C. § 2241 or 28 U.S.C. § 2255 [petition]. It is not subject to the constraints imposed by the Anti Terrorist [sic] and Effective Death Penalty Act (AEDPA). The courts' authority to provide the relief appellant was seeking in his October 3 pleading is contained in 28 U.S.C. §§ 2241 and 2255. That everything written herein is correct and true to the best of my knowledge and belief . . . . </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/04/04-1379.PDF">OPINION/ORDER</A><BR> Are sought for use in the forthcoming trial in the Southern District of New York of a suit challenging the constitutionality of the Partial Birth Abortion Ban Act of 2003. Hammond is one of the plaintiffs in that suit and will also be testifying as an expert witness. The district court held that the production of the records is barred by regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Or implementation specifications that are more stringent than the requirements. A standard is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-9002.wpd">OPINION/ORDER</A><BR> The Tax Court upheld those (1) This order and judgment is not binding precedent except under the doctrines of law of the case. The cause is therefore ordered submitted without oral argument. <hr> assessments. There is no requirement to file an income tax return. As copies of 1040s from the relevant years were not included in the record for our review. It is therefore denied. The IRS determined that Pond had failed to report any income from 1995 to 2001 and was liable for penalties under 26 U.S.C. 6651(f). That finding is not challenged on appeal. Therefore he cannot be assessed penalties because he is protected by the Act's self help provision found at 44 U.S.C. 3512. He insists that 6012(a)(1) only requires the filing of a federal tax return when gross income equals or exceeds the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/04/04-1379T.PDF">OPINION/ORDER</A><BR> In view of the pressures of time discussed later in the opinion. * This opinion is being released in typescript. A printed version will follow. Are sought for use in the forthcoming trial in the Southern District of New York of a suit challenging the constitutionality of the Partial Birth Abortion Ban Act of 2003. Hammond is one of the plaintiffs in that suit and will also be testifying as an expert witness. The district court held that the production of the records is barred by regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Or implementation specifications that are more stringent than the requirements. A standard is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca7.uscourts.gov/op/96/96-2242.txt">OPINION/ORDER</A><BR> Although we are troubled by the manner in which Justin's hearing was conducted. We find that Justin was able to present all of the relevant evidence about his disability. Was not prejudiced by any error in the hearing. Because the decision to deny benefits was based on substantial evidence. His case was set for a hearing before ALJ Lawrence E. Justin was eight years old. He was represented at the hearing by his mother. The ALJ's examination of Justin was. Justin answered simple </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=01&date=01&year=02">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=02&date=01&year=02">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=04&date=01&year=04">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=05&date=01&year=00">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=06&date=01&year=99">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=07&date=01&year=96">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/95opinions/95-5122.html">STINSON V. U.S.<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=08&date=01&year=96">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=09&date=01&year=03">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19964291.OPA.pdf">OPINION/ORDER</A><BR> Eckerd is appealing the district Eckerd argues on court's judgment awarding Shannon $70. 714.35. appeal that the district court erred in denying its motion for summary judgment and in finding that the Plan's original denial of benefits was arbitrary and capricious. Thomas Shannon is a beneficiary under the Jack Eckerd Corporation Health Benefits Plan ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=09&date=01&year=04">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=10&date=01&year=01">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=11&date=01&year=01">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=11&date=01&year=96">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/cgi-bin/new/release.pl?B1=Search+Month&month=12&date=01&year=98">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca11.uscourts.gov/opinions/ops/19943145.OPA.pdf">OPINION/ORDER</A><BR> The four defendants are Healthchoice. The and Orlando Regional hospital's parent The incidents giving rise to the lawsuit are Dr. attempt to gain provider membership in unsuccessful Healthchoice and CFMA. Because we conclude that there is no genuine issue of material fact about Dr. That the defendants are accordingly entitled to judgment as a matter of law. The following is a summary of the facts as viewed in the light most favorable to Dr. Levine is an internist. completing his residency in California. Was granted. Provisional staff privileges at the ORHS hospitals.2 ORHS is a nonprofit organization that owns and operates five Orlando area hospitals: Orlando Regional Medical Center ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=99-2323.01A">OPINION/ORDER</A><BR> Was on brief. Plaintiff Josefina Cantellops was the sublessor of property in Condado. Was to eventually take over the lease from CHR and operate a restaurant there. </P> <P> Chapel asked Cantellops if the lessor had consented to the sublease by CHR. Lack of Diversity Jurisdiction</U> </P> <P> The district court determined that plaintiff had presented sufficient facts to show she was a domiciliary of Georgia or Florida and all defendants were domiciled in Puerto Rico. That determination is reviewed for clear error. <U>See</U> <U>Lundquist</U> v. <U>Precision Valley Aviation. 11 (1st Cir. 1991). </P> <P> The complaint was filed on April 28. Cantellops' affidavit said in early 1994 she was living in Florida and moved to Georgia. The complaint alleged she was a resident of Georgia. Defendants make much of the complaint's use of the term </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/01/991713P.pdf">OPINION/ORDER</A><BR> The District Court's findings are not clearly erroneous. I. The defendant is a provider of home healthcare services. Was Branch Manager of defendant's Gurdon. The plaintiff is black. The plaintiff's two supervisors were Fred Harris. This would have been a violation of Medicare regulations. There was no prior documentation of any problem with plaintiff's performance. She concluded that the plaintiff's attitude was that she would not try to comply with regulations. Was a registered nurse who on numerous occasions failed to record her nurse's notes in timely fashion. Harris were aware of this violation of defendant's policy. Kuyper was not disciplined. Kuyper served as Interim Branch Manager after the plaintiff was terminated. She was caught stealing a patient's narcotic pain killer and replacing it with Tylenol. She was reported to the Arkansas Board of Nursing and given an administrative leave. She was allowed to return to work as a nurse with the defendant. Was a registered nurse and Branch Manager in defendant's Arkadelphia office. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/03/993412U.pdf">OPINION/ORDER</A><BR> We conclude there is substantial evidence to support the jury's verdict. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/05/992570P.pdf">OPINION/ORDER</A><BR> Was a shareholder in the law firm of Schwebel. An emergency meeting was held during which the shareholders confronted Moskal with their suspicions. Moskal was indicted in October 1998 and entered a plea agreement with the United States Attorney with respect to sentencing that resulted in an expected sentencing range of thirty to thirty seven months. Vulnerable Victim Under section 3A1.1 of the Sentencing Guidelines </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/mar2003/02-11116.opn.html">UNITED STATES V. GOMEZ (3/12/2003, NO. 02-11116)<BR></A><BR> Raul Gomez was federally indicted for conspiracy to commit Medicare Fraud. Gomez pleaded guilty to two counts of the indictment and was eventually sentenced to 55 months' imprisonment. A PSI was prepared and filed. To which Gomez filed his objections.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=98-1199.01A">OPINION/ORDER</A><BR> Were on brief. Covington & Burling were on brief. L.L.P. were on brief. The Statute Regulation is not a stranger to the tobacco industry. Existing state law is not much more intrusive. Only Minnesota and Texas have required any reporting of tobacco ingredients. When Section 307B was enacted as a means of regulating the tobacco industry. Pro consumer bill that will give people all the information they need to make educated decisions about what they put in their bodies </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=97-2389.01A">OPINION/ORDER</A><BR> With whom Harry Anduze Monta¤o was on brief. Velez Gonzalez and Vivas & Vivas were on brief. Raul Torres Vargas are the adult children of Raul Torres Arroyo. The district court granted summary judgment for Santiago on the ground that he was an employee of the Commonwealth of Puerto Rico and. Was entitled to immunity under Puerto Rico law. Claiming that Santiago was an independent contractor (not covered by the immunity provision). That discovery should have been allowed before the court ruled. Those who were covered by Medicare or private insurance). The procedure went badly: Santiago experienced difficulty in intubating Torres Arroyo and a tracheotomy was required. That his employment status was a question of fact for trial. The Contract does not compel the conclusion that the defendant was an employee of the Commonwealth within the meaning of the immunity statute. Our review is plenary. (2) the harm caused by his malpractice must have taken place in the practice of his profession. (3) he must have acted in compliance with his duties and functions as an employee of the Commonwealth of Puerto Rico. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/00/07/994204U.pdf">OPINION/ORDER</A><BR> Plus three additional days because the government's motion papers were served by mail. Who was then incarcerated. