Federal Attorneys

It took Bob Sumoski three years, but he finally got his Medicare HMO to pay for the latex gloves he needs for personal hygiene. Sumoski, a paraplegic who lives in Lancaster, Calif., did it though a special appeals program intended to help Medicare patients who feel they’re not getting proper care from their HMOs. Unfortunately, many of the 5.5 million patients who rely on Medicare HMOs will find the process complicated and time-consuming. ”It can get very frustrating,” says Sumoski, 58.

I, too, have had experience battling the system–not for myself but for my late father, Herbert. Our dispute began when his HMO refused to pay for home health care beginning in August, 1996. Two years after his death, the case is unresolved. But I’ve learned how consumers can make the system work better for them.

UNENFORCED RULES. First, be aggressive. ”People don’t know they have appeal rights, but it’s their responsibility to know,” says Diane Archer, director of the Medicare Rights Center (212 869-3850), which serves patients in New York City. Medicare has created a three-step process for most cases (table)–an internal HMO review, an appeal to an outside Medicare contractor, and a hearing before an administrative-law judge. HMOs are supposed to review emergency cases within 72 hours and resolve other disputes within 60 days. But federal Medicare officials who govern the insurers don’t know how many cases are appealed within HMOs, how they are handled, or how long the reviews take. Patients who miss filing dates can lose appeal rights, but no HMO has ever been sanctioned for missing a deadline. Medicare will propose new rules in a few weeks to speed the process for non-emergency cases, but it has made little effort to enforce rules that now apply. That leaves patients on their own. Still, there are ways to improve your chance of a successful appeal.

If an HMO denies care or refuses to pay in full, it’s supposed to notify a patient in writing and explain the review process. If you don’t get a written notice, demand one. Then, get help. Navigating the HMO appeal maze is too much for many patients, especially those who are sick and frail. You can hire a lawyer who understands arcane Medicare rules, or contact a local Medicare rights group, which may have legal aides or experienced volunteers who can help. Call your local council on aging or Medicare’s Hotline at (800) 638-6833 to get the number of a nearby organization.

More : businessweek.com

Followers of Iraq’s most revered cleric are circulating a petition condemning the country’s interim constitution — the blueprint for the fast-approaching handoff of power to an Iraqi government.

The petition, which is giving many Iraqis their first news of the interim constitution, is worded to play to many Iraqis’ deepest fears. It describes the law as “a tragedy” that paves the way for the United States to dominate Iraq’s future, encourages immoral behavior, and opens the door for Jews to take power.

The petition is being passed around Baghdad neighborhoods and colleges by men who say they will deliver the signatures to Grand Ayatollah Ali al-Sistani, a spiritual leader to millions of Shi’ite Muslims. Some Baghdad residents say they signed the petition for fear that they would otherwise be branded as collaborators.

“The law was made with the help of the occupying authorities, and we can see its stamp very clearly,” says the two-page flier that accompanies the petition. “God only knows where it will lead us.”

The petition is the latest challenge to the embattled plan for the transition to Iraqi sovereignty, which US officials have revised numerous times since November because of Sistani’s objections.

More : commondreams.org

In the first case completed under a voter-initiated rollback of automobile insurance rates, California’s Insurance Commissioner today ordered the 20th Century Insurance Company to pay more than $100 million in refunds to 650,000 policyholders.

But company officials, contending that their rates were among the industry’s lowest, said they planned to appeal the refund order in California state courts. Insurers had fought the voter initiative, known as Proposition 103, before it was passed in November 1988, and most have continued to oppose its provisions in court. The measure, together with court rulings, requires rate rollbacks based on the profitability of the insurers.

The state Insurance Commissioner, John Garamendi, had adopted rollback regulations implementing the proposition in October 1991. The hearings on 20th Century, before an administrative law judge, Elizabeth Laporte, were the first to be completed under those regulations. Sets a Precedent

As the first rollback case to go through an administrative law hearing, the action on 20th Century sets a precedent for other insurance companies.

More : query.nytimes.com

Discussing the union’s unfair-labor- practice charge against the baseball owners that is pending before the National Labor Relations Board, an owner recently expressed no concern for what the board might do.

“We know the N.L.R.B. will always rule in favor of a union,” the owner said. “Our lawyers let us know the chances of management winning in front of this board are slim. But rulings don’t mean beans. It’s what happens in court that counts.”

