RESOLVING MEDICAID LIENS IN GEORGIA
November 28th, 2009 by Stephanie F. Brown
An earlier blog talked about the Medicaid lien that the Georgia Department of Community Health will hold on any personal injury settlement where Medicaid benefits have been paid on behalf of the plaintiff. Resolving a Medicaid lien must be done at the settlement of any personal injury claim or lawsuit. When a lawsuit if filed on behalf of a Medicaid beneficiary in Georgia or when a claim is asserted, the attorney filing the lawsuit or asserting the claim has a statutory duty to report the claim to the Georgia Department of Community Health.
The Georgia Department of Community Health can assert their reimbursement claim through their right of subrogation, through a lien against any personal injury recovery obtained by the beneficiary, or through an assignment of the beneficiary’s claim against the responsible third party. The assignment arises automatically upon payment of any benefits to the beneficiary.
The Georgia Department of Community Health has a Subrogation Unit that enforces the Department’s recovery rights. Upon settlement of any personal injury claim where the plaintiff has received Medicaid benefits, the attorney representing the plaintiff must notify the Subrogation Unit in order to resolve any outstanding reimbursement claims.
Our firm can assist you in resolving any outstanding Medicaid reimbursement claims at the settlement of a personal injury action.
Posted in Injuries to Elderly and Disabled Adults, Nursing Home Abuse and Neglect, Personal Injuries | No Comments »
SURVIVING SPOUSE AUTHORIZED TO OBTAIN MEDICAL RECORDS TO PURSUE WRONGFUL DEATH CLAIM
November 9th, 2009 by Stephanie F. Brown
The Georgia Supreme Court has ruled that a surviving spouse acting on behalf of a deceased spouse or his estate in bringing a wrongful death action is entitled to access to the deceased spouse’s protected health information under federal HIPAA laws. The case, Alvista Healthcare Center, Inc. v. Miller, was a wrongful death action brought by a spouse against a nursing home for her husband’s wrongful death. (Georgia Supreme Court S09G1005 Nov. 2, 2009).
After her husband died, the wife requested copies of her husband’s medical records for purposes of investigating the wrongful death action. The nursing home denied the request on the grounds that the records could only be released to the estate’s permanent executor or administrator under federal HIPAA laws.
The Supreme Court relied on a Georgia statute, Code Section 31-33-2, to hold that a surviving spouse to act on behalf of the deceased spouse or his estate in order to obtain copies of protected medical records. This opinion lifts a heavy burden off of a surviving spouse who can now sign a HIPAA authorization without first being appointed as the administrator or executor of the estate.
Posted in Injuries to Elderly and Disabled Adults, Nursing Home Abuse and Neglect, Personal Injuries, Wrongful Death and Catastrophic Injury | 1 Comment »
GEORGIA INSURANCE COMMISSIONER FINES UNITED HEALTHCARE FOR DELAYS IN PAYING CLAIMS
November 2nd, 2009 by Stephanie F. Brown
Georgia’s insurance commissioner, John Oxendine, has fined United Healthcare Insurance Company $750,000.00 for its delay in paying health insurance claims. The fine was on approximately $20,000,000 in health care claims. Under Georgia law, health insurance companies are required to pay claims within 15 days of receiving a claim or notify the health care provider or the insured of the reason why a claim has not been paid.
Consumers who believe that their health insurance carrier delays payment of health care claims should notify Georgia’ insurance commissioner of these concerns. For information on submitting a complaint, see http://www.inscomm.state.ga.us/ConsumerService/Complaint.aspx.
Posted in Personal Injuries | No Comments »
GEORGIA HOSPITALS RANK LOW IN MEDICARE RATINGS
October 4th, 2009 by Stephanie F. Brown
In recent rankings issued by Medicare, Georgia’s hospitals ranked low in hospital performance statistics. Overall, Georgia hospitals were rated as “weak” in terms of quality of care.
In several specific areas, Georgia hospitals were rated as worse than the national average. For example in the treatment of patients with pneumonia, Medicare rates the 30 day death rate that hospitals experience. In this category, several metro-Atlanta hospitals fared poorly, including Grady Memorial Hospital, Emory Eastside Medical Center, and Rockdale Medical Center. Only Piedmont Hospital scored better than the national average.
In evaluating the quality of patient care, patients can view information available as Medicare’s website, www.hospitalcompare.hhs.gov. In addition, patients can research facilities at www.qualitycheck.org, www.gahospitalqualitycheck.org, and www.georgiahealthinfo.gov/cms.
Posted in Medical Malpractice | No Comments »
AUTO ACCIDENT VICTIMS IN GEORGIA RECEIVE LONGER STATUTE OF LIMITIATIONS IN SUPREME COURT RULING
September 29th, 2009 by Stephanie F. Brown
In yet another ruling in favor of personal injury victims, the Georgia Supreme Court held in Beneke v. Parker that the statute of limitations is tolled in auto accident cases where a traffic charge is pending against the responsible driver. The time for filing a lawsuit after an auto accident is usually two years from the date of the accident. This time has been extended, however, by the Supreme Court’s decision.
The Court relied on a Georgia statute that says that civil lawsuits filed by a victim of a crime are tolled from the date of the crime until the prosecution of the crime becomes final or is terminated, as long as that time does not exceed six years. Based upon this statute, the Court held that in auto accident cases where the responsible driver has received a misdemeanor traffic citation, such a charge is a crime and therefore, tolls the statute of limitations.
If you have been involved in an automobile accident, our Atlanta personal injury attorneys can evaluate your case and give you advice on how to proceed.