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=97-1054.01A">OPINION/ORDER</A><BR> P.A. was on brief for appellant. Were on brief for appellees. HHS had denied Pine Tree's MUP application after applying criteria and standards that were issued by HHS in June 1995 ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/01/12/003931P.pdf">OPINION/ORDER</A><BR> They were preempted by ERISA. Crews that removal was improper. So a cause is not removable simply because a federal defense like preemption may be raised in it. The Court has concluded that ERISA is such a law. That are preempted by another provision. Are removable to federal court. The central issue in this case is whether General American's alleged promise to provide employees who stayed with the company through a fixed date with benefits was premised on or constituted an employee benefit plan. Crews's action comes within the scope of § 1132(a)(1)(B) and is preempted by § 1144(a). Hence her action was removable to federal court. Then removal was improper. The district court concluded that the promised benefits were derived from an employee benefit plan because they </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/02/02/011908P.pdf">OPINION/ORDER</A><BR> North Central traders were paid commissions on the sales they negotiated. The traders were not paid a commission on the funds North Central used to satisfy these payroll tax obligations. That the resulting mail fraud was a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/02/07/011896P.pdf">OPINION/ORDER</A><BR> Plaintiffs asserted that the more generous benefits offered as part of the 1993 early retirement program are vested and unalterable. Concluding that plaintiffs are not entitled to relief under either theory. NCR offered the 1993 Enhanced Retirement Program (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=95-2057.01A">OPINION/ORDER</A><BR> With whom Foote & Temple was on brief. Was on brief. Petitioner appellant Ryan Allen seeks to block the State of Maine from prosecuting him for operating a motor vehicle under the influence of alcohol (OUI) in violation of 29 M.R.S.A. 1312 B (West Supp. 1994).1 He insists that continued prosecution of this charge will transgress the Double Jeopardy Clause. Are without intrinsic merit. It is said that every action produces an equal and opposite reaction. Id. 2403 (ensuring credit for an administrative suspension if a suspension is later ordered as part of a corresponding criminal sentence). The petitioner (who had been released on bail and was. Me. 1995) (explaining that the suspension provision </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/01/021151P.pdf">OPINION/ORDER</A><BR> He was diagnosed at Cardinal Glennon Children's Hospital with osteomyelitis and cellulitis in his right foot. Hunt now claims that these conditions would not have occurred had the staff at LCMH performed an appropriate medical screening examination and provided the necessary antibiotic treatment. The break in the skin from the nail was not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=95-1849.01A">OPINION/ORDER</A><BR> Were on brief for appellants Bullen. Nicholson and Ropes & Gray were on brief for appellees Visiting Nurse Association of North Shore. I I BACKGROUND BACKGROUND Medicaid is a joint federal state program designed to afford medical benefits to low income individuals. A State which elects to participate in Medicaid is eligible to receive federal funds only if its State Plan is approved by the Federal Health Care Financing Administration ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/07/031721P.pdf">OPINION/ORDER</A><BR> This case is about Temporary Medical Assistance. Are members of a class. Under a provision of what was popularly known as the Welfare Reform Bill. Plaintiffs are ineligible for Medicaid benefits unless they qualify under transitional provisions now found in Sections 1925 and 1931 of the Social Security Act. Plaintiffs' claim is likely to succeed under the plain meaning of the relevant statutes. After such proceedings as are necessary to put the case in a position for final decision. The principal federally funded public assistance program in this country was called Aid to Families with Dependent Children (AFDC). States do not have to participate in Medicaid. Was that persons receiving AFDC would also be eligible for Medicaid. States were permitted. This regime was fundamentally changed in 1996 by the enactment of welfarereform legislation that ended the AFDC program and made other important changes in federal assistance to the needy. This enactment was called the Personal Responsibility and Work Opportunity Reconciliation Act. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=94-1613.01A">OPINION/ORDER</A><BR> Is amended as follows: On cover sheet. Richardson & Troubh were on brief for appellant. Ashley & Bull were on brief for appellee. Was a preexisting condition excluded from coverage under the Policy and therefore the district court erred in not granting Golden Rule judgment as a matter of law. We agree that Golden Rule was entitled to judgment as a matter of law. Those who knew Catherine Atallah realized that something was amiss with her. She was becoming increasingly unable or unwilling to perform the ordinary tasks of everyday life. Her utility and telephone services were cut off more than once. Explained that she was doing so to learn </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/03/09/023756P.pdf">OPINION/ORDER</A><BR> This is a case about the taxability of business and entertainment expenses spent on a Canadian fishing trip. After the Internal Revenue Service determined that the per employee cost of Townsend Industries' annual fishing trip was wages. Sitting by designation. 1 expenses involved in the trips were employee wages within the meaning of the Internal Revenue Code. Ruled that a portion of these wages should have been withheld for income tax and Social Security and Medicare taxes. Business discussions were conducted on an on going basis during the trip. The District Court's holding that Townsend failed to establish that its trips had a business purpose is a legal conclusion that we review de novo. 469 U.S. at 249 n.8 (explaining that presence of elements constituting </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/04/04/024083P.pdf">OPINION/ORDER</A><BR> His profit making scheme was detected when one of the doctors who bought from Courtney became suspicious that he was selling more chemotherapy drugs than he was buying from the manufacturers. The lab reported that it contained 32% of the Taxol it was supposed to contain. They found that the doses contained from 17% to 50% of the chemotherapy drugs they were supposed to contain. He was arrested and indicted. Resulting in serious bodily injury to them when it was administered. Resulting in serious bodily injury to them when it was administered. As to the eight patients who were named in the product tampering charges. He diluted fifty additional doses of Gemzar and Taxol that were administered to them. As to twenty six more patients who were not identified in the indictment. Courtney diluted 102 doses of Gemzar and Taxol that were administered to them. Each of the eight product tampering convictions was placed in a single count group because each involved a different victim. A two level enhancement because the victims were vulnerable. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/05/12/043908P.pdf">OPINION/ORDER</A><BR> I. The parties' relationship was reflected in a Development Agreement signed June 1. Only the Development Agreement is at issue on appeal. The Agreement provided that the total Project costs including the Development Fee </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=93-1622.01A">OPINION/ORDER</A><BR> Ricklefs & Giordano were on brief for petitioner. Were on brief for respondent. This is an appeal BOWNES. The amounts are substantial. The computations are not contested. That contention is the main issue before us. Petitioner is a convicted drug dealer. In October 1987 petitioner was indicted along with Frederick A. Petitioner entered into a plea agreement with the United States Attorney whereby he agreed to plead guilty to all the counts in the indictment in which he was named. Petitioner claims that the value of the forfeited property is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/may97/96-4291.opa.html">SHANNON V. JACK ECKERD CORP.<BR></A><BR> This document was created from RTF source by rtftohtml version 2.7.5 > <title>Shannon v. Eckerd is appealing the district court's judgment awarding Shannon $70. Eckerd argues on appeal that the district court erred in denying its motion for summary judgment and in finding that the Plan's original denial of benefits was arbitrary and capricious. Eckerd also contends that the district court erred in directing the Plan administrator on remand to consider evidence available subsequent to the initial determination.<p> Thomas Shannon is a beneficiary under the Jack Eckerd Corporation Health Benefits Plan ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/02/044051P.pdf">OPINION/ORDER</A><BR> Hernandez was found guilty of conspiring to distribute methamphetamine and possessing methamphetamine with intent to distribute in violation of 21 U.S.C. §§ 841(a)(1) & 846. He was sentenced to 168 months of imprisonment. A sentencing error related to whether methamphetamine was a Schedule III or Schedule II drug for sentencing purposes. Hernandez was appointed counsel in September 2002. The amended materials were filed on November 12. Arguing that while all the claims were meritless. The new claim of ineffective assistance was also untimely and thus barred by the statute of limitations.2 The Antiterrorism and Effective Death Penalty Act of 1996 (AEDPA) established a one year statute of limitations for § 2255 motions for post conviction relief. Which was vacated on August 16. Hernandez obtained a certificate of appealability from the district court on seven issues: (1) the district court's ruling that there was no Apprendi4 violation. The certificate of appealability was obtained by Hernandez prior to the Supreme Court's decision in Booker but post Blakely. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-2442.01A">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/04/051115P.pdf">OPINION/ORDER</A><BR> The issue presented in this appeal is whether the district court erred by ordering the Arkansas Department of Human Services (ADHS) and the Arkansas Foundation for Medical Care (AFMC) to publish to Medicaid service beneficiaries and providers the identity of physician reviewers who make decisions to approve or deny medical care to Medicaid eligible children. Because the district court's order is at odds with the relevant Medicaid regulations. We reverse. 3 BACKGROUND The general background to this case is detailed in our prior decisions in Pediatric Specialty Care. The plaintiffs are applicants for Medicaid services. ADHS) to disclose to Medicaid service recipients and providers the names of the physician reviewers who made determinations regarding whether and to what extent children were eligible for treatment. Holding that such disclosure was prohibited by applicable Medicaid Act provisions and regulations. The district court informed the parties that it was reconsidering its earlier decision and solicited letter briefs on the matter. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-1738.01A">OPINION/ORDER</A><BR> She was subjected to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/05/052791P.pdf">OPINION/ORDER</A><BR> The class contends that they are eligible for temporary medical assistance (TMA) benefits described in 42 U.S.C. § 1396r 6. Which provides up to one year of transitional medical coverage to certain categories of people who have lost Medicaid because of an increase in the amount of their earned income. Arguing that the district court erred in concluding that the class members were entitled to TMA benefits. TMA is </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-1473.01A">OPINION/ORDER</A><BR> Bates was on brief for the Ellenwoods. Was on brief for the State of Maine. McGill were on brief for Exxon Shipping Company. Was removed from his position as chief engineer of another Exxon oil tanker. Relying primarily on the company's previous written policy that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-1342.01A">OPINION/ORDER</A><BR> Inc. was on brief. Were on brief. Were on brief. Once the wheat is shaken from SELYA. Our burden of exegesis is considerably reduced. The statute reads in pertinent part: [T]he Secretary [of the United States Department of Health and Human Services] shall not approve any State plan for medical assistance if (1) the State has in effect [AFDC] payment levels that are less than the payment levels in effect under such plan on May 1. 1992 than they would have received under the May 1. The case was submitted to the district court 1Stowell sued H. Since Maine is the real party in interest. We will sometimes refer to Ives as </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=92-1270.01A">OPINION/ORDER</A><BR> 1993 is amended as follows: In footnote 1. 1993 is amended as follows: On page 7. Millimet & Branch were on brief for appellants. Bass & Green were on brief for appellees. Both sides are engaged in providing medical services through health maintenance organizations ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/07/051600U.pdf">OPINION/ORDER</A><BR> Is substituted as respondent pursuant to Federal Rule of Appellate Procedure 43(c). 1 Jo Ann Hoffmann appeals the district court's2 judgment upholding the final decision of the Secretary of Health and Human Services denying certain claims for benefits under Part B of the Medicare program. We agree with the district court that the Secretary's decision is supported by substantial evidence. Hoffmann's pending motions are denied. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=91-1592.01A">OPINION/ORDER</A><BR> Is amended as follows: On page 37 at line 10. Lynette Labinger with whom Roney & Labinger was on brief for appellants. & Murphy was on brief for Milton W. Lowe </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov94/haynes_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/08/053434P.pdf">OPINION/ORDER</A><BR> 2 which included up to a twelve percent discount that Millennium would receive only if the fundamental aspects of all seven machines were identical. The contract provided that any changes to the final scope of the project were to be made in accordance with a written order to Slidell and agreed to by the parties. Millennium decided to upgrade the Including the price for change orders that are not in dispute. The total contract price for all seven machines and some additional equipment was about $11.2 million. 2 2 supervisory system specified in the contract and executed two change order development requests that authorized Slidell to start designing the system. Millennium was dissatisfied with this price and requested that Slidell remove the supervisory system from the scope of its work. Millennium confirmed that it was removing the supervisory system from the scope of the contract with Slidell. There is evidence that around May 11. Sensitive information regarding Slidell's design of the machines was provided to the RoviSys Company (RoviSys) without Slidell's consent. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/09/053803P.pdf">OPINION/ORDER</A><BR> The plaintiffs are current and former firefighters for the City of Aberdeen. Who have sued the City to recover overtime pay that they claim is due them under the Fair Labor Standards Act (FLSA). Both sides agreed that no facts were in dispute and moved for summary judgment. Concluding that the FLSA's plain language prevents the payment of overtime wages to those who have not actually worked. Because the relevant facts are not in dispute and the judgment is final. The plaintiffs were often scheduled to work more hours than the FLSA permits an employee to work without receiving overtime pay. This kind of arrangement is common among firefighters and is permissible under the FLSA so long as it is voluntary and done with the employer's permission. 29 U.S.C. § 207(p)(3). The amount that the substitute receives is fixed by private agreement between the two employees. It refused to pay them the overtime to which the FLSA plainly would have entitled them had they worked the shifts themselves. The law provides that </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=06-1925.01A">OPINION/ORDER</A><BR> The defendant entities\ are subsidiaries of defendant Triple S Management Corporation\ ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/10/054261U.pdf">OPINION/ORDER</A><BR> Stating: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-2271.01A">OPINION/ORDER</A><BR> </span><sup>4</sup>Thurston argues that the district court was wrong to accept\ the enhancements imposed in the first sentencing on the ground that\ <span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/10/061999P.pdf">OPINION/ORDER</A><BR> Was convicted of filing false Medicare and Medicaid claims and sentenced to a $1. The resulting fine range was $1. On the earlier appeal we found there was sufficient evidence to support the findings on which the district court relied in calculating the guideline range. It was also unclear whether PTS had been found to be a criminal purpose organization under U.S.S.G. § 8C1.1 (fines should divest such a defendant of all its net assets). Which are now relevant. The court asked whether there was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=04-1526.01A">OPINION/ORDER</A><BR> LLP</SPAN> were on brief. LLP</SPAN> was on brief. The first is whether the health centers serving those populations have enforceable rights to sue. The second is how a federal court hearing such a prospective claim should proceed when parallel litigation is proceeding in a state court. Such parallel suits are not uncommon. <STRONG></STRONG></SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/06/11/053873P.pdf">OPINION/ORDER</A><BR> A group of consumers and organizations from Minnesota who have purchased prescription drugs in the United States from the defendant drug companies in the United States. The gravamen of the complaint was that the defendants unlawfully conspired to suppress the importation of Canadian prescription drugs for personal use. Including: (1) requiring Canadian pharmacies to certify that they were not selling prescription drugs to persons whom the pharmacies knew or should have known were taking the drugs outside the country. (3) creating </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/02/062854P.pdf">OPINION/ORDER</A><BR> Which was never mailed to employees. His benefits were exhausted. Fairview argues on appeal that the district court erred as a matter of law by concluding that: (1) Greeley's action was not barred by the applicable two year statute of limitations. (3) Greeley was prejudiced by the SPD. Because the district court erred in its determination that Greeley was prejudiced by the memo. Greeley must show that he was prejudiced by it. The court concluded that Greeley was prejudiced and explained the prejudice standard it applied as follows: It is not clear what showing of prejudice is required under Eighth Circuit law. The Second Circuit requires a plan participant to show that he or she </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/07/09/063549P.pdf">OPINION/ORDER</A><BR> Hammonds and Hartford entered into a settlement agreement in July 1993 (the 1993 Agreement) which was approved by the South Dakota Department of Labor later that month. Again titled </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/95/12/952608P.pdf">OPINION/ORDER</A><BR> Were declared constitutional by the district court. We conclude that section 130.100 is unconstitutional and reverse the judgment of the district court. Will have an aggregate value in excess of the limits stated in section 1. They are not irreconcilably inconsistent. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov97/95-6861.opa_fn.html">OPINION/ORDER</A><BR> This document was created from RTF source by rtftohtml version 2.7.5 ></head><body><a name= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/byDate/Jun2004/Jun16/03-20792.0.wpd.pdf">OPINION/ORDER</A><BR> Who is black. She was assigned to the Pursuant to 5TH CIR. The court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. The group was supervised by Mary McCullen. Smith's performance ratings were consistently </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/96/07/953477P.pdf">OPINION/ORDER</A><BR> A teaching hospital's graduate medical education ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/97/07/962922P.pdf">OPINION/ORDER</A><BR> Who was born in 1937. She was notified that she was being transferred from the program into a regular classroom. Zotos was transferred back to the gifted program. Two weeks later she was assigned to a third grade class. Zotos informed the district that she was exercising her right to take early retirement effective July 1. The ADEA was amended to eliminate this 2 year limit. An ADEA lawsuit must now be filed any time from 60 days after a charge is filed until 90 days after receipt of notice that EEOC has completed action on the charge. Because it is not clear whether this amendment applies to instances of alleged discrimination occurring before November 21. Whichever is earlier. The District asserted that Zotos' </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/98/02/963231P.pdf">OPINION/ORDER</A><BR> Tucker was indicted in a twenty one count indictment. Tucker was indicted on the conspiracy charge and ten substantive counts based on individual transactions. The district court dismissed Counts 8 11.1 The remainder of the case was submitted to the jury. Tucker contends the convictions should be reversed because after trial it was discovered that a juror was married to a former state prisoner to whom Tucker. Tucker further objected to the empaneling of a juror who gave answers to a written jury questionnaire that were inconsistent with a defendant's right to remain silent and the presumption of innocence. Tucker contends that there was insufficient evidence to convict him of mail fraud and conspiracy. Hale was a municipal judge in Little Rock. All were active in state politics in one capacity or another and all had multifarious business interests. Hale told McDougal that the lending limit was $150. The lending limit was a function of the amount of capital Hale had available to invest in Capital Management Services. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/98/12/974389P.pdf">OPINION/ORDER</A><BR> The Department of Health and Human Services must determine whether a loan is necessary and what the hospital's investment income is. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/09/991197U.pdf">OPINION/ORDER</A><BR> Because the parties' submissions show they are thoroughly familiar with the issues before the court as well as the controlling legal principles. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1604OPN.01A">OPINION/ORDER</A><BR> Was on brief. <SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca8.uscourts.gov/opndir/99/11/992190U.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=02-1452.01A">OPINION/ORDER</A><BR> P.C.