The owner, in a sense, was correct. Whatever the board does — issue a complaint, seek an injunction — the action ultimately will be determined in court.

If the board seeks an injunction, a United States District Court judge has to decide whether or not to grant it. If a complaint is issued, an administrative law judge finds merit in it after a hearing and the five-member labor board upholds the decision, a United States Court of Appeals panel could be asked to review the case.

If the courts, then, are the battleground where the owners will choose to make their stand, it would be worth knowing how the N.L.R.B. has fared in court. The owners, on second thought, might not want to know.

More : query.nytimes.com

Several associates of former Mayor Rudolph W. Giuliani took the rare step of publicly criticizing the Bloomberg administration yesterday as they reacted with anger and confusion to the city’s handling of a workers’ compensation claim filed by a former deputy mayor who served Mr. Giuliani for eight years.

New details emerged yesterday about the claim filed by the former deputy mayor, Rudy Washington, 51, who has asserted that he has severe respiratory ailments, requiring prescription drugs and emergency hospitalizations, as a result of his work near ground zero on Sept. 11, 2001, and afterward.

On March 14, a state administrative law judge ruled that Mr. Washington was entitled to health-care benefits because he had been injured on the job. On April 10, lawyers for the city appealed, arguing that Mr. Washington was not entitled to the benefits because he did not file his claim within two years of the injury.

Mayor Michael R. Bloomberg said yesterday that he believed the appeal was based on “a technicality” and that the lawyers had erred. “A lawyer was probably reading the law too closely and shouldn’t have done that,” he said.

Yesterday afternoon, city lawyers requested a meeting with Mr. Washington’s lawyer “to discuss the claim” and present any supporting documentation, so that we may move forward,” the Law Department said in a statement. It stopped short of saying that it would drop the appeal.

More : nytimes.com

While Law Professor Regina Austin made history by becoming the first African American to be named to an endowed chair at the Law School, the appointment of Law Associate Dean Michael Fitts was almost expected.

“I am a third generation [endowed chair recipient],” explained Fitts, whose father and grandfather were named to endowed chairs in the Medical and Wharton schools, respectively.

Fitts, who has lived in West Philadelphia most of his life, called the Robert G. Fuller, Jr. Chair “a great honor,” noting that Fuller, a 1964 Law graduate, is “loyalÉ and actively involved.”

Law School Dean Colin Diver, who made the appointments, honored Fitts because of his exceptional skills as a teacher and lawyer — skills the school were “especially interested in recognizing and promoting when [it] established the chair.”

Diver called Fitts “one of the leading American law scholars.”

“He is an invaluable asset to me as dean,” he added.

A Yale Law School graduate, Fitts specializes in separation of powers, the presidency and administrative law.

As associate dean, Fitts is currently striving to create “programs to connect with Law and the rest of the [University] community” and making progress facilitating interdisciplinary degrees more feasible.

More : media.www.dailypennsylvanian.com

A federal administrative law judge rejected claims by California for nearly $9 billion in refunds for what officials said was price gouging during the energy crisis of 2000-2001 and instead said the state owed $1.2 billion to cover unpaid electricity bills.

The judge, Bruce L. Birchman of the Federal Energy Regulatory Commission, ruled that energy companies overcharged California about $1.8 billion during the crisis but said the state had an unpaid balance of $3 billion and thus owed $1.2 billion.

The ruling, which will be reviewed by the three-member commission, was cheered by the industry but attacked by California officials, who accused the commission of ”rigging” the rules that guided the judge’s findings.

But the decision today is far from the final word on the matter, as commission officials are examining evidence on several fronts that natural gas and electricity prices were artificially inflated through manipulative trading tactics and the withholding of energy supplies.

State officials contend that widespread price gouging caused blackouts and the bankruptcy of the state’s largest electric utility.

More : query.nytimes.com

A customer who sued a dry cleaner for $54 million over a missing pair of pants has asked the judge who threw out the widely mocked case to reconsider, saying she committed a “fundamental legal error.”

Roy L. Pearson, a local administrative law judge, argued Wednesday that District of Columbia Superior Court Judge Judith Bartnoff failed to address his legal claims. Bartnoff had ruled that the business owners did not violate the city’s consumer protection law by failing to live up to his expectations of a “Satisfaction Guaranteed” sign once displayed in the store.

