Monday, December 19, 2011

Med-Cal Fraud for billing device other than one used

The Second Appellate District in California affirmed a judgment of conviction for a physician who committed fraud for knowingly billing Medi-Cal for use of an expensive and approved medical device when he instead used a cheaper device that was not approved for reimbursement. 

From 2004-2006, the office of OB-GYN Eduardo Guzman billed Medi-Cal for the insertion of 176 IUDs. The billings used the precedure code designated for teh trade name "ParaGard" when in fact he used a cheaper type of IUD manufactured in Mexico.

The court found the evidence at trial was sufficient to show an intent to defraud Medi-Cal.

The case is: People v. Guzman, ___C.A.2nd; Dec. 12, 2011; B232299.

Thursday, December 1, 2011

The Conrad Murray Sentence in the Wake of California’s Prison Realignment Act of 2011

Conrad Murray – to be known forever as the man associated with the King of Pop’s untimely death. Despite being convicted by a jury of involuntary manslaughter, Dr. Murray may never see the inside of a state prison cell. He has the California Realignment Act of 2011 and the United States Supreme Court to thank for that bit of good news (Brown v. Plata was discussed in our last email blast).

Upon his conviction for a violation of California Penal Code § 192(b), Dr. Murray faced a sentence of 2, 3, or 4 years. Prior to the passage of AB 109 (the Realignment Act of 2011), Dr. Murray would have had to serve these years in state prison pursuant to Penal Code § 193. Post-AB 109 – no longer the case. Dr. Murray, sentenced to 4 years on November 29, 2011 by the Los Angeles County judge presiding over the case, will now serve his time in a local county jail, which comes with its own benefits.

California’s Prison Realignment Act of 2011, passed in order to address prison overcrowding per a mandate from the U.S. Supreme Court, dictates that non-violent felons are not required to go to state prison, and can serve their sentence in county jail. Under this act, sentences for most felonies that are non-serious, non-violent and non-registerable sex offenses, if the defendant also has no prior serious, violent, or registerable convictions, will now be served in the county jail. See Penal Code § 1170(h)(2-3). Approximately 60 other offenses, known as Exclusions, will still trigger state prison sentences. These offenses generally involve a weapon or injury or certain prior convictions.

The Realignment Act comes with many, many more revisions to California’s sentencing system, including parole, calculation of conduct credits, and multiple counts, which are too expansive to simplify and explain here, but have been well summarized by Judge J. Richard Couzens. See: http://www.courts.ca.gov/partners/documents/felony_sentencing.pdf.

In Dr. Murray’s case, he can expect to serve half of his 4-year term; that is, unless the Los Angeles County Sheriff releases him even earlier. It is well-known that LA County jails are bursting at the seams, resulting in many inmates being released after doing only 10% of their sentenced time. Thus, the actual length of time Dr. Murray will sit behind bars could range from a few months to two years. One other caveat – Los Angeles County District Attorney Steve Cooley has stated publicly that he is considering an appeal to require Dr. Murray to serve his sentence in state prison. Unless Mr. Cooley can overcome the U.S. Supreme Court’s mandate to reduce state prison overcrowding, Dr. Murray shouldn’t lose any sleep in his county jail bunk over that announcement.

Stay tuned for many more publications and public discussions with respect to the drastic changes in California’s sentencing laws.

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