Court Round Up

California: State settles health provider billing lawsuit
LOS ANGELES (AP) — California regulators have reached a $1.2 million settlement with a hospital system accused of unfairly billing HMO patients for services not covered by insurers.

In the settlement, Prime Healthcare Services was accused of sending letters to approximately 3,700 patients, threatening to send their billings to collections agencies if they didn’t pay.

The practice called balance-billing typically happens when out-of-network care results in an unpaid balance between an insurer and a provider, and the provider bills the patient for the remainder.

Department of Managed Health Care Director Cindy Ehnes said the practice potentially puts consumers at risk of unfair, limitless billing from health care providers.

“Under an HMO product, an enrollee only is required to pay their copay,” said Ehnes, but Prime’s billing practices wrongly exposed some to “thousands of dollars in charges.”

Prime Healthcare Systems operates 13 acute care hospitals and three medical groups in San Bernardino, San Diego, Los Angeles, Orange and Shasta counties.

Prime Healthcare responded to the settlement Monday in a statement saying it “would have prevailed at trial” but settled to avoid further costs for all parties, including taxpayers.

Half the settlement will go to Prime’s charity foundation, and six clinics will split the rest evenly.

The settlement also requires Prime to audit their records for the past six years and provide refunds with interest to any patients affected by the practice.

The settlement did not require Prime to admit fault.

North Carolina: Man charged with posing as 3-star Marine officer
WILMINGTON, N.C. (AP) — A man who pleaded guilty last year to altering an identification card after he was spotted in the uniform of a three-star Marine general has been charged again with posing as a highly decorated Marine officer.

Sixty-seven-year-old Michael Hamilton of Richlands was charged last week with wearing a Marine colonel’s uniform and three counts of wearing medals, including two Navy Crosses, the second highest award for valor, according to court papers.

Hamilton was photographed wearing the uniform and medals at Jacksonville’s Vietnam Memorial during a military recognition day ceremony last month.

It is a federal offense to claim or wear military decorations and carries punishment of up to one year in prison and a fine.

Hamilton is to appear in federal court next month. He said Tuesday that he didn’t know about the charges. “I have no comment,” Hamilton said.

It’s not immediately clear if he has a lawyer.

In a biography distributed at the April ceremony, Hamilton claims he was promoted from private first class to colonel between 1961 and 1969 and was awarded 80 medals, including two Navy Crosses. An affidavit filed by investigators said the highest rank Hamilton attained was private first class.

Hamilton only served nine months and was discharged in February 1962, according to the affidavit. It said his only decoration was a rifle qualification badge.

This is not the first time Hamilton has been in charged for fraud related to military service.

Hamilton was investigated in 2007 for wearing the rank of a three-star general and altering a military identification card, according to court papers. He pleaded guilty to altering the identification card in 2009 and was sentenced to probation for six months, records show.

John Cooney, the adjutant of the Beirut Memorial Chapter of the Military Order of the Purple Heart, attended the ceremony in April and was happy to hear Hamilton had been charged again.

“It is about time something is done,” said Cooney, 69, who served two tours in Vietnam. “The disservice he did to the 58,000 dead on that wall was unforgivable.” About 58, 000 Americans died of combat related injuries in Vietnam.

Cooney said he thinks Hamilton needs psychiatric help.

“I think he believes he served in Vietnam and he rates all those medals,” Cooney said. “I don’t want to see him go to prison. I hope he gets help.”

Pennsylvania: Man gets life for shooting ex near 13-yr-old daughter

GREENSBURG, Pa. (AP) — A western Pennsylvania man has been sentenced to life in prison for shooting his ex-wife in front of the couple’s 13-year-old daughter.

Thirty-four-year-old Dean Zisek Jr., of Mount Pleasant Township, was sentenced after pleading guilty to first-degree murder on Monday.

Zisek’s attorney says he entered the plea to spare his daughter the trauma of testifying about her mother’s murder on Jan. 11, 2008.

The couple were married for six years and had been divorced for two years before Zisek shot 34-year-old Debra Zisek twice in the back and once in the head as their daughter watched.

Zisek claimed in court last year that his wife was not really dead, prompting a Westmoreland County judge to order a mental health evaluation. He was later found mentally competent.

Wisconsin: Court says payday loans can’t stop class action suits
MADISON, Wis. (AP) — A court says payday lenders cannot require customers to waive their ability to join class action lawsuits in order to receive loans.

The District 3 Court of Appeals ruled Tuesday that such requirements, typically in fine print, violate the Wisconsin Consumer Act.

The court says the ability to file or join class action lawsuits is often the only effective way to protect consumers from unfair practices.

The case involves Cottonwood Financial, which runs a payday lender called The Cash Store.

Borrower Darcie Estes received $1,400 cash at high interest rates and ended up paying back $4,500. Estes defaulted still owing $1,000.

Because of the provision in the loan agreement, Estes was prevented from filing a lawsuit alleging violations of the consumer act.

Mississippi: Suspects plead guilty in Meridian slaying case
MERIDIAN, Miss. (AP) — Five men have been sentenced to life in prison for their roles in the 2009 death of a homeless man in Meridian.

District Attorney Bilbo Mitchell tells WTOK-TV that each of the five suspects pleaded guilty to murder Monday in Lauderdale County Circuit Court.

The pleads were entered by D’Anthony Davis, Marcus Anderson, Antonio Chapman, Antshawn Davis and a 17-year-old.

The body of 52-year-old David Caraway was found in June 2009 in an alley behind a thrift store.

Authorities say Caraway had been beaten to death.