“The court effectively substituted a guarantee of satisfaction with ‘reasonable’ limits and preconditions for the unconditional and unambiguous guarantee of satisfaction the defendant-merchant chose to advertise for seven years,” Pearson wrote. “That was a fundamental legal error.”

If Bartnoff rejects Pearson’s motion, he could take the matter to the District of Columbia Court of Appeals.

More : guardian.co.uk

An administrative law judge today barred Meyer Blinder from the securities business for life, although Mr. Blinder, the head of the nation’s best-known penny stock brokerage, can appeal the ban in two years.

An administrative law judge today barred Meyer Blinder from the securities business for life, although Mr. Blinder, the head of the nation’s best-known penny stock brokerage, can appeal the ban in two years.

Brenda P. Murray, the adminstrative law judge, also barred Mr. Blinder’s firm, Blinder, Robinson & Company, from participating in any stock underwriting for two years and suspended it from the broker-dealer business for 45 days.

Today’s decision is the latest step in a decade-old court battle between the Securities and Exchange Commission and Mr. Blinder that has been waged all the way to the Supreme Court.

Fraud Charges and Findings

More : query.nytimes.com

In Florida, real estate organizations are coming to legal blows over the interpretation of the state’s new “non-disclosure” law. Are licensees and consumers caught in the middle?

In the most unfriendly blow to consumer-friendly representation yet on record, the Florida legislature passed a new law which the Florida Association of REALTORS® had initiated in an attempt to completely eliminate agency disclosure. Recognizing the regressive ramifications and adverse affects on both licensees and consumers, the Department of Business and Professional Regulation introduced amendments which postponed disclosure requirements from the time of first contact to the time of listing or showing properties. That compromise amounted to what has been described as a seduction period. FAR readily accepted the compromise and successfully lobbied to have the bill unanimously passed in the legislature.

FAR is now backpedaling, saying that the new law does not require disclosure to parties whom licensees do not intend to represent. However, on the heels of the new law taking effect Oct.1, 1999, the DBPR issued its own interpretation that consumers should all be given a form that addresses representation. The DBPR directed the Division of Real Estate and Attorney General’s office to announce that, since the Notice of Nonrepresentation no longer exists, real estate licensees must instead give a Transaction Broker or Single Agent Notice to all consumers. Chief prosecutor of the Division of Real Estate Daniel Villazon announced that failure to follow the directive will result in a $100 fine.

Objections have been raised by licensees who fear that handing out the new notices will only cause confusion among consumers who will be non-represented. The DBPR responded by suggesting that licensees simply cross off language that does not apply or prepare their own disclosures, including the “important notice” spelled out in statute. Meanwhile, DBPR is working on a new form which would eliminate the need to deface the Single Agent or Transaction Broker Notices provided in the revised statute.

More : realtytimes.com

Kaiser Foundation Health Plan Inc. began its appeal yesterday of a $1.1 million fine — the largest ever issued by the state against an HMO — by questioning the state’s authority to impose the fine.

The Department of Managed Health Care, the state agency that regulates health maintenance organizations, fined Kaiser last year for systemic problems with its emergency care system based on the case of a 74-year-old San Leandro woman, Margaret Utterback, who died in 1996 from a ruptured aneurysm. To bolster the case, the state has since added two patients who died of the same condition.

Kaiser attorney Steven Madison, in his opening statements before Administrative Law Judge Michael C. Cohn in the state Office of Administrative Law in Oakland, didn’t dispute the facts surrounding how the patients died.

But, he argued, those were medical decisions — not those of the health plan. According to Madison, the state agency only has the authority to regulate the health plan — the entity that sets up the doctor-hospital networks and has various contracts in place to provide care.

More : sfgate.com

Hundreds of Harvard Law School (HLS) students have signed a petition urging the school to hire professors who specialize in environmental law, an area that many say is ignored at Harvard.

HLS second-year Christopher T. Giovinazzo, who organized the petition, presented copies to University President Lawrence H. Summers and the entire Law School faculty yesterday.

He also presented the document, which has 350 student signatures, to incoming Dean of the Law School Elena Kagan.

