Articles Posted in Miscellaneous

us supreme court.jpgNot infrequently, Medicaid will step up and cover the medical expenses of persons severely injured in accidents before other sources do so. This is commendable. However, where the Medicaid recipient is subsequently compensated by a third party for damages sustained in the accident, Florida Statute 409.910 says that Medicaid must be reimbursed from the proceeds.

How the statutory formula is applied has been the subject of appeals both in Florida and in other states (other states have similar statutory provisions). The many opinions have created some confusion. This blog attempts to clarify the law in Florida.

First, a basic understanding of the Medicaid system is in order. A good explanation comes by way of EMA ex rel. Plyler v. Cansler, 674 F. 3d 290 – Court of Appeals, 4th Circuit 2012.

The Medicaid program, launched in 1965 with the enactment of Title XIX of the Social Security Act, as added, 79 Stat. 343, 42 U.S.C. §§ 1396-1396v, is a cooperative program by which the federal government pays a percentage of the costs a state incurs for medical care for individuals who cannot afford to pay their own medical costs. [Arkansas Dept. of Health and Human Servs.] v. Ahlborn, 547 U.S. at 275, 126 S.Ct. 1752. Although states are not required to provide Medicaid assistance, all 50 states currently do. Id. In exchange for receiving federal financial support for state-run Medicaid programs, states must comply with federal Medicaid laws, including statutory third-party liability requirements, 42 U.S.C. §§ 1396a(a)(25)(A), (B), (H); 1396k, and anti-lien provisions, id. §§ 1396a(a)(18), 1396p.

States providing Medicaid assistance must comply with several provisions concerning third-party liability. For instance, states are required to “take all reasonable measures to ascertain the legal liability of third parties … to pay for care and services available under the [State’s Medicaid] plan.” 42 U.S.C. § 1396a(a)(25)(A). In addition to this identification requirement, the state agency administering the Medicaid program … must seek reimbursement for medical assistance to the extent of such legal liability. Id. § 1396a(a)(25)(B). In order to secure its reimbursement from liable third parties, the state must,

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pinoccio.jpgThe elements of defamation are that the Defendant published a false statement, that the statement was communicated to a third party, and that the Plaintiff suffered damages as a result of the publication. Axelrod v. Califano, 357 So.2d 1048 (Fla. 1st DCA 1978).

In some instances, a qualified privilege exists in the communication. For the communication to be privileged, it “must be made by a person having a duty or interest in the subject matter, to another having a corresponding duty or interest.” Axelrod at 1051. The nature of the duty or interest may be public, personal or private, either legal, judicial, political, moral, or social. It need not be one having the force of a legal obligation; it may be one of imperfect obligation. The interest may arise out of the relationship or status of the parties. Leonard v. Wilson, 150 Fla. 503, 8 So.2d 12 (1942). It is called a qualified or conditional privilege, because the libelous statement must be made in good faith, that is, with a good motive, and not for the purpose of harming the subject of the defamation. Drennen v. Washington Electric Corp., 328 So.2d 52, 55 (Fla. 1st DCA 1976).
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pregnant.jpgFederal law, Title VII of the Civil Rights Act of 1964 (Title VII) — see 42 U.S.C. Section 2000e et seq.; 42 U.S.C. Section 2000e-2 — expressly forbids sex discrimination on the basis of pregnancy. Florida’s discrimination statute, the Florida Civil Rights Act of 1992, does not. See Fla. Stat. Section 760.10.

While Florida’s statute does not expressly prohibit discrimination on the basis of pregnancy, one Florida appellate court, the Fourth District Court of Appeals has decided that a cause of action does exist under Section 760.10 for discrimination in employment based on pregnancy. See Carsillo v. City of Lake Worth, 995 So.2d 1118 (Fla. 4th DCA 2008).

Florida has five District Courts of Appeals. While the Fourth has decided that a cause of action does exist under 760.10, the First, in

us supreme court.jpgThere are numerous procedural, substantive, and even attitudinal differences in the way civil cases are handled between State and Federal Courts. The differences can determine the outcome of a case.

In many instances, the line is sharp over which court system has jurisdiction, leaving little to no choice over which system will get the case. In others, however, legal maneuvering can dictate where a case will land. It is important, therefore, for lawyers to fully understand the factors that determine the outcome.

Given the significance of the outcome, parties to legal proceedings have always tussled over the jurisdiction issue, spawning a plethora of statutes and case law. Ironically, the many statutes and opinions on the subject have to a degree created more confusion than clarity.
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drunk.jpgPIP (Personal Injury Protection) and health insurance will cover most motor vehicle-related medical expenses. However, these insurance policies are subject to deductibles and copays, leaving insureds with out-of-pocket medical expenses even under the best circumstances. An exception applies when the insured is a victim of a DUI crash.

