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Archive for the category: Medicare
  • Reproductive Medicine

    According to the American Society for Reproductive Medicine In 2010, 61,000 babies were born through assisted reproductive technology; a few State higher courts have addressed what happens to the frozen embryos once a couple separates. The Illinois court has ruled on an embryo case but the ruling still allows many of the issues to remain unresolved because Justice Patrick J. Quinn wrote that the trial court judge should have sought arguments and rendered an opinion on the validity of the first and second contracts rather than ruling on the arguments about the parties’ rights to become a parent. The circumstances began in March 2010 when Karla Dunston was diagnosed with non-Hodgkin lymphoma and was told that treatment would likely leave her infertile. With her then boyfriend, Jacob Szafranski, they decided to attempt in vitro fertilization. Szafranski donated sperm samples and Dunston donated eggs on April 6, all of which were fertilized before the couple ended their relationship in May 2010. Both signed an agreement stating that, “[n]o use can be made of these embryos without the consent of both partners (if applicable).” A second agreement was drawn up several days later stating that Dunston would have sole control of the eggs and pre-embryos in case the two split up, and that Szafranski “agrees to undertake all legal, custodial, and other obligations to the [c]hild regardless of any change of circumstance between the [p]arties.” This second contract was never signed. In 2011, Szafranski tried to stop Dunston from using the pre-embryos, arguing that he had a constitutional right not to father a child against his will. Dunston argued that her ex-boyfriend was bound agreement terms because he had donated sperm, thereby performing his obligation and making her believe he was committed to the undertaking. She also argued that Szafranski had intended to sign the second contract giving her control of the pre-embryos but Szafranski disagreed with that, as well as the idea that his sperm donations made the agreement legitimate. A Cook County trial court awarded the rights to the embryos to Dunston but Szafranski appealed. A higher court sent the case back, explaining that the case focuses on prior agreements rather than the interests of either party. The case now concerns whether the pact occurred when Szafranski gave the sample or when they signed the medical consent form requiring joint consent for the use of the embryos. A New York[READ MORE…]

  • Health Care Fraud Schemes To Defraud Medicare

    Recent news agencies in the Chicago areas have reported that area physicians and health clinic owners are among defendants charged in health care fraud schemes to defraud the Medicare program and/or private health insurers of millions of dollars. The Medicare Fraud Strike Force, operating in major cities, has charged more than 85 defendants, including doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes. Medicare fraud is a frequent topic in almost every media but most people have no idea what it is or the role they can play in stemming the almost $50 billion dollars that improper payments cost taxpayers every year. Most Medicare fraud occurs when doctors, hospitals and other health care providers bill for non-existent patients, false diagnoses, unnecessary tests or services that were not provided. In addition, billing errors and improperly coded services add to the dollars that are incorrectly spent. Additionally, many of these same health care providers also violate the anti-kickback statute by offering, paying, soliciting, or receiving payments in exchange for referrals of Medicare patients. The charges most often involve medical treatments and services, as well as durable medical equipment such as home health care equipment. While Medicare provides necessary and much needed access to health care for more than 48 million Americans, The Government Accountability Office (GAO) has identified Medicare as a high-risk federal program because it is vulnerable to waste, fraud and abuse. The majority of the beneficiaries of Medicare are over age 65 or are younger people with permanent disabilities. Government officials and legislators continue to look for new methods of containing and eliminating opportunities for fraud. Decentralization of payments makes health care fraud easier to detect as officials can often see localized patterns or sequences of claims made by a particular provider that triggers additional attention by authorities. There is also a need to provide more oversight to Medicare databases to ensure that provider information is accurate and up to date in order to more easily identify trends in fraud, waste and abuse. Another program, currently being carried out by New Jersey, attempts to prevent individuals who have previously engaged in fraudulent practices from collecting Medicaid in the first place. As a consumer, you should carefully review your bills from hospitals and doctors. If a bill indicates services or tests that you neither requested nor received, ask your health care provider to explain the[READ MORE…]

  • Health Care Fraud Schemes To Defraud Medicare

    Recent news agencies in the Chicago areas have reported that area physicians and health clinic owners are among defendants charged in health care fraud schemes to defraud the Medicare program and/or private health insurers of millions of dollars. The Medicare Fraud Strike Force, operating in major cities, has charged more than 85 defendants, including doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes. Medicare fraud is a frequent topic in almost every media but most people have no idea what it is or the role they can play in stemming the almost $50 billion dollars that improper payments cost taxpayers every year. Most Medicare fraud occurs when doctors, hospitals and other health care providers bill for non-existent patients, false diagnoses, unnecessary tests or services that were not provided. In addition, billing errors and improperly coded services add to the dollars that are incorrectly spent. Additionally, many of these same health care providers also violate the anti-kickback statute by offering, paying, soliciting, or receiving payments in exchange for referrals of Medicare patients. The charges most often involve medical treatments and services, as well as durable medical equipment such as home health care equipment. While Medicare provides necessary and much needed access to health care for more than 48 million Americans, The Government Accountability Office (GAO) has identified Medicare as a high-risk federal program because it is vulnerable to waste, fraud and abuse. The majority of the beneficiaries of Medicare are over age 65 or are younger people with permanent disabilities. Government officials and legislators continue to look for new methods of containing and eliminating opportunities for fraud. Decentralization of payments makes health care fraud easier to detect as officials can often see localized patterns or sequences of claims made by a particular provider that triggers additional attention by authorities. There is also a need to provide more oversight to Medicare databases to ensure that provider information is accurate and up to date in order to more easily identify trends in fraud, waste and abuse. Another program, currently being carried out by New Jersey, attempts to prevent individuals who have previously engaged in fraudulent practices from collecting Medicaid in the first place. As a consumer, you should carefully review your bills from hospitals and doctors. If a bill indicates services or tests that you neither requested nor received, ask your health care provider to explain the[READ MORE…]

