Will the employer be able to recover healthcare costs while she was out on leave if she does not return to work?

FMLA has ended and there is a possibility the doctor may deem her as unable to perform key job functions.

Nathan’s Answer

Generally, employer can recover its share of premiums if the employee doesn't come into work after the FMLA leave period is complete. This doesn't apply if employee doesn't come into work because of a reason out of their control, or because of a serious health condition of employee or their family member. There are many sub-rules that apply depending on whether the employee returns for less or more than 30 days, and other significant facts. Contact an attorney for a consultation.

In Arizona I had medicaid. My physician co pay was $1. Here I have something similar but they call it medi-cal. I go to chir

Chiropractor here w $6 copay and even have secondary insurance. Secondary insurance does not require copay. $1 copay could be waived at drs discretion. Dr here says that his $6 copay to be waived is illegal. I think that he is very much lying. I know that it is illegal to waive copays w exception of medicaid. Is it true in CA? Also can dr legally charge full office visit cost when he knows u r on medic-cal/medicaid and force patient to sort out the insurance on his own, in an emergency?? Have heard conflicting statements on that one. Tyvm.

Nathan’s Answer

It can be waived, but on a very limited basis. What used to be a professional courtesy in the past is now under the ever sharpening eye of governmental pressure to ensure accountability. Can you prove further documented financial hardship? Otherwise, the doctor is looking at possible violations of the False Claims Act, the Anti-Kickback Statute (AKS) as well as a host of insurance fraud and other laws. The reason for this is say a procedure is allowed at $100 with Medicare or Medicaid (Medi-Cal in California) and the doctor is paid $80 with the patient paying $20. (80% standard) If the $20 is waived, the doctor should be getting reimbursed at $64 (80% of $80) not $80 (80% of $100). As a result, the doctor may have overcharged the government causing a situation where the government refuses to reimburse any the doctor on any further patient procedures pending civil (and possible criminal) investigations. As far as being forced to sort out the insurance on your own, if you are seeking care from a doctor who has opted out of Medi-Cal, you may be paying full fees if there is a private contract with a waiver. If the doctor participates in Medi-Cal, your rights for reimbursement will be stronger. However, this is on a case by case basis depending on the sort of treatment you are seeking.

Factual Innocence/Bar Application

When applying for the bar (or other professional license) is it necessary to disclose an arrest that was later sealed and destroyed, via 851.8? Both the FBI and CA DOJ now indicate "no criminal record found" when a fingerprint search is performed.

On one hand, I can see erring on the side of caution and disclosing. On the other hand, what is the point of this remedy (which is the strongest type available in CA) if it can't be followed statutorily, as the arrest is no longer deemed to have ever occurred, with absolutely no caveats. Unlike PC 1000 and other types of record sealing, where you must disclose in some instances.

My concern is that the stigma of the arrest, even with a factual innocence finding, will hurt my chances and/or serve to create a paper trail when now there is none.

Nathan’s Answer

There are caveats:

851.8...

(i) (1) Any finding that an arrestee is factually innocent pursuant to subdivision (a), (b), (c), (d), or (e) shall not be admissible as evidence in any action.

(2) Notwithstanding paragraph (1), a finding that an arrestee is factually innocent pursuant to subdivisions (a) to (e), inclusive, shall be admissible as evidence at a hearing before the California Victim Compensation and Government Claims Board.

However, you are ostensibly not dealing with the CVC or GCB. Nonetheless, you are dealing with the State Bar, an administrative agency that has plenary power to inquire. In other words, should they find information related to this arrest that you did not disclose, that could be grounds for deeper inquiry.

Please find qualified counsel to help you prevent a potentially career ending/delaying maneuver.

Should I pursue sueing a hospital I like and may need in the future, for allowing an unwanted visitor in the ICU

I am very scared to pursue further surgery, because this hospital said they have an open door policy in the ICU. I was in there after 6 hour surgery. I had given notice of unavailability to my ex and her lawyer in which I stated that stress...

Nathan’s Answer

At least one state requires service of an individual in a hospital to be made by the person in charge of the institution, or a designee. I am not aware of any such thing in California. You may want to switch hospitals, to preserve your privacy while you are incapacitated.

Can medical licensing boards see sealed juvenile records? If so, what level of detail can they see?

I had 2 juvenile cases sealed in California but it just came to my attention that medical licensing boards want one to be forthright in these matters even it the record was sealed. The Orange County Superior Court says that juvenile records will be destroyed 5 years after sealing. So are these records still available to certain agencies even after they are destroyed? Also, if I apply for a license in a state that doesn't have a juvenile record sealing process, am I protected under CA law in this matter even if I'm applying out of state? How does it work at the federal level, I'm so confused : (

Nathan’s Answer

If a question explicitly tells you it is okay to exclude juvenile sealed records, it would make sense not to list those cases, but you would still want to communicate with an administrative lawyer first because there might be spillover from the facts that lead to that sealed record, to other matters in your life, that if not addressed, might be construed as lack of candor (the kiss of death).