</SPAN> were on brief for appellants and cross appellees</SPAN> <BR WP= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/08C2E9937236E370882572BF0058795F/$file/0555211.pdf?openelement">OPINION/ORDER</A><BR> Was also on the brief. Circuit Judge: We must decide whether the children of Dimitris and Yvette Papakosmas were habitual residents of Greece within PAPAKOSMAS v. Dimitris and Yvette Papakosmas were married in Las Vegas. The couple have two children together. Both children were born in Los Angeles. Never learning of the other sale until the family was in Greece. Although she contends that such sale was unrelated to the move but instead a result of the dog's behavior problems. Dimitris contends that Yvette's trip was to deal with a bounced check and to return a passport to her son from a previous marriage. Was also in Greece. Denies that she was his mistress. Yvette's wrist was cut and she was hospitalized. That Yvette's wound was selfinflicted. After Yvette was released from the hospital. Therefore determined that there was no shared. Because the court determined that Dimitris had failed to meet his burden of proving that Greece is the children's habitual residence. Which is stayed pending the outcome of these proceedings. 1 4252 PAPAKOSMAS v. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-5100.wpd">OPINION/ORDER</A><BR> Both sides have now appealed. We decline to consider plaintiffs' assertion of a private right of action pursuant to 42 U.S.C. 1396a(a)(43) because the arguments now made on appeal by plaintiffs were neither asserted nor addressed below. I. Plaintiff Oklahoma Chapter of the American Academy of Pediatrics (OKAAP) is a non profit professional organization of pediatricians and pediatric specialists. (CAPTC) is a non profit organization located in Tulsa. The individually named plaintiffs are thirteen children and their parents. All of whom have been designated as representatives of the class certified by the district court. Defendants are officials of the State of Oklahoma and the Oklahoma Health Care Authority (OHCA). Alleging that defendants' policies and procedures denied or deprived eligible children in the State of Oklahoma of the health and medical care to which they were entitled under federal law. (c) their alleged right pursuant to 42 U.S.C. 1396a(a)(30)(A) to have provider reimbursement rates set at a sufficient level to assure Medicaid recipients of equal access to quality health care. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-2718.01A">OPINION/ORDER</A><BR> With whom <SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=05-4317.wpd">OPINION/ORDER</A><BR> Lyman is a licensed physician's assistant who worked under the supervision of various SJHSD physicians beginning in 1995.(1) After leaving Dr. Her request was delayed. 000 to compensate for </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca1.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-2357.01A">OPINION/ORDER</A><BR> Were on brief for appellee.</SPAN></P> <BR WP= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/1BA7E556D075EA0488256E5A00707C12/$file/9935936.pdf?openelement">OPINION/ORDER</A><BR> Were not eligible for pension benefits under the NWP plans. I. BACKGROUND NWP is a private corporation formed by a group of physicians to provide medical services to members of the Kaiser Permanente Medicare Care Program (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/nov98/96-8775.man.html">UNITED STATES V. HERNANDEZ (11/9/1998, NO. 96-8775)<BR></A><BR> For two of his business enterprises.<A HREF= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/2457FDB8B7C15C2688256A9C005962B2/$file/9935936.pdf?openelement">OPINION/ORDER</A><BR> Were not eligible for pension benefits under the NWP plans. I. BACKGROUND NWP is a private corporation formed by a group of physicians to provide medical services to members of the Kaiser Permanente Medicare Care Program (the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/25DCAFFA6C110DD088256D870082947A/$file/0255848.pdf?openelement">OPINION/ORDER</A><BR> Was charged a prepayment penalty of six months' interest on 100 percent of the balance of the loan. Governing Law Provision This Note and the related Security Interest are governed by the Alternative Mortgage Transaction Parity Act of 1982. We have jurisdiction pursuant to 28 U.S.C. § 1291. DISCUSSION [1] An award of fees and costs associated with removal or remand under 28 U.S.C. § 1447(c) is reviewed for an abuse of discretion. Although an order remanding a case to state court is not reviewable. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/September2004/032187p.pdf">OPINION/ORDER</A><BR> If a medication is subsequently returned to a defendant pharmacy for resale. Requiring Medicaid provider pharmacies to credit Medicaid when a medication is returned for resale. Is disturbing. Quinn's failure to present evidence of the actual submission of a single false claim to Medicaid is fatal to this qui tam action. Were charged by Thomas Quinn with submitting false claims in violation of the False Claims Act (FCA). 31 U.S.C. § 3729 et seq.1 Quinn Pompton is a Medicaid provider pharmacy that provides medications to individuals residing in long term care facilities. Pharmacy are also subsidiaries of Omnicare. Focused solely on Pompton's recycling and crediting practices because Quinn worked at Pompton and did not advance a theory of FCA liability against any other Omnicare subsidiary that was not advanced against Pompton. We too will focus solely on Pompton's recycling and crediting practices. 2 The complaint also named Alan Traster. East are the same entities. Cherry Hill Pharmacy and W inslow's 1 Approximately sixty percent of the medications that Pompton dispenses are paid for by New Jersey Medicaid.2 The remainder are paid for by the patients themselves or by private insurers. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/97opinions/97-5093.html">HATTER TERRY JR. V. U.S.<BR></A><BR> With him on the brief were W. Of counsel on the brief were Ellen E. With her on the brief was David M. Of counsel on the brief were Mildred L. We reverse and remand the matter for further proceedings.<p> <p> BACKGROUND<p> The facts of this case have been discussed in detail in our previous two decisions. The pertinent facts are that the Hospital Insurance (HI) tax (i.e. Medicare) was imposed upon federal judges for the first time on January 1. The Old Age Survivors and Disability Insurance tax (OASDI) was first imposed upon federal judges on January 1. The plaintiff judges asserted that their compensation was<p> diminished in violation of the Compensation Clause. Holding that the judges' claim was under the Compensation Clause for money damages. Holding that there was no constitutional diminution because the taxes imposed were nondiscriminatory and generally applicable to the public. Our judgment was affirmed in Hatter V due to lack of a quorum.2<p> On remand. The Court of Federal Claims awarded damages only to the eight original judges3 who were parties to the original complaint filed on December 29. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/2674E4B3307E9C6C88256E5A00707C7E/$file/9971278.pdf?openelement">OPINION/ORDER</A><BR> A survivor receives an annuity if he becomes disabled before the age of twenty two and is unable to engage in any regular employment. He no longer was eligible for an annuity because his job with the Oxnard School District constituted </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Oct2003/013720p.pdf">OPINION/ORDER</A><BR> The district court found that the Copyright Office's rulemaking 4 with respect to the Internet </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Nov2003/023340p.pdf">OPINION/ORDER</A><BR> Lawrence argues that photographic arrays shown to government witnesses were unduly suggestive. That the evidence was insufficient to prove the premeditation required for first degree murder. Lawrence argues that the government failed to establish that the weapon involved was not an antique and therefore not a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/2D6495646EB35EBE882571ED007FCF23/$file/0455122.pdf?openelement">OPINION/ORDER</A><BR> Our jurisdiction is pursuant to 28 U.S.C. § 1291. Are not suspected of fraud or ineligibility. Are automatically enrolled in Project 100%. The parties are essentially in agreement as to the structure and operation of Project 100%. The visit includes a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/305546C2DD86DE6A88256E00005FC9D3/$file/0171902.pdf?openelement">OPINION/ORDER</A><BR> Geoffrey Wilcox also were on the briefs. McDonough also were on the briefs. Guthery also were on the brief. 2003 is hereby amended as follows: Slip. Lines 10 8 from the bottom: Replace the sentence that currently reads </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/July2004/034124np.pdf">OPINION/ORDER</A><BR> We will affirm. We will therefore set forth the facts and relevant inferences as derived from plaintiffs' complaint. When plaintiffs retired they were covered by a collective bargaining agreement between the Rockwood Area School District ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/32EAEE29F5DC76ED8825733300553778/$file/0555710.pdf?openelement">OPINION/ORDER</A><BR> Then promptly moved to dismiss the action on the basis that Cedars Sinai's claims were preempted. Finding that Cedars Sinai's claims were preempted by the Federal Employee Health Benefits Act ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/July2002/002855.pdf">OPINION/ORDER</A><BR> The issue before us is whether we can hear its appeal. Pharis was the CEO and president of Hudson. The trial was scheduled to start on Monday. Arguing that the proposed evidence was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=04-3075.wpd">OPINION/ORDER</A><BR> REVERSE its determination that no sanctions were required against MSC. MSC was convinced its superior technology would give it a competitive advantage over its rivals. Was told (1) After examining the briefs and appellate record. These cases are therefore ordered submitted without oral argument. This order and judgment is not binding precedent. R. 36.3. <hr> that the building in question was already leased and the lessee. The offer was contingent upon GE's acceptance by May 23. The day the offer was made. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/410347FABA0293F388257251006DF1D1/$file/0510067.pdf?openelement">OPINION/ORDER</A><BR> Were on the briefs. Were on the brief. 19790 UNITED STATES v. The government was also required to give up all notes made by reviewing agents. 1 UNITED STATES v. The subpoenas were returnable on February 5. Consists of two professional baseball leagues the National League of Professional Baseball Clubs and the American League of Professional Baseball Clubs. 4 The names of the players are under seal and are not disclosed in this opinion. 5 CDT is a third party administrator of </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/4EE1DAEB1D688C258825730C004C0D4F/$file/0555126.pdf?openelement">OPINION/ORDER</A><BR> The sole issue on appeal is whether the Feres doctrine. We have jurisdiction pursuant to 28 U.S.C. § 1291. I. Aaron Schoenfeld was a Lance Corporal in the United States Marine Corps stationed at Marine Corps Base. He was generally on duty from Monday to Friday and had weekends off. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/50EB8ECDDADDFFDE88256B9D0079D4ED/$file/0055065.pdf?openelement">OPINION/ORDER</A><BR> The petition for rehearing is denied and the petition for rehearing en banc is denied. Is hereby AMENDED as follows: 1. Id. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/Feb2004/031247np.pdf">OPINION/ORDER</A><BR> Lopez Falcone was sentenced to three years probation. Was ordered to pay restitution in the amount of $46. A notice of appeal was timely filed and we appointed James C. Asking this court to allow him to withdraw because he is unable to identify any non frivolous issues for our review. We have jurisdiction under 28 U.S.C. § 1291. We will grant counsel's motion to withdraw and affirm the District Court's judgment of sentence. As is required under Anders. The plea hearing conducted by the District Court complied with Rule 11 of the Federal Rules of Criminal Procedure and was. The rights he was forfeiting by pleading guilty. The record in this matter reflects the District Court's efforts to ensure that there was an adequate factual basis for Lopez Falcone's guilty plea by personally questioning him regarding the facts of the case. Our independent review of the record satisfies us that LopezFalcone's sentence was legally imposed. Because Lopez Falcone's plea proceeding was proper and his sentence legal. We will GRANT counsel's request to withdraw. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/oct2002/02-10018.opn.html">UNITED STATES V. ROBERTS (10/4/2002, NO. 02-10018)<BR></A><BR> He was entitled to a new trial. The petitioner would like to state that this is </SPAN><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/fed/opinions/99opinions/99-5159.html">MARCINKOWSKY ARTHUR E V. U.S.<BR></A><BR> With him on the brief were <U>Loretta . Marcinkowsky was employed by the Union Carbide Corporation from August 1961 until October 1991. Which found that his termination was wrongful. From which federal income tax and FICA (Social Security and Medicare) tax were withheld on his behalf.</P> <P ALIGN= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/59605DD1748974D888256D170082557F/$file/0110152.pdf?openelement">OPINION/ORDER</A><BR> Section 666 of Title 18 is a broad statute designed to protect the financial integrity of programs 5694 UNITED STATES v. 000.1 The only significant legal question before us is whether the government was required to prove that the theft had some effect on a program receiving federal funds. Whether this federal nexus is required is an open question in this circuit. Assuming there is such a requirement. It was more than satisfied here. Cabrera was the Secretary of Finance for the Commonwealth. It was his job to account for the receipt and disbursement of all Commonwealth funds from federal or Commonwealth sources. Any requirement of a federal nexus was clearly met. 1 18 U.S.C. § 666 provides in material part as follows: Theft or bribery concerning programs receiving Federal funds (a) Whoever. Property that (i) is valued at $5. (ii) is owned by. Or is under the care. Or both. (b) The circumstance referred to in subsection (a) of this section is that the organization. The Secretary is the highest position in the Department of Finance. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/5D6C066EBF6660308825710E007B92EC/$file/0435704.pdf?openelement">OPINION/ORDER</A><BR> Who are seniors and disabled individuals. We have jurisdiction under 28 1514 WATSON v. The district court is thus affirmed in part. The Medicaid Framework Medicaid is a cooperative Federal State program with the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.villanova.edu/locator/3d/August2004/032263np.pdf">OPINION/ORDER</A><BR> The issue presented by this appeal is whether an individual retirement account ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6021792918194F9C88256EB300563324/$file/0335104.pdf?openelement">OPINION/ORDER</A><BR> Is substituted for his predecessor. We have jurisdiction under 28 U.S.C. § 1291 and affirm the district court. The benign effect of the President's designation was that public utilities reeling from the severe weather. It was the District's policy to append a thirty six percent </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/626F14EE357BC01688256AB6005E5FA4/$file/9971278.pdf?openelement">OPINION/ORDER</A><BR> A survivor receives an annuity if he becomes disabled before the age of twenty two and is unable to engage in any regular employment. He no longer was eligible for an annuity because his job with the Oxnard School District constituted </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/7F5ADFBA60A012A188256B4B00155B57/$file/0055065.pdf?openelement">OPINION/ORDER</A><BR> Plaintiffs are providers of medical services to Medi Cal recipients. The California Department of Health Services ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Sept1995/95a1168p.txt">OPINION/ORDER</A><BR> Paul's obligation to defend is also based on the comprehensive general liability coverage it purchased from St. I. Facts and Procedural History VNA is a non profit corporation engaged in the business of providing home health care and related services throughout the Delaware Valley. Agencies such as VNA typically provide home health care to patients who are discharged from hospitals and require follow up care. Which are required as a condition of participating in the Medicare and Medicaid programs to transfer or refer their patients to appropriate facilities. In February 1993 VNA was sued by AHS. Paul was required to defend VNA in the lawsuit brought by AHS and a judgment for all monies expended by VNA and all liabilities incurred but not yet paid by VNA with respect to the defense of the AHS suit. The district court held that VNA is not entitled to coverage under the commercial general liability portion of the policy. After the notices of appeal were filed. We have jurisdiction under 28 U.S.C. §1291. Our review of the district court's grant and denial of the summary judgment motions is plenary. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Sept1994/94a0840p.txt">OPINION/ORDER</A><BR> An administrative Declaratory Order interpreting the Act are preempted by ERISA. We find the Act and its regulations are not preempted because they confer broad authority that may be implemented in a manner consistent with ERISA. Therefore we will affirm the judgment of the district court striking the Declaratory Order. The Prevailing Wage Act The purpose of the Prevailing Wage Act </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Oct2000/995489.txt">OPINION/ORDER</A><BR> We will only call a charge an Allen charge when the court directed the minority jurors to reconsider their views in light 2 counts against the three defendants: the Podlasecks. We will REVERSE and REMAND for a new trial.2 I. David Podlaseck was president of EMB. Was EMB's primary salesman. Was its treasurer and office manager. Were also indicted by the grand jury. The defendants were charged with: one count of conspiracy in violation of 18 U.S.C. We will refer to charges as the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Oct1997/97a1728p.txt">OPINION/ORDER</A><BR> In part: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Oct1997/97a1728p.htm">OPINION/ORDER</A><BR> In part: </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/11circuit/sept2000/99-12507.man.html">FLORIDA ASS'N OF REHABILITATION FACILITIES, INC. V. FLORIDA DEP'T OF HEALTH (9/1/2000, NO. 99-12507)<BR></A><BR> That in any event the relief ordered by the district court is barred by the Eleventh Amendment to the extent it effectively requires the State to pay money to redress pre judgment violations. We remand for determination of whether Plaintiffs' entitlement to prospective relief had become moot by the time of judgment.</SPAN></P> <P><SPAN STYLE= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/May2000/982052.txt">OPINION/ORDER</A><BR> Is set in the familiar factual pattern of an employee's being denied a more advantageous pension because of a minor shortfall in the required period of service. When Harte's service was terminated. He was nineteen days short of eligibility for the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/89034F9A7D6E0A9788256C4B007BA8C7/$file/0235161.pdf?openelement">OPINION/ORDER</A><BR> DOC challenges the district court's finding that the adjusted data are neither predecisional nor deliberative as required to permit nondisclosure under the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/98C7F538AA7B5F6388256EBE004D44B4/$file/0235727.pdf?openelement">OPINION/ORDER</A><BR> As this is an appeal from a denial of a motion to dismiss on grounds largely of qualified immunity. We are asked to decide these weighty questions aided only by the skeletal at best factual picture sketched out in the complaint. 1 2 Pub. The federal courts may not dismiss a complaint unless </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Mar1995/95a0994p.txt">OPINION/ORDER</A><BR> The general issue we address is whether Fair Acres Geriatric Center. The jury was asked to decide whether. Wagner was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.ca10.uscourts.gov/cgi-bin/getopn.pl?OPINION=01-3310.wpd">OPINION/ORDER</A><BR> Edward Shaw was convicted by a jury of knowingly engaging in a scheme to falsify. In violation of 18 U.S.C. 1001(a)(1).(1) He was sentenced to four months imprisonment. Which was stayed pending this appeal. Shaw challenges his conviction and sentence on the following grounds: (1) the district court lacked subject matter jurisdiction over his prosecution under 18 U.S.C. 1001 because 42 U.S.C. 7413(c) is the exclusive means by which the Government may prosecute the making of a false statement on a form required by the Clean Air Act (CAA). (2) his prosecution under 18 U.S.C. 1001 was barred by the five year statute of limitations. After briefing was completed in this matter. Which was granted. Shaw argues Blakely applies to the federal sentencing guidelines and he was sentenced in violation of the Sixth Amendment. We divide our discussion in two (1) This order and judgment is not binding precedent except under the doctrines of law of the case. One of those companies was Southwest Wrecking. Also present at the walk through were Steve Allred and Barry Yaffe. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Jan2001/003307.txt">OPINION/ORDER</A><BR> 1993 ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Feb2001/991702.txt">OPINION/ORDER</A><BR> He argues that his guilty plea was not knowing. We conclude that his plea was knowing. We conclude that the district court did err in not considering Mustafa's ability to pay the restitution that was imposed in the amount of $732. We will remand for resentencing proceedings consistent with this opinion. Each redemption certificate purported to verify that the food stamps Mustafa was depositing were obtained in a manner that was consistent with controlling USDA r egulations. The government also intr oduced the testimony of an employee who testified that Mustafa had attempted to persuade him to say that the fir e was caused by a pot of potatoes left on the stove. Testimony of witnesses regarding the food stamp fraud Mustafa was conducting fr om the 1. The supermarket was in serious financial trouble. Some of the income Mustafa was deriving from the supermarket was derived from a fraudulent food stamp scheme. Mustafa's only viable asset was the insurance policy on the building and the super market business. 