Georgia Trial Lawyer Blog

Medicare covers more than 46 million Americans who are elderly or disabled and pays out nearly $500 billion annually. However, Medicare fraud costs taxpayers around $60 billion a year and has become what many have described as the most profitable crime in America.

60 Minutes ran a recent story on the issue.

Authorities admit that deceiving the government with false Medicare claims is quite easy. Typically, an offender will attain a list of Medicare patients with their names, social security numbers and birth dates. The offender will then open a phony store front that claims to be a pharmacy, clinic or medical supply store and simply bill Medicare for items and services that never existed.

Under the law, Medicare must pay the claim within 15 to 30 days. Since Medicare only has a few auditors, much of the fraud simply goes undetected. When inspectors are sent to investigate a suspicious claim, they generally do so after the checks have been delivered. By that time, the phony business has usually been abandoned and the offender has moved onto a new phony business. FBI agents say that it’s not unusual for a single fraudster to make $400,000 or more a month.

However, Medicare fraud is not limited to the common fraudster. Doctors have been convicted of Medicare fraud for billing unnecessary prescriptions and procedures. And hospitals have been accused of taking in homeless patients to fill empty beds. Government officials fear the problem will only grow worse as people create new ways to take advantage of the system.

Yet, taxpayers are empowered to stop Medicare fraud through whistleblower laws. Any person who has direct and independent knowledge of Medicare fraud may bring a civil suit on behalf of the government. This is known as a qui tam action. Under federal law, those committing the fraud are liable for each act of fraud between $5,000 and $10,000 and three times the amount of damage that the government sustained. The person who brings the suit is generally entitled to 15 to 30 percent of the amount recovered.

Our whistleblower attorneys have helped several people blow the whistle on government billing fraud and false claims. It is important to understand that Medicare fraud can occur in many different ways including billing for non-existent patients, services that were never performed, giving false information or false certification, kickbacks, upcoding schemes and lack of medical necessity. By blowing the whistle on these practices, a person can help the government put an end to the fraud and attain significant monetary damages.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

The manufacturer of the most common brand of electroshock gun, Taser International, issued a warning last week for officers to stop stunning people in the chest. The company warns that shooting someone in the chest may cause an “adverse cardiac event.”

The Atlanta Journal Constitution has the story.

The warning came in the form of a training bulletin to all law enforcement officers that carry the company’s stun guns. Instead of shooting someone in the chest, face or neck, Taser International recommends shocking a person in the back, abdomen or thigh. The warning comes after numerous law enforcement agencies have faced law suits due to the device’s ability to cause heart attacks.

Taser International’s product delivers 50,000 volts to a victim’s body for the purpose of incapacitation. Normally, such a shock will incapacitate a suspect for about five seconds without causing permanent injury. However, more than 400 people have died after being shocked with a Taser since 2001. Of those deaths, medical examiners have found that Tasers contributed to more than 30. It is unclear how many more deaths may have been caused by Tasers.

Three such deaths happened in the Gwinnett County jail after deputies shocked inmates that they say were combative. In two of those cases, the cause of death was ruled to be cardiac arrest, however, the cause of the heart attacks were not determined.

The latest warning has not deterred officers in the Atlanta area from carrying Tasers, but many police departments pledge to retrain their officers including Atlanta, Gwinnett and Clayton. Cobb County has already implemented the recommendations with its officers. Fulton County Police say they are currently reviewing the warnings, and the DeKalb County Sheriff’s Office has stated that it is aware of the recommendations.

Our personal injury attorneys have reviewed several Taser cases. While Tasers may represent a non-lethal way for officers to subdue a suspect, they are often used improperly, excessively or on persons with underlying medical conditions. As this story highlights, the resulting medical complications can lead to permanent damage and even death.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

On Friday, a Watkinsville, Georgia physician assistant, Ulys Randall Riner, pleaded guilty in Newton County to running a Ponzi scheme in which he stole more than $4.5 million from investors. Prosecutors believe that Riner stole from more than 20 Georgians, and that most of the victims were his friends.