Kagan told a meeting of law school student leaders yesterday that hiring faculty who specialize in environmental law is a priority, according to Giovinazzo.

Kagan could not be reached for comment.

The petition claims that “opportunities in environmental law at Harvard remain clearly sub-standard,” and that HLS has “fewer environmental classes than law schools half our size.”

There are no professors at HLS whose primary focus is environmental law, and the school offered only five classes in the field this year.

More : thecrimson.com

The consumer is also reimbursed for other expenses including sales taxes, registration and licensing fees, towing charges, rental expenses and finance charges that have been paid.

Before a complaint can be filed, Mr. Wigder said, the consumer must prove that the manufacturer and dealer had three opportunities to correct any single defect or that the vehicle was out of service for 20 days or more as the result of one or more defects.

The consumer must also prove that he has mailed to the manufacturer by certified mail a “Lemon Law letter” giving the manufacturer itself one final chance to repair the defect within 10 days. That letter is typically mailed after the second unsuccessful repair attempt, or after the vehicle has been out of service for repairs for 20 days.

After that letter is sent, the consumer then files a formal complaint with the Lemon Law Unit and pays a $50 filing fee. The unit then schedules the matter for a hearing before an administrative law judge within 20 days.

More : query.nytimes.com

A Federal administrative law judge ruled today that stiff landing fees aimed at keeping smaller aircraft out of Boston’s Logan International Airport violated Federal aviation law because they were discriminatory and unfair.

A Federal administrative law judge ruled today that stiff landing fees aimed at keeping smaller aircraft out of Boston’s Logan International Airport violated Federal aviation law because they were discriminatory and unfair.

A final decision on how to deal with the fee structure imposed last summer by the Massachusetts Port Authority rests with the Federal Department of Transportation. The department announced that it would decide by Dec. 17 whether to uphold the recommendations of the administrative law judge, Burton S. Kolko.

The case has been seen within the aviation industry as a test over how much power the Federal Government intends to allow local officials and airport operators in dealing with air traffic congestion.

More : query.nytimes.com

Federal regulators said today that Neil Bush could face a lifetime prohibition against serving on the boards of federally insured banks and savings and loan institutions as a result of next week’s public hearing in Denver.

Federal regulators said today that Neil Bush could face a lifetime prohibition against serving on the boards of federally insured banks and savings and loan institutions as a result of next week’s public hearing in Denver.

Mr. Bush, the President’s son, is charged by the Office of Thrift Supervision with conflicts of interest involving two business partners who were big borrowers and preferred stockholders of the Silverado Banking, Savings and Loan Association of Denver. Mr. Bush was a Silverado director for three years, ending in August 1988.

Federal regulators have asked for a cease-and-desist order against Mr. Bush, which would require that he avoid any future conflicts of interest similar to those they have found objectionable. But Harris Weinstein, chief counsel of the thrift office, told reporters that ”it could lead to a prohibition” against any future service in the savings industry if the evidence prompts the agency’s director and the administrative law judge in the case to recommend it.

More : query.nytimes.com

Joseph Jett, the bond trader accused of creating $339 million in false trades at Kidder, Peabody & Company, won a partial vindication yesterday as an arbitration panel rejected Kidder’s accusation that Mr. Jett had engaged in ”fraud, breach of duty and unjust enrichment.”

”For two and a half years, the Kidder publicity machine classified Joseph Jett as a rogue trader, a crook, a fraud and a thief and now a securities industry panel of arbitrators looks at all of the proof and has rejected all of Kidder’s claims,” said Kenneth Warner, Mr. Jett’s lawyer. Kidder contends that Mr. Jett created false trades to increase his compensation and to hide trading losses.

Though the panel ruled in Mr. Jett’s favor, that decision does not clear him entirely. The Securities and Exchange Commission has brought civil proceedings against Mr. Jett, accusing him of fraud. A ruling by an administrative law judge is due early next year. Securities lawyers said the arbitration panel’s ruling might not be much of a precedent for the S.E.C.’s decision.

The panel, of the National Association of Securities Dealers, awarded Mr. Jett the rights to the $5 million in his brokerage account, which Kidder froze after the supposedly false trades were discovered in 1994. It gave him immediate access to $1 million in that account, with the disposition of the remainder subject to a hearing in January as to whether Kidder will have to pay Mr. Jett’s attorney’s fees.