It is imperative you read the call of the question carefully whether you are reviewing an applicant admission form, DEA registration application, credentialing and privileging (down the road) and so on. Some questions are construed broadly, some narrowly, with some applications telling you to NOT list sealed juvenile records. In order to be sure, contact an attorney who practices administrative law who can review the application with you in order to provide an opinion as to the best approach.

Are there any licensing requirements In CA for a person to send emails containing legal documents to attorneys from a pro per l

If I am asked by a friend to send some legal documents to an attorney for the party my friend is suing, do I need to be licensed in any way, my friend has no computer.

Nathan’s Answer

You need not be licensed to serve legal papers as long as you are not a party named in the lawsuit, and are over 18. You may have to become licensed and bonded if you serve over 10 documents in a one year period.

Medical Assistant Scope of practice (gray area)

Can an attending physician train a medical assistant to assist in endoscopic and colonosopic procedures. My question, specifically is, are they allowed to assist in the ACTUAL procedure. The physician will be the one using the scopes, but if somehow there needs to be a polyp (abnormal tissue) removed the MA would be the one to hook up polyp remover instrument to the scope so the doctor can guide the instrument to where it needs to be. The instrument has a close and open switch. Once at the designated spot controlled by the physician, he or she will tell the MA to use the switch at the end of the polyp tool to open and then close over the abnormal tissue. And then extract it by pulling the instrument out of the scope. Is this reasonably in the MA scope of practice?

Nathan’s Answer

You are asking a question that does not have an accurate answer unless there are more facts. Generally speaking, medical assistants are unlicensed in California. They are certificated though. You would study their supervisor to see if they carried malpractice insurance that covered medical assistant. If the medical assistant performed an invasive procedure, that may be beyond their scope.

Is it a HIPPA violation to confirm admittance in a rehab facility & to refund money to a third party without patients knowing?

My boyfriend had paid ($30k in full) for me to enter a 90 day sober living facility upon completion of the 30 day program (unoffiliated with the Sober Living facility) I had attended. I completed the 30 day & never entered the Sober Living facility. I never filled out paperwork or set foot on their property. However, my boyfriend and i agreed to leave the money there in the event I decided I wanted to attend . Unfortunately, a year later my boyfriend passed away and a year after that I decided I wanted to attend. When I called to ask about my status with the rehab, I decided to talk to a very good friend that had worked there whom, at the time, was a high-up executive. He informed me that the full amount had been refunded to my boyfriends mother. Was it legal for them to do that?

Nathan’s Answer

By your own admission, you never filled out paperwork, or set foot on their property. Thus there is no protected health information that could have been generated that could have been passed along unless you're asking about something entirely different. Also, was there a written agreement between boyfriend and entity that they would hold this money for you until and if you decided to attend? If so, you may have rights. Speak to an attorney. If not, it'll be difficult to enforce a right you cannot provide evidence was in fact established, especially after your former boyfriend passed on and cannot testify to what you are alleging is a right.

Will an expunged drug paraphernalia charge in NC affect medical licensure in CA or show up on background checks?

Charged with drug paraphernalia in 2012 in NC, an attorney helped expunge the charge. Applying to medical school but am worried that my expunged charge may negatively affect medical licensing in CA.

Nathan’s Answer

It is laudable you sought and received expungement. In California, Boards have plenary power to investigate the facts that resulted in the underlying conviction, in order to assess your suitability for licensing. Applying for medical school, rotations, residency and eventually credentialing/privileges will result you in you having to confront a host of applications that will ask about past convictions. The application for licensing as a doctor will be the most thorough, and will require a well thought out submission in addition to the application that explains the facts underlying the conviction. It is important to note that a drug matter is not taken lightly by the Medical Board, and you will need to demonstrate factors that go to your rehabilitation from whatever the Board is entitled to reasonably perceive was the problem. Assistance from an attorney in an application to medical school may be warranted, as this will set the state for the later application submissions. Becoming a doctor is an arduous path, and if you are seriously pursuing this learned profession, this should not be a set-back, as long as you have learned from a former charge.

Curious what an attorney’s advice would be to a client that had evidence a former political official lied under oath?

The impact being favorable financial incentives to friends and family at the cost of the US taxpayer.

Nathan’s Answer

It is important that if you seek litigation to address this matter, that you keep confidential this information, and address it only with attorneys. Otherwise, someone could beat you to the claim if there are any awards to be had for being the "relator" of such information. Usually these kinds of cases are not worth it unless you have extensive evidence that you have not obtained unlawfully.