3 supermarket. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Feb2000/981497.txt">OPINION/ORDER</A><BR> Merena * The Honorable Will L. The government suspected that the laboratories had </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/997F1ECF5E6740C788256EAF0053D8EF/$file/0235550.pdf?openelement">OPINION/ORDER</A><BR> White is not challenging the validity of his state court conviction. Was in violation of both the United States and Washington constitutions. After rejecting the State of Washington's argument that jurisdiction was proper only under 28 U.S.C. § 2254. Reasoning that a COA was not necessary when a petitioner seeks habeas relief under 28 U.S.C. § 2241. White's appeal raises several issues that we have not previously addressed concerning the proper jurisdictional statute and procedural requirements for a state prisoner attacking the legality of his detention resulting from an administrative decision by state prison authorities. The circuits that have addressed these issues are divided on whether jurisdiction is proper under 28 U.S.C. § 2241 or under § 2254. On whether a COA is required. Which is properly understood as a general grant of habeas authority that provides federal court jurisdiction to a state prisoner when that prisoner is not in custody pursuant to a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/B5BF84E7139F52B8882571FC0049D312/$file/0672498.pdf?openelement">OPINION/ORDER</A><BR> UNITED STATES DISTRICT COURT OPINION PER CURIAM: The United States of America petitions this court for a writ of mandamus to require the district court to hold a jury trial in a criminal case in which the defendants are charged with acts involving interstate travel and the sexual abuse of young children. The minor will be portrayed in a visual depiction engaging in. The victims were the children of the defendants: Allen Harrod and Irene Hunt of Sacramento. The minor will be portrayed in a visual depiction engaging in. If any of the circumstances described in subsection (c) of this section exist. (c) The circumstances referred to in subsection (a) and (b) are that (1) in the course of the conduct described in such subsections the minor or the actor traveled in or was transported in interstate or foreign commerce . . . 18 U.S.C. §§ 2251A(a). Acts that the children were forced to commit. The five children involved three daughters of the Labrecques and one son and one daughter of Harrod and Hunt were as young as seven at the time of the abuse. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/C41BF3D4165B1D1E88256DB900713778/$file/0171902.pdf?openelement">OPINION/ORDER</A><BR> Geoffrey Wilcox also were on the briefs. McDonough also were on the briefs. Guthery also were on the brief. Environmental Protection Agency lawfully concluded that a Southern California county would have achieved the 24 hour air quality standards required by the Clean Air Act but for the negative effects of transborder emissions from Mexico. 600 square miles in Southeastern California and is bordered by Riverside County to the north. The county's other two major population centers are El Centro and Brawley. The States are responsible for ensuring compliance with both standards for PM 10 and must formulate a state implementation plan ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="ftp://opinions.ca5.uscourts.gov/unpub/03/03-60331.0.wpd.pdf">OPINION/ORDER</A><BR> As the Board decision at issue was a refusal to reopen Mims's case for failure timely to appeal the underlying hearings officer decision. We have no jurisdiction to consider Mims's petition. The court has determined that this opinion should not be published and is not precedent except under the limited circumstances set forth in 5TH CIR. 1 asserting that he was disabled for all work. Mims pursued his When these applications were denied. The Board found that Mims was not totally disabled. The Board's Director of Operations notified him that this application was denied. Was informed by letter dated December 10th. The that Mims was disabled from all work 1 Codified at 45 U.S.C. § 231a(a)(1)(v). in the United States District Louisiana. His case was jurisdiction. That he was entitled to a monthly disability annuity under the Railroad Retirement Act. That Mims was ineligible for a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Dec1995/95a1229p.txt">OPINION/ORDER</A><BR> I. We set forth the facts as the jury could have found them in support of its verdict. SEPTA would have to pay substantial penalties. If the actual cost was 90% or less of that estimate. Pierce was responsible for monitoring those costs. John Doe is a SEPTA employee. Doe was HIV positive. Retrovir is a prescription drug used solely to treat HIV. If he or anyone else reviewed employee names in association with the drugs the employees were taking. He was never informed that this change might alter his confidentiality status. These reports were part of the contract between Rite Aid and SEPTA. This report listed employees who were filling prescriptions at a cost of $100 or more per employee in the past month. It was immediately apparent to Pierce that the reports would reveal employees' medications. Pierce stated that her purpose in reviewing the reports with Aufschauer was several fold. Some employees would purchase prescription drugs under the SEPTA health plan in order to give them to an ill friend or relative who was not covered by SEPTA's benefit package. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/01opinions/01-5013a.html">STATE OF ARIZONA, ET AL V. TOMMY THOMPSON<BR></A><BR> Ar gued the cause for appellees.<span style= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CB08491C8B53D6B888256BBF0016FCFD/$file/0016399.pdf?openelement">OPINION/ORDER</A><BR> Plaintiffs further alleged that after David returned to the emergency room the next day and was admitted to the hospital for inpatient care. Plaintiffs' remedies for David's alleged inadequate medical care were under state law. I. Factual and Procedural History David was a 17 year old boy who was severely disabled and had the mental capacity of a young child. He was unable to communicate with anyone other than close relatives. Rosenthal noticed that David was coughing up yellow phlegm. Was wheezing. Because David was agitated. The medical staff was not able to inject the full dosage of Rocephrin. As David and his family were preparing to leave for the hospital. He was transferred from the emergency room to a medical/surgical room. Because there were no beds available in the Intensive Care Unit. David was transferred to U.C. Plaintiffs do not contend that this emergency transfer to the Center was improper or a violation of EMTALA. David was released from U.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug2000/993455.txt">OPINION/ORDER</A><BR> Cefaratti pleaded not guilty and was released after executing an unsecured bond. The S 1957 charge is of a lesser offense than theS 1956 charge in the original indictment. S 3B1.1(c) and that the sentencing range of 51 to 63 months was unconstitutionally disproportionate to the sentences 1. The court found that the two level adjustment for playing a leadership role was warranted and imposed a sentence of 51 months. We have jurisdiction pursuant to 28 U.S.C. Cefaratti was an owner and also the president of the Franklin School of Cosmetology and Hair Design in Elizabeth. Students were eligible for federalfinancial assistance only if they had a high school diploma. A student was considered to be in default after a 180 day grace period if the student failed to make payments unless the student was granted a deferment or forbearance for his or her repayment obligations. Cefaratti implemented a scheme to manipulate Franklin's default rate by submitting false deferment and forbearance forms to student loan lenders and by making payments on behalf of student borrowers who were on the verge of defaulting. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug2000/991854.txt">OPINION/ORDER</A><BR> We will affirm the district court's order dismissing the complaint on the ground that appellants have not alleged an injury to business or property cognizable under RICO. Appellants instituted this purported class action on behalf of themselves and all members of a class 4 consisting </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CCAC494C54AB3E6C88256E5A00707C71/$file/9915716.pdf?openelement">OPINION/ORDER</A><BR> The case was tried to the bench before District Judge Robert H. The case was reassigned to District Judge Saundra Brown Armstrong. The case was later reassigned to District Judge Susan Illston. (2) that Federal Rule of Civil Procedure 63 was violated because the successor judges did not certify familiarity with the record. (3) that the plan was not an ERISA plan. (4) that benefits checks from the employer's stop loss carrier were not ERISA assets. (5) that genuine issues of material fact existed regarding whether Sahni was a fiduciary. The money he retained was reasonable compensation that had been disclosed to and approved by Patelco. (7) that evidence and a witness were erroneously excluded. (8) that sanctions were imposed in violation of Rule 11 and Rule 63 of the Federal Rules of Civil Procedure. FACTUAL BACKGROUND Plaintiffs in this action are Patelco Credit Union. Defendants are Sudhir Sahni. Prior to 1983 the Plan was fully insured by Travelers. None of these components was itemized. Sahni either approved or denied them and then wrote checks to medical care providers for those services that were covered. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Aug1997/97a1682p.txt">OPINION/ORDER</A><BR> We are faced with an apparent conflict between </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/94opinions/94-5190a.html">DICKSON D. V. SECY DEF<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/CF89023CAB836C8E88256AB4006D403E/$file/9915716.pdf?openelement">OPINION/ORDER</A><BR> The case was tried to the bench before District Judge Robert H. The case was reassigned to District Judge Saundra Brown Armstrong. The case was later reassigned to District Judge Susan Illston. (2) that Federal Rule of Civil Procedure 63 was violated because the successor judges did not certify familiarity with the record. (3) that the plan was not an ERISA plan. (4) that benefits checks from the employer's stop loss carrier were not ERISA assets. (5) that genuine issues of material fact existed regarding whether Sahni was a fiduciary. The money he retained was reasonable compensation that had been disclosed to and approved by Patelco. (7) that evidence and a witness were erroneously excluded. (8) that sanctions were imposed in violation of Rule 11 and Rule 63 of the Federal Rules of Civil Procedure. FACTUAL BACKGROUND Plaintiffs in this action are Patelco Credit Union. Defendants are Sudhir Sahni. Prior to 1983 the Plan was fully insured by Travelers. None of these components was itemized. Sahni either approved or denied them and then wrote checks to medical care providers for those services that were covered. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Apr2001/003056.txt">OPINION/ORDER</A><BR> Plaintiffs have frequently sought damages from affiliated corporations. Plaintiffs with claims arising from non WARN Act sources of law against debt laden or bankrupt corporations have occasionally attempted to sue the corporations' major secured lenders. On the theory that the lenders have exercised such control over the corporations that veil piercing is appr opriate. The question before us is whether the for mer employees of Component Technology (CompTech). Have set forth sufficient evidence to cr eate a genuine issue of material fact as to whether . Requires us to consider not only the prerequisites for parent/subsidiary liability in the WARN Act context (as will be shown. That 2 jurisprudence is apposite here). Courts have been extr emely reluctant to hold lenders liable for their borrowers' actions. Some version of the </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Apr1996/96a1291p.txt">OPINION/ORDER</A><BR> After he was released. After summary proceedings in which no evidence was heard and virtually no factual record developed. These cross appeals present numerous questions (some of which are quite difficult): (1) Do the registration and notification provisions of Megan's Law constitute </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://vls.law.vill.edu/locator/3d/Apr1996/96a1287p.txt">OPINION/ORDER</A><BR> Have standing to bring an antitrust action against the sellers of the photocopies. We hold that such clients lack standing to bring a treble damages claim because they are not </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200706/06-5190a.pdf">OPINION/ORDER</A><BR> With him on the briefs was Larry I. With him on the brief were Peter D. The FAA's preemption of OSHA's regulatory authority extends </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/E6EA6819078EAEB188256D13006BEA3B/$file/0036060.pdf?openelement">OPINION/ORDER</A><BR> Alleged that his termination from the residency program was motivated by Seyfer's retaliation against him for questioning Seyfer's billing practices. He had a one year contract that was renewable for a second year. Ostad contends he was ordered to sign the letter and </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ca9.uscourts.gov/ca9/newopinions.nsf/opinions%20by%20date?OpenView&Start=1&Count=100&Expand=3.4#3.4">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-1083.pdf">OPINION/ORDER</A><BR> With him on the brief was Michael J. On the brief were James M. Of counsel was Mark B. On the brief were Peter D. Of counsel on the brief was Charles R. Which is known as the Byrd Amendment. Customs determined that Cathedral and Root were ineligible for those distributions because the two companies had not made timely requests for payment. The National Candle Association filed an antidumping petition alleging that the importation of petroleum wax candles from China was causing and threatening to cause material injury to the domestic candle industry. The questionnaires were marked </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-5027.pdf">OPINION/ORDER</A><BR> Of counsel on the brief was Brian C. With her on the brief were Peter D. This is a consolidated appeal from two decisions of the Court of Federal Claims. Because the RAC is an agent of the United States. BACKGROUND I At the heart of this case is the administration of the AMAA. The AMAA was originally enacted during the Depression. Producers the principal purposes of which are to raise the price of agricultural products and to establish an orderly system for marketing them. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200611/06-5154a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Peter D. Dance was on the brief for amicus curiae Blue Cross & Blue Shield Association. With her on the brief were Kate C. With him on the brief were John C. Theodore Case Whitehouse was on the brief for amicus curiae Generic Pharmaceutical Association in support of appellees. Branded drug and markets an approved generic version of that drug or prevails in litigation establishing that the patent is valid or not infringed. Thereby depriving the generic manufacturers of an opportunity to have a period of marketing exclusivity. We hold the FDA's requirement that a generic manufacturer's patent challenge give rise to litigation as a condition of retaining exclusivity when a patent is delisted is inconsistent with the Act. Which provides that the first generic manufacturer to file an approved application is entitled to exclusivity when it either begins commercially to market its generic drug or is successful in patent litigation. Including evidence the drug is safe and effective. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200608/04-5315a.pdf">OPINION/ORDER</A><BR> With him on the briefs was Kimberly Carey Williams. Were on the brief for amicus curiae Bipartisan Legal Advisory Group of the United States House of Representatives in No. 04 5315. Was on the brief for amicus curiae Congressman Henry J. With her on the briefs was Toby R. With him on the brief were Douglas B. I. No. 04 5315 is an appeal from a district court order denying a motion to dismiss a complaint alleging that the Office of Representative Eddie Bernice Johnson discriminated against Beverly A. No. 045335 is an appeal from a district court order denying a motion to dismiss a complaint alleging that the Office of Senator Mark Dayton discriminated against Brad Hanson because of a perceived disability and violated the Fair Labor Standards Act. 4 The Office of Representative Johnson and the Office of Senator Dayton (collectively. The </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200603/05-5401a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Peter D. With him on the briefs were Christine J. With him on the brief was Steven A. Whichever is earlier. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/04-5067.pdf">OPINION/ORDER</A><BR> With her on the brief were Peter D. The appeal of the court's denial of the motion to transfer is dismissed. Background Appellants are Texas. MPCI is issued by private insurers and reinsured by the Federal Crop Insurance Corporation ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/05-1241.pdf">OPINION/ORDER</A><BR> With him on the brief were Robin L. Of counsel on the brief were Juliana M. Of counsel was Charles E. That the asserted claims were invalid as anticipated because Go was not entitled to claim the priority date of an earlier application. Go argues that (1) the district court erred in granting summary judgment on the patent claim because there were factual disputes as to whether the earlier patent application met the requirements of 35 U.S.C. § 112. (2) prejudgment interest should have been awarded because the contract damages were liquidated. (3) the damages award should not have been reduced. Most of the bacteria are concentrated in the first 1.5 cm to 2 cm of the urethra. The '259 patent was issued from a 1985 continuation in part application that claimed the priority date of an application filed on September 12. 1979.1 The claims of the '259 patent recite the use of a stop member to limit the insertion of the sheath to either </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/05-1331.pdf">OPINION/ORDER</A><BR> With him on the brief were Bruce M. Of counsel was Herbert W. Inc. were Darrell L. Of counsel on the brief were David M. Nor do we conclude that the district court abused its discretion in determining that infringement is likely and that the harm and public interest favors enjoining Teva and Ranbaxy. injunction. Many ACE inhibitors including quinapril are susceptible to degradation due to cyclization. They chose excipients known to have low moisture content. Claim 1 is a composition claim: A pharmaceutical composition which contains: (a) a drug component which comprises a suitable amount of an ACE inhibitor which is susceptible to cyclization. Claim 16 is a process claim: A process for stabilizing an ACE inhibitor drug against cyclization which comprises the step of contacting the drug with: For more background on the development of ACE inhibitors. Drug and Cosmetic Act.2 Because Teva was the first company to file an ANDA for the generic version of AccuprilŽ. Teva was entitled to a 180 day generic market exclusivity period pursuant to 21 U.S.C. § 355(j)(5)(B)(iv). </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/05-3302.pdf">OPINION/ORDER</A><BR> With him on the brief was Harvey M. With him on the brief were Peter D. Of counsel on the brief was Daniel C. Denying his request for correction of disciplinary actions taken in retaliation for certain critical statements that he made while he was Medical Director of the Nuclear Medicine Section at the Harry S. The Board upheld the agency's position that the letter of reprimand and reduced proficiency rating would have been given because of the manner in which the protected disclosure was made. Greenspan was not entitled to the protection of the WPA.1 We conclude that the Board erred in law. For the WPA does not contemplate removal of protection when protected subject matter is stated in a blunt manner. Greenspan was elected by the Truman Hospital's medical staff to serve as Medical Staff Representative to the hospital management. This was Ms. Was to </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200506/05-5004a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Theodore C. Monroe Sampson were on the brief for amicus curiae Mylan Pharmaceuticals. With him on the brief were Peter D. With him on the brief were Karyn K. Which is the bioequivalent to a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200506/04-5157b.pdf">OPINION/ORDER</A><BR> FINAL.odl.wpd (Read Only)] </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200502/04-5252a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Robert F. Brink mann were on the brief for amici curiae Chamber of Commerce of the United States of America. On the brief were Peter D. The only circuit then to have considered </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.fedcir.gov/opinions/06-1391.pdf">OPINION/ORDER</A><BR> McDermott Will & Emery LLP. Of counsel on the brief were Kevin A. With him on the brief was Geoffrey D. Of counsel were Michael J. This is a patent infringement case in which the United States District Court for the Western District of New York concluded at summary judgment that suit against a hazardous waste remediation contractor was barred by government contractor immunity under 28 U.S.C. § 1498. Because we agree with the district court that the contractor's use of the accused method was </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200412/04-5211a.pdf">OPINION/ORDER</A><BR> With him on the briefs were Christine J. With him on the brief was William B. With him on the brief were Peter D. Were affirmed by this court in a consolidated appeal. At issue in this case is a dispute over the proper interpretation and application of the pre amended version of the 180 day generic marketing exclusivity provision of the Federal Food. Is now running and will not expire until April 2005. Because the parties in this case are the same parties who appeared in TorPharm. A final judgment was rendered against Apotex in TorPharm. There have been no material changes in the facts since the judgment in TorPharm. Because FDA's interpretation of § 355(j)(5)(B)(iv) was reasonable and thus entitled to deference. We vacate the District Court's alternative holding reaching the merits of whether FDA's interpretation of 21 U.S.C. § 355(j)(5)(B)(iv) is reasonable. 