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Reimbursement

Feb 28, 2018

Securities – Medical reimbursement scheme was material omission

Holding: Investors’ complaint against a medical device company sufficiently alleged violations of § 10(b) of the Securities Exchange Act, claiming that the company’s officers knowingly misrepresented material facts constituting a fraud on the market. Background Appellee TranS1 received approval in 2004 to sell its AxiaLIF system, a medical device for spinal surgery. TranS1 derives its [&helli[...]

Feb 19, 2015

Trusts & Estates — UTMA – Custodian’s Withdrawals – Out-of-Pocket Expenses – Reimbursement – First Impression

In re Alessandrini (Lawyers Weekly No. 15-07-0154, 10 pp.) (John Tyson, J.) Appealed from Rowan County Superior Court (Mark Klass, J.) N.C. App. Holding: The respondent-custodian paid his children’s expenses out of pocket and then reimbursed himself from their Uniform Transfers to Minors Act accounts. In a matter of first impression, the court finds no […]

Jul 9, 2012

Elections – Fundraising – Corporate Contributions – Donor Recruitment – Reimbursement

U.S. v. Danielczyk In this prosecution of two corporate executives for an alleged scheme of recruiting donors and reimbursing their contributions to Hillary Clinton’s 2006 and 2008 Senate and Presidential Campaigns, the 4th U.S. Circuit Court of Appeals reverses dismissal of a charge of corporation contributions in violation of 2 U.S.C. § 441b(a).

Jun 13, 2012

Administrative – Medicare – Reimbursement – 1995 & 1997 Guidelines – Estoppel – Dated Record – Medical Complexity

Ojebuoboh v. Sebelius The plaintiff-doctor did not raise the issue of which set of Medicare Guidelines (the 1995 version or the 1997 version) applied until his motion for reconsideration before the Medicare Appeals Council (MAC). Accordingly, the MAC’s adoption of the independent reviewer’s decision to use the 1997 guidelines was not arbitrary, capricious, or an abuse of discretion.

Apr 28, 2011

Administrative – Medicaid – Reimbursement – Ambulance/Emergency Services – Rates

Healthkeepers Inc. v. Richmond Ambulance Authority. In this Medicaid reimbursement case, the 4th Circuit holds that ambulance services are "emergency services" under 42 U.S.C. § 1396u, and defendant . . .

Jan 21, 2011

Administrative – Medicaid – Federal Waiver – Unpromulgated Rule – Home Care – Reimbursement

McCrann v. N.C. Department of Health & Human Services. (Lawyers Weekly No. 11-07-0066, 22 pp.) (Robert N. Hunter Jr., J.) Appealed from Wake County Superior Court. (Donald W. Stephens, J.) N.C. App. Click here for the full text of the opinion. Holding: The respondent-agency’s interpretation of changes to a Medicaid program was a rule. Since […]

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