More : query.nytimes.com

A large Chicago bank has agreed to pay $14 million in back pay to women and minority employees as part of a record settlement of Federal charges of sexual and racial discrimination.

A large Chicago bank has agreed to pay $14 million in back pay to women and minority employees as part of a record settlement of Federal charges of sexual and racial discrimination.

But in announcing the settlement today, the Harris Trust and Savings Bank continued to deny the Government’s allegation that the employees had faced discrimination.

The Labor Department, which brought the charges, said the settlement was the largest amount of back pay ever obtained in a Federal discrimination case.

It is also the most money recovered under a 1965 executive order that bars companies doing business with the Federal Government from discriminating in hiring and promotion, the department said.

More : query.nytimes.com

Colin Diver will continue to teach and research full time at the Penn Law School.

Colin Diver felt his time as dean of the Law School had simply come to an appropriate end.

After nearly a decade at the school’s helm, the administrative-law and public-policy scholar said yesterday that he would step down from his post at the end of the current academic year, which expires June 30, 1999. He intends to stay at Penn to teach and research at the Law School. The process of finding a replacement will begin soon, University officials said.

During his tenure, Diver, 54, has increased the faculty size by one-third, expanded the school’s facilities and academic support services and raised more than $100 million for the school’s activities and endowment.

“The decision was made more at an emotional level than a rational level, as these decisions often are,” he said. “In the end, it felt like I was coming to the end of a cycle.”

He arrived at the University in 1989 after being lured away from the same position at the Boston University School of Law.

In his letter of resignation, Diver wrote that with the approaching 150th anniversary of the school’s founding and the 10th anniversary of his own appointment, “a new cycle will begin” and “new challenges will call forth new energy and new ideas.”

More : media.www.dailypennsylvanian.com

New Jersey’s Tiger Lady lost another round yesterday in her effort to renew her license to keep and exhibit the big cats on her property.

An administrative law judge upheld a decision by the New Jersey Division of Fish, Game and Wildlife not to renew the license of the woman, Joan Byron-Marasek, to operate the Tigers Only Preservation Society, in Jackson Township.

Finding that the compound in which 26 adult and baby tigers live is ”unsanitary and rat-infested” and that Ms. Byron-Marasek failed to keep adequate records or cooperate with state inspectors, the judge, John R. Tassini, recommended it close.

He gave Ms. Byron-Marasek ”a reasonable period of time” to move the tigers to properly licensed compounds elsewhere.

Under state law, the commissioner of the State Department of Environmental Conservation has 45 days to accept, modify or reject the administrative law judge’s decision. If he accepts it, Ms. Byron-Marasek could appeal the ruling to the Appellate Division of the state court system.

Neither Ms. Byron-Marasek nor her lawyer, Valter Must, could be reached for comment on the ruling or on any plans to appeal.

More : query.nytimes.com

Situated in the Capital, the Indian Law Institute (ILI) is one of the country’s premier institutions. It was founded in 1956 by the efforts of leading jurists of India. The institute has been attracting both Indian and foreign research scholars every year.

According to the registrar of the ILI, Dalip Kumar, “The objectives of the institute are to cultivate the science of law, promote advanced studies and research in law to suit the socio-economic and other needs of the people; promote systematisation of law, encourage and conduct investigations in legal and allied fields; undertake documentation of important legal and allied materials, improve legal education, impart instructions in law; publish studies, books and periodicals.”

The institute offers post-graduate courses in Administrative Law, Corporate Law and Management, Cyber Law, Intellectual Property Rights Law, International Trade Law; Labour Law and Taxation Law. Started in 1964, the diploma programme has now shaped into a full-fledged care activity of the institute.

The corporate law diploma of the ILI is very ‘popular’. Kumar said: “The programme is recognised by the Government of India for jobs as company secretaries in companies having paid up share capital of less than Rs 2 crore.”

The institute offers programmes in cyber laws and human rights law too, and fee for both these courses is around Rs 10,500 and Rs 3,500 respectively.

The fee of other diploma courses is Rs 5,000. These fees are inclusive of admission, tuition, library, examination and identity cards. Total fee is payable at the time of admission in cash or by demand draft and once paid is not refundable.

More : timesofindia.indiatimes.com