4 I. NDAs are usually lengthy. Information demonstrating that the generic version is the bioequivalent of the approved version of the drug. ANDAs must also address patents that apply or might apply to the drug for which the ANDA is submitted. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.ll.georgetown.edu/federal/judicial/dc/opinions/94opinions/94-5271a.html">ARENT SHEREEN V. SHALALA, DONNA E.<BR></A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200403/03-1008a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/02/96-3181.htm">96-3181 -- COPELAND V. TOYOTA MOTOR SALES U.S. INC. -- 02/17/1998<BR></A><BR> </strong>Circuit Judge. <p> <hr align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/03/97-6064.htm">97-6064 -- MCGRAW V. PRUDENTIAL INSURANCE COMPANY OF AMERICA -- 03/06/1998<BR></A><BR> The Disease</strong> <p> Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. That is. It is believed. To have problems with balance and bladder control. Are interrupted by remissions. Much less common is a chronic progressive form in which spinal cord and cerebellar dysfunction predominate. The course of MS is unpredictable.<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/06/96-3025.htm">96-3025 -- MISSION GROUP KANSAS INC. V. RILEY -- 06/01/1998<BR></A><BR> For profit postsecondary institutions are statutorily barred from participating in Title IV programs unless they derive at least 15% of their gross revenues from sources other than Title IV. <u>See</u> 20 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/docs/common/opinions/200303/01-5449a.pdf">OPINION/ORDER</A><BR> </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/12/97-3001.htm">97-3001 -- HEALTHCARE AMERICA PLANS INC. V. CONSTANCE BOSSEMEYER -- 12/15/1998<BR></A><BR> Bossemeyer was not covered by the health care plan. The two actions were consolidated. Determining the fiduciary's denial of coverage was not arbitrary and capricious. <em>Healthcare America Plans. We have jurisdiction under 28 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1998/12/97-3001a.htm">97-3001A -- HEALTHCARE AMERICA PLANS INC. V. BOSSEMEYER -- 12/15/1998<BR></A><BR> 1998 is now being amended to add the concurrence filed by Judge Robert Henry on this date. The concurrence is appended immediately following the majority decision which remains the same as when filed. <p> The amended copy of the decision is attached. <p> Very truly yours. Bossemeyer was not covered by the health care plan. The two actions were consolidated. Determining the fiduciary's denial of coverage was not arbitrary and capricious. <em>Healthcare America Plans. We have jurisdiction under 28 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/1999/12/99-4056.htm">99-4056 -- GILCHRIST V. NATIONAL ASSOCIATION OF LETTER CARRIERS -- 12/23/1999<BR></A><BR> (2) dismissing the claims for room and board for the years 1995 and 1996 because they were incurred under a negotiated agreement and therefore not subject to review by the Office of Personnel Management (OPM).<a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2000/02/98-5229.htm">98-5229 -- WALKER V. U.S. -- 02/04/2000<BR></A><BR> The district court determined that the Walkers were entitled to a refund of $42. We reverse. <p align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2001/09/99-1351.htm">99-1351 -- U.S. V. ROCKWELL INTERNATIONAL CORP. -- 09/24/2001<BR></A><BR> Rockwell was compensated on a </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200203/01-5013a.txt">OPINION/ORDER</A><BR> With her on the brief was Scott R. We conclude that HHS erroneously determined that it was without discretion to permit those expenditures. Which was an individual entitlement program. The amount of a state's TANF grant is based on the amount of the reim bursement paid to the state under AFDC during an historical base period. A state may spend its grant </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/03/99-1351.htm">99-1351 -- U.S. V. ROCKWELL INTERNATIONAL CORP. -- 03/04/2002<BR></A><BR> Was circulated to the members of the panel and all circuit judges of the court in regular service. That suggestion is denied. <p> The petition for rehearing by the panel has been considered by the panel and it has been determined that rehearing is granted for the limited purpose of modifying the opinion and ordering a limited remand to the district court as provided herein. The limited remand to the district court is for the purpose of that court making findings of fact and conclusions concerning the issue of disclosure prior to filing of this action in accordance with the False Claims Act. A supplemental record will be transmitted to this court containing the additional findings and conclusions made on this limited remand. This court will otherwise retain jurisdiction of this cause. The rulings made previously in our opinion are undisturbed. Final disposition of these appeals will be made. <p> The court's opinion as modified on rehearing by the panel is being filed along with this order. <p> ENTERED FOR THE COURT <p> <p> Patrick Fisher. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2002/05/99-4149.htm">99-4149 -- DAVIS V. NORRIS -- 05/01/2002<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Appellant Deborah Norris appeals from the district court's dismissal with prejudice of her counterclaims for intentional infliction of emotional distress. Who was her neighbor. Davis claimed that their sexual encounters were consensual. The litigation was bitter. The state court ordered that they were to remain confidential and not to be disseminated beyond use by the experts in the Utah state case. <p> In 1993. Davis was convicted of Medicare/Medicaid and insurance fraud in conjunction with his practice as a physician and was sentenced to federal prison. Numerous articles were published about his alleged illegal activities between 1989 and 1994. Norris was interviewed was published in a Salt Lake City. Davis was pending and that she was aware of four other women who claimed he had sexually assaulted them. <p> In June 1995. Norris sent a copy of the 1994 article to the federal prison where he was incarcerated and that he suffered loss of privileges and a . </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2003/11/00-3181.htm">00-3181 -- BUTLER V. BIOCORE MEDICAL TECHNOLOGIES INC. -- 11/04/2003<BR></A><BR> Circuit Judge<strong><em></strong></em> <p align= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200010/99-5305a.txt">OPINION/ORDER</A><BR> With him on the brief were David W. It also claims that the District Court erred in denying its motion to amend its complaint to include claims that the USDA's new rule both is arbitrary and capricious and violates the Consti tution's Interstate Commerce Clause. We hold that the District Court properly concluded that USDA was not required to engage in notice and comment rulemaking. I. BACKGROUND Appellee Daniel Glickman is the Secretary of the USDA. The USDA's Food Safety Inspection Service ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://pacer.cadc.uscourts.gov/common/opinions/200010/99-1531a.txt">OPINION/ORDER</A><BR> With him on the briefs were William T. Jr. were on the brief for amicus curiae in support of petitioner. With him on the brief were Christopher J. With him on the brief were Thomas F. Qwest contends that the Order is contrary to s 1905 of the Trade Secrets Act. Is a wholly owned subsidiary of U S West. That the Commission has failed to explain how its Order is consistent with its policy regarding the treatment of confiden tial information. The Region al Bell Operating Companies ( </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/02/02-7077.htm">02-7077 -- LOCAL 514 TRANSPORT WORKER UNION OF AMERICA V. KEATING -- 02/13/2004<BR></A><BR> 1A of the Oklahoma Constitution were preempted by federal law and that any remaining non preempted provision was not severable from the preempted provisions. 1A that were preempted by federal labor law were </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/03/99-1351.htm">OPINION/ORDER</A><BR> HOLLOWAY </strong>and <strong>HARTZ</strong></a><a href= </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/05/03-6236.htm">03-6236 -- U.S. V. TAGOE -- 05/19/2004<BR></A><BR> The case is therefore ordered submitted without oral argument. <p> Appellant Edward A. That no downward adjustment for acceptance of responsibility was warranted. This court </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.kscourts.org/ca10/cases/2004/08/03-1074.htm">03-1074 -- HOUGHTON V. REINERTSON -- 08/24/2004<BR></A><BR> We reverse and remand with directions to enter summary judgment in favor of the Sellers. <p> <center>I.</center> <p> <strong> </strong>Medicaid is a cooperative federal state program authorized under Title XIX of the Social Security Act of 1965. <u>See</u> 42 U.S.C. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/dec95/95-5044.html">UNITED STATES V. CORDOBA<BR></A><BR> Cordoba was stopped by the Oklahoma Highway Patrol for driving his Chevrolet van twelve miles over the speed limit. The van was then seized along with $4. $778 which was found in a bag beside the driver's seat in the van. The FBI seized the van and currency based on the belief that they were subject to forfeiture pursuant to 21 U.S.C. 881(a)(4) and (a)(6) because the van was used by Cordoba to transport 10 kilograms of cocaine and because both the van and currency were the proceeds of drug trafficking. A federal complaint was filed against Cordoba and a codefendant on charges relating to possession with intent to distribute 10 kilograms of cocaine. 000.00 cashier's check owned by Cordoba and his wife was seized as drug proceeds. A Corvette owned by Cordoba was also seized as drug proceeds. That is. Cordoba asserted that the Double Jeopardy Clause of the Fifth Amendment was violated as a result of the administrative forfeiture of his property and his subsequent criminal conviction. This term of imprisonment was to be followed by a five year term of supervised release on count one and a three year term of supervised release on count three. </TD> </TR> <TR CLASS="swhit"> <TD CLASS="swrank"><IMG SRC="/usca/images/score-1.gif" ALT="149"></TD> <TD CLASS="swtitle"><A HREF="http://www.law.emory.edu/10circuit/feb96/94-1285.html">UNITED STATES V. 9844 S. TITAN CT.<BR></A><BR> There is merit in both arguments. These were adjacent units in an industrial condominium. Philip May was indicted on January 28. He was convicted on all counts. He was sentenced to ten years' imprisonment. Frances May was never arrested or charged with any crime. Contending that the property was connected with the sale and distribution of controlled substances under 21 U.S.C. 881(a)(6) and (a)(7). By reason of any act or omission established by that owner to have been committed or omitted without the knowledge or consent of that owner. (7) All real property. Which is used. By reason of any act or omission established by that owner to have been committed or omitted without the knowledge or consent of that owner