Posted in Auto and Truck Accidents, Personal Injuries, Wrongful Death and Catastrophic Injury | 1 Comment »
REGULATION OF DAY CARE CENTERS IN GEORGIA
September 21st, 2009 by Stephanie F. Brown
Day care centers in Georgia are regulated by the Georgia Department of Early Care and Learning. This agency licenses and monitors day care centers as well as family day care homes. Georgia recognizes three types of child care programs: family day care homes, group day care homes, and child care learning centers. All three types must be licensed by the state of Georgia.
The Georgia Department of Early Care and Learning monitors day care centers through inspection procedures which include annual inspections of facilities as well as inspections following complaints that have been made about a facility. Annual inspection reports are available on line at the Department’s website at http://decal.ga.gov/Default.aspx.
In selecting a day care center for your child, carefully research the facility on the Department’s website in addition to visiting the facility. If your child has been injured while in the care of a day care facility in Georgia, consult with our Atlanta personal injury lawyers for advice on how to proceed.
Posted in Injuries to Children, Personal Injuries | No Comments »
GEORGIA SUPREME COURT HEARS ARGUMENTS ON TORT REFORM STATUTE LIMITING DAMAGES IN MEDICAL MALPRACTICE CASES
September 15th, 2009 by Stephanie F. Brown
This blog site previously discussed Georgia’s Tort Reform Act of 2005 which, among other restrictions, limited recovery for injured patients in medical malpractice actions to $350,000.00 for pain and suffering. That provision of the Tort Reform Act of 2005 was considered in oral arguments before the Georgia Supreme Court today.
The case before the Court was a medical malpractice action that was filed after the Tort Reform Act was passed. The plaintiff won a verdict in excess of the $350,000 cap for her pain and suffering. The trial court judge declared the cap unconstitutional and the defendant doctor appealed that ruling.
The trial judge ruled that the medical malpractice cap was unconstitutional because it violated the right to a trial by jury, the separation of powers doctrine and equal protection of the laws. The injured plaintiff urged the Georgia Supreme Court to uphold the trial court’s ruling and overthrow the tort reform statute that placed caps on medical malpractice awards.
We will watch for the outcome of this case and hope that the Georgia Supreme Court will continue this year’s trend of upholding the rights of injured victims in Georgia.
Posted in Medical Malpractice, Personal Injuries | No Comments »
GEORGIA SUPREME COURT TO CONSIDER CONSTITUTIONALITY OF STATUTE PROVIDING IMMUNITY TO EMERGENCY ROOM DOCTORS
September 4th, 2009 by Stephanie F. Brown
The Georgia legislature passed a tort reform package in 2005 that provided immunity to emergency room doctors from lawsuits unless the injured patient can prove by clear and convincing evidence that the doctor was grossly negligent. This burden of proof and the lax standard of care for the doctor present an almost insurmountable hurdle for any patient injured by the negligence of an emergency room doctor.
Two cases are now before the Georgia Supreme Court challenging the constitutionality of this law. This statute is concerning for a number of reasons. The statute creates a separate group of patients who can be subjected to a lower standard of care than other patients. The emergency room patient cannot hold the doctor responsible so long as the doctor exercised only “slight care” as opposed to the usual requirement that a doctor must exercise the degree of care that doctors would ordinarily exercise under the same or similar circumstances. In the emergency room, however, doctors must only exercise the degree of care that a doctor, however inattentive he may be, would exercise under similar circumstances.
Overturning this statute will return the law to its prior status-requiring emergency room doctors to exercise the degree of care that emergency room doctors in the same or similar circumstances would exercise. In addition, the injured patient would have the traditional preponderance of the evidence burden of proof.
Posted in Medical Malpractice, Personal Injuries | No Comments »
WHAT DAMAGES CAN YOU RECOVER IN GEORGIA FOR YOUR PERSONAL INJURY?
August 24th, 2009 by Stephanie F. Brown
In a lawsuit filed in Georgia for personal injury, you can recover three kinds of damages: economic damages, non-economic damages and punitive damages. Economic damages include your past and future medical expenses incurred as a result of the injury. Also, if you lost time from work or will be unable to work in the future because of your injury, you can recover past and future lost income.
Non-economic damages compensate you for your pain and suffering as a result of the injury. Pain and suffering includes mental suffering as well as physical suffering and includes things like anxiety, shock and worry and the loss of capacity to work.
Punitive damages are only awarded under certain circumstances-where the evidence establishes that the wrongdoer’s conduct showed willful misconduct, fraud, wantonness, oppression or that entire want to care that would raise the presumption of conscious indifference to the consequences of the conduct.
Posted in Personal Injuries | No Comments »
PROVING YOUR CASE IN GEORGIA
August 14th, 2009 by Stephanie F. Brown
In a personal injury lawsuit in Georgia, the injured person is required to prove his or her case by a “preponderance of the evidence.” This means the greater weight of the evidence or that something is more likely true than not true. The injured person does not have to establish his case beyond a reasonable doubt. The reasonable doubt burden of proof applies in criminal cases and does not apply in a civil lawsuit for personal injuries.
In proving your case, you will have to show that the responsible party owed you a duty, breached that duty and caused your injury and that you were damaged as a result. All of these elements: duty, breach, causation and damages, must be proven by a preponderance of the evidence.
If you have been injured, contact our Atlanta personal injury law firm for advice on how to proceed. Often potential clients wait to contact us until a good bit of time has elapsed. That time lapse, however, can harm your case. Getting legal advice early will help you in proving your case and recovering for your injury.