The Atlanta Journal Constitution has the story.

Riner was arrested in 2006 for using a strategy called “factoring” in which he sold fraudulent promissory notes to investors. Specifically, Riner would use the money attained from investors to buy discounted accounts receivables on government contracts. Prosecutors allege that he told the investors that they would receive a full return. He would then sell the promissory notes through his business, Express Factors. He would take that money and pass it on to other companies, and when those companies failed, he used funds from new investors to hide the money that was lost.

Riner was indicted in 2006 on 29 counts for selling unregistered investments and was set to go to trial on October 26. However, he entered a guilty plea on October 23 in which he agreed to pay back $2 million to investors. The plea stated that he will pay $125,000 within 60 days and then $2,000 per month. Investors are set to be paid based on a percentage of what they gave Riner. That amount ranges from $2,000 to $650,000. In addition, he agreed to 17 years on probation with two years in a work-release program. The judge also let Riner plead first offender which may help him keep his medical license.

This criminal prosecution may also lead to a civil suit against Riner and other responsible parties. Our business fraud attorneys have successfully represented several clients who have fallen victim to Ponzi schemes and other unscrupulous investment practices. In our experience, the criminal justice system may punish the offender and force some restitution, but it often fails to fully compensate a victim of investment or business fraud. A good business fraud attorney will work with prosecutors, law enforcement and investigators to find every possible source of money an offender has to ensure that the victim is fully compensated for his losses in civil court.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

On Monday, the Supreme Court of Georgia made it easier for insurance customers to sue their insurance companies when the company has acted in bad faith during settlement negotiations. The Court ruled that an insurer that offers the full amount of its policy in a settlement involving multiple insurers is not automatically immunized from a bad faith claim, because an insurer must still act reasonably in regards to any conditions it attaches to the offer.

A bad faith settlement claim essentially alleges that an insurance company has not fulfilled its duties to its customer, because it wrongfully exposed the customer to a verdict at trial which goes beyond policy coverage instead of settling the case before trial.

In the case before the Court, the plaintiff, Fortner, was injured by the defendant in an auto wreck. The defendant had two insurers: the first, Grange Mutual Casualty, with a policy of $50,000 and the second with a policy of $1,000,000. Fortner offered to settle the case with Grange for $50,000 if the second insurer paid $750,000. Grange responded by offering $50,000 if Fortner would sign a full release with indemnification language and dismiss his claim against the defendant with prejudice. No settlement occurred and Fortner won $7,000,000 at trial. After trial, the defendant assigned Fortner any cause of action he may have against Grange for bad faith in failing to settle.

Fortner sued Grange for bad faith but lost in a jury trial. The instructions the jury received basically stated that an insurer only needs to offer the maximum amount of its policy limits to fulfill its duty to its customer. Fortner’s attorney, Robert B. Turner of the Savannah firm Savage, Turner, Pinson & Karsman, argued the instructions were erroneous, since they didn’t say that Grange had to act reasonably. The Supreme Court agreed. Georgia law requires that an insurance company act reasonably. When a plaintiff makes an offer with a condition beyond the control of an insurer, an insurer can avoid bad faith liability by offering the portion of the demand over which it has control. Grange would have escaped liability if it had responded to Fortner’s offer by offering its policy limits. Instead, Grange put conditions on its offer by demanding that Fortner sign a full release of his claims with indemnification language and dismiss his suit against the defendant. Accepting such an offer would have prevented the $7,000,000 verdict against the defendant. The Court ruled that the settlement conditions were within Grange’s control, and as a result, the jury should be able to decide if the settlement conditions were reasonable.