  • No-fault Divorces

    Divorce is never easy but Illinois is one of more than 20 states that allow no-fault divorces as well as fault dissolution’s on the grounds of impotency, adultery, bigamy, desertion, cruelty or a felony conviction. Couples often seek a no-fault divorce but find that they have issues when it comes to the division of property. In Illinois, property is divided between the two spouses in an equitable manner by determining the following: how long was  the couple married; what is a value of the property that each spouse claims and what are the economic circumstances of each of them. Martial property, acquired during the marriage, as well as debts acquired during the same time period, is divided between the two parties. The court also considers what property each of the spouses brought into the marriage, as well as gifts or inheritances that either person received during the marriage; usually this property remains with the spouse whose property it was initially. But, in a recent case, In re marriage of Christopher Washkowiak and Rosana Washkowiak, the Appellate Court of Illinois 3rd District ruled that the settlement of Mr. Washkowiak’s workers’ compensation suit that was placed in a Medicare set-aside account (MSA) was considered to be net proceeds, just as his initial workers’ compensation settlement was considered to be; therefore his wife was entitled to a portion of those proceeds also. MSA funds are usually reserved to pay future medical costs. Under the federal rules, Medicare pays only after the insurance company has paid and, in the case of Workers’ Compensation, Mr. Washkowiak had followed the Medicare Secondary Payer (MSP) suggested guidelines and placed a portion in a bank account restricted to paying medical bills.  While the Court found in favor of the wife on the appeal, one judge dissented claiming the funds were set aside only for the purpose of satisfying Medicare’s interest. It is important to consult with an attorney when dealing with Workers’ Compensation claims as even simply claims and settlements may have unforeseen consequences.

  • Medicare Pilot Program for Montana Asbestos Victims

    In 2009, the Environmental Protection Agency declared a public health emergency arising from the long term asbestos exposure of Libby, Montana residents. The exposure occurred due to the operation of a vermiculite mine in Libby from the 1920s to 1990. Earlier this month, the Centers for Medicare & Medicaid Services announced that people residing in and near Libby that suffered from certain medical conditions would be eligible for Medicare under the Affordable Care Act’s “Exposure to Environmental Health Hazards” provision and could thus participate in a new Medicare Pilot Program for Asbestos-Related Disease. In order to qualify for the program, applicants must: 1) qualify for Medicare under the Affordable Care Act’s “Exposure to Environmental Health Hazards” provision; 2) live in Lincoln or Flathead County, Montana; 3) have Medicare Part A (hospital insurance); and 3) have Medicare Part B (medical insurance). The program is designed to provide services that Medicare would not usually cover by offering comprehensive, coordinated health care coverage for those detrimentally affected by the asbestos exposure. As explained in this  NBC news article, the pilot program will cover the following services not normally covered by Medicare: Special home care services Special medical equipment Help with travel to get care Special counseling, for example, help quitting smoking Nutritional supplements Prescription drugs not covered by Medicare drug plans (Participants in the Pilot Program must be in a Medicare drug plan to receive this benefit). This is a very interesting development and many are carefully following the progress of this innovative pilot program. Asbestos-related illnesses are quite serious–even deadly– and can severely limit the quality of life of those affected. Programs like this one are a promising development and have the potential to positively affect the lives of those suffering from the after effects of asbestos exposure. Howard Ankin of Ankin Law Office LLC (www.ankinlaw.com) handles  workers’ compensation and personal injury cases. Mr. Ankin can be reached at (312) 346-8780 and howard@ankinlaw.com .

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    ankin law office llc

    162 West Grand Avenue
    Chicago, Illinois 60654
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    Local: 312-346-8780

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    Our firm handles workers' compensation and personal injury claims in Chicago, Berwyn, Joliet, Cicero, Waukegan, Chicago Heights, Elgin, Aurora, Oak Park, Oak Lawn, Schaumburg, Bolingbrook, Glendale Heights, Aurora, Niles, Schaumburg, Arlington Heights, Naperville, Plainfield and all of Cook, DuPage, Lake, Will, McHenry, LaSalle, Kankakee, McLean and Peoria Counties.