The exception is contained in Florida Statute Section 624.128:

Crime victims exemption.–Any other provision of the Florida Statutes to the contrary notwithstanding, the deductible or copayment provision of any insurance policy shall not be applicable to a person determined eligible pursuant to the Florida Crimes Compensation Act, excluding s. 960.28.

The DUI crash victim must apply for crime compensation with and be found eligible by the Office of the Attorney General, Division of Victim Services. (Here is a link to the Victim Compensation Claim Form.) A victim found eligible will be notified by the Office of the Attorney General. The victim should then present the notice of eligibility to the appropriate insurance companies to obtain the waiver.
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calculator.jpgObviously, medical records are important for many reasons. They do not come without a price.

Florida Statute Section 456.057 is titled “Ownership and Control of Patient Records; Report or Copies of Records to be Furnished,” and it defines the owner of medical records as the health care practitioner who generates a medical record after essentially performing an examination of a patient. The owners sell copies of their records to those who request them.

The cost of copies is controlled by 456.057 and Rule 64B8-10.003 of the Florida Administrative Code. A plain reading of Rule 64B8-10.003 makes it clear that the cost of medical records is determined by the status of the person making the request.
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dollars.jpgThe Huns are at it again.

Not satisfied with controlling the Governor’s Office (Tea Party darling Rick Scott) and the Florida Legislature (both chambers have large Republican majorities), the US Chamber of Commerce and its right-wing allies are mounting a campaign to unseat three moderate Florida Supreme Court Justices. If the Justices are unseated and Rick Scott chooses their replacements, any hope that the poor, the injured, the forgotten, the voiceless, the defenseless and the damned have of receiving a fair shake will be vanquished. The three seats of our state government – Executive, Legislative, and the Courts – will be in the hands of the Huns. Shudder the thought!

Every six years, Florida’s Supreme Court Justices are subject to a “yes” or “no” merit retention vote by the general electorate. No Supreme Court Justice has ever been voted out of office. However, no Justice has faced what Justices R. Fred Lewis, Barbara J. Pariente, and Peggy A. Quince will be facing in the coming months in the lead up to their merit retention votes in November, 2012.
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A deposition is the gathering of sworn verbal testimony under oath. Except for communications that are protected by attorney/client privilege and the 5th amendment right against self-incrimination, witnesses are required to answer deposition questions. If a lawyer feels that a question is confusing, misstates testimony, lacks foundation, or assumes facts not in evidence, it is proper for an objection to be lodged before the question is answered. In most instances, the objection should simply be, “I object to the form of the question.” This alerts the deposing lawyer that there may be a problem with the question. However, unless the lawyer invites the objecting attorney to explain or clarify the objection, nothing more should be said. Unfortunately, some lawyers abuse the right to object by not only explaining and clarifying without been asked to do so, they also suggest the response the witness should make. This obstructs the fact gathering process and is prohibited by various authorities.

It is difficult to keep disagreeable attorneys from staying in bounds during depositions. One solution is to warn the attorney and if the abuse continues, try to get the presiding judge on the telephone to issue a ruling on the spot. Sanctions can be sought after the deposition, but the cat is out of the bag by then.
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pinoccio.jpgPrior to 1990, Florida employers had a common law qualified privilege to discuss current and former employees with prospective employers. The leading case was Nadar v. Galbreath, 462 So.2d 803 (Fla. 1984). For an employee to overcome the privilege, and thus hold the employer liable for defamation or intentional interference with a business relationship, proof was required that the false information was made with express malice – not to be confused with “actual malice,” the standard applicable to claims against public officials or public figures – described as “where the primary motive for the statement is shown to be an intention to injure the plaintiff.” Nadar, 462 @ 806 (citing Loeb v. Geronemus, 66 So.2d 241 (Fla. 1953). This common law standard needed to be shown by a preponderance of the evidence.

Florida Statute 768.095 appears to have superseded the common law. (The case law handed down since the enactment of 768.095 is somewhat confusing on the interplay, if any, between the statute and the common law.)
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moses.jpgThe Republican Establishment has chosen Willard Mitt Romney to lead its people to The Promised Land. It points to his success in making large sums of money as the primary qualifying factor for the selection.

G-d chose Moses to lead the Jews to their Promised Land. Interestingly, what persuaded G-d to select Moses was his compassion more than his accomplishments.

The Book of Exodus tells us that Moses was rescued from the Nile River as an infant and raised by the Pharoah’s daughter. One day he witnessed an Egyptian beating a Jew. He killed the Egyptian. Later he intervened in a fight between two Jews, the circumstances of which forced him to flee Egypt. While in the desert, he saved the seven daughters of Jethro from evil shepherds.

These acts showed perseverance, courage and fortitude. This was not enough for G-d.
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