Our personal injury attorneys have successfully represented clients that were the victims of an insurance company’s bad faith refusal to settle a claim. In our experience, bad faith practices by insurance companies are unfortunately common, and customers must be ever vigilant to ensure that they are not being taken advantage of. While this case highlights and corrects some of the abuses which occurred during settlement negotiations, it is important to understand that insurance customers may also have bad faith claims against their insurance companies for other unfair practices such as refusing to pay benefits that are owed or causing payments to be unreasonably delayed.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

DeKalb County, Georgia was facing a lawsuit by a homeless man who complained that a police officer kicked him out of the county and then beat him. The county settled the case last week for $165,000.

The Atlanta Journal Constitution has the story.

The incident happened five years ago when Robert Williams was found sleeping behind a restaurant on Halloween by Officer Ronald Jones. Williams asked to be arrested in order to find warmth and food, but instead, the officer drove Williams to Rockdale County and ordered him out of the car. Williams refused and a fight ensued which left both men badly beaten. Williams was then arrested on false charges. Jones initially lied to authorities by saying that Williams had placed him in the trunk of the vehicle and drove him across county lines at gunpoint. Eventually, authorities learned the truth, and Jones was charged with kidnapping, aggravated assault and violating his oath of office.

According to some former officers, the practice of transporting a drunk or bothersome vagrant across county lines was an unofficial policy for years, since it was easier than executing an arrest. When an officer makes an arrest, he has to spend time booking the offender into jail, but because driving the offender across County lines saved time, many police supervisors simply turned a blind eye to the practice. In fact, Atlanta officials have accused DeKalb and other counties of dumping vagrants into the city for years. The practice went largely undetected until the fight between Williams and Jones occurred.

Williams and his attorney, Mike Puglise, argued that kicking Williams out of DeKalb County, beating him and filing false charges against him all violated his civil rights. DeKalb decided to settle the case before it proceeded to trial. The hope is that this case will shed light on the widespread problem and cause police supervisors to crack down on the practice.

Our victims’ rights attorneys have successfully represented several clients who have been abused and brutalized by police officers. Police abuse or brutality covers a wide range of actions including physical attacks, verbal threats, excessive use of force, false arrest, sexual abuse and intimidation. As seen in this case, some unofficial police policies or customs are often kept from public view. A good victims’ rights attorney will expose these practices by filing suit against the officer and department under various state and federal laws which are designed to help the victims of police abuse. Doing so will ensure that the illegal practices stop and that the victim receives the maximum amount of monetary damages allowed by law.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.

The Georgia Supreme Court heard arguments this week about whether to uphold a Georgia law which requires a plaintiff to establish gross negligence in order to prove medical malpractice in emergency rooms.

The Atlanta Journal Constitution has the story.

Georgia recently passed a wave of "tort reform" laws aimed at making it harder to sue doctors. One such law raised the level of culpability that an injured emergency room patient must prove to hold a doctor liable from negligence to gross negligence. Gross negligence is extremely difficult to prove. It has been described as being the conscious and voluntary disregard of the need to use reasonable care which is likely to cause foreseeable grave injury. For ordinary negligence, a plaintiff only has to prove that a doctor failed to exercise ordinary care.

On Tuesday, the Georgia Supreme Court heard both sides make their cases. Atlanta attorney Michael Terry argued that the law was made for medical corporations and insurance companies that had lobbied the state legislature for special benefits. He also argued that the law virtually eliminates all ER medical malpractice claims and gives hospitals an inequitable advantage. One of the attorneys for the other side, Wade Copeland, argued that the Legislature wanted to attract and keep the best doctors, and that this legislation accomplishes that goal.

The Court should issue its decision within a few months.

Pate & Brody is an accomplished Georgia law firm with offices in Atlanta, Macon and Madison. Our lawyers are dedicated to pursuing justice for crime victims, people who have been defrauded by deceptive business practices, or injured through the fault of others. Our lawyers have been recognized on the list of Georgia's "Super Lawyers", and included among Georgia's "Legal Elite" by Georgia Trend Magazine.