Chiropractor Disciplined for Improper Billing Chiropractor Lies to Board and Loses Right to Practice Post 4930 Read the full article at https://www.linkedin.com/pulse/chiropractor-disciplined-improper-billing-barry-zalma-esq-cfe-4qjdc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. This appeal arises from an attempt by the state of Illinois to impose discipline upon plaintiff Christopher D. Leone, D.C., due to certain improper activities performed as a licensed chiropractor in the state of Illinois. In Christopher D. Leone, D.C. v. The Department Of Financial And Professional Regulation, Division Of Professional Regulation; and Cecilia Abundis, in Her Official Capacity as Acting Director of the Department of Financial and Professional Regulation, No. 4-22-0753, 2024 IL App (4th) 220753-U, Court of Appeals of Illinois, Fourth District (November 6, 2024) the Court of Appeal resolved the multiple claims of the chiropractor. BACKGROUND Leone has practiced as a chiropractor since 1999 and initially practiced in the state of Washington. The matter was resolved pursuant to an informal disposition via stipulation. Leone began practicing in Illinois in 2004, and in 2010 and a consent order was issued pursuant to which Leone admitted to the allegations and was reprimanded with a $5000 fine and a requirement that he undertake 20 hours of continuing education; 10 of those hours were to focus on Medicare billing and insurance coding and another 10 on record keeping. In 2013, the United States alleged that Leone “knowingly and fraudulently” submitted Medicare claims of less than $1000 for one-on-one physical therapy services that were not provided. Following negotiation, the parties entered into a plea agreement, pursuant to which Leone pleaded guilty to the one-count information and stipulated to a factual basis for his plea. Shortly after the Medicare fraud charge was filed against Leone, the State filed a five-count complaint alleging multiple violations of the Medical Practices Act of 1987 (Act). During the litigation, Leone applied to renew his chiropractic license. One of the questions on the application asked whether he had been convicted of any criminal offense, state or federal, since July 2011; Leone answered, “No,” failing to document the Medicare fraud conviction. Attempting to explain his federal guilty plea, Leone said that he was unable to modify the language in the plea agreement, as “the time for negotiations had run out” and the plea was a “take-it-or-leave-it” proposition. Leone read the plea agreement line by line and, although he claimed it contained false information, he signed it. ALJ Report and Recommendation The Administrative Law Judge (ALJ) issued his report and recommendation, finding that, pursuant to the guilty plea in the federal case, Leone had admitted that his patients performed physical therapy on their own without supervision. Also, Leone admitted in his plea that entries in patient records indicating that they received hands-on or one-on-one physical therapy were false. Further, the guilty plea established that Leone knowingly submitted claims to Medicare for services that he did not provide. Leone had also billed private insurers numerous times under the same code as Medicare. The conviction also established that he engaged in false billing and false entries in patient records. The ALJ recommended an indefinite suspension of Leone’s license for a minimum of two years. An expert testified that chiropractors who engaged in Medicare fraud violated several tenets of chiropractic ethics. There was a pattern of overcharging for services that were not provided, false notations in patient records to support the false charges, and the submission of false claims to insurance that went on for at least five years. Leone obtained fees by fraud, deceit, or misrepresentation, and those actions fell below the professional and ethical standards required of chiropractors in Illinois. Leone’s conduct, along with his past disciplinary history, “demonstrate[d] a pattern of behavior that [was] not acceptable.” ANALYSIS It was undisputed that Leone submitted charges under billing code 97110. Leone pled guilty to submitting a false demand for payment upon the United States. In his plea, Leone admitted to billing for services that were not actually provided to his patients as claimed, “and the instruments containing the demands for payment of public money, therefore were false when they were submitted” and “were submitted to Medicare with the knowledge that he did not perform the service charged.” The guilty plea supports the conclusion that Leone knowingly and intentionally submitted claims for reimbursement for services provided under code 97110 where the services did not meet the requirements to be paid under that code. This pattern went on for approximately five years, resulting in 1324 false claims in the amount of $93,900. The Department established a violation of the Act where Leone failed to note the federal conviction on his renewal application. Discipline A review of the initial circuit court order in this matter reveals that it merely recommended that the Department consider probation as a punishment; it did not make a ruling to that effect. There was no abuse of discretion in the discipline imposed. For the reasons stated, the Court reversed the circuit court’s judgment and affirm the Director’s decision. ZALMA OPINION Leone successfully committed fraud on the United States, the state of Illinois, and the insurance industry by falsely billing services he did not provide. He pleaded guilty to one count of Federal Health Insurance fraud and then lied to the state of Illinois when he applied to renew his license. With lawyers and retained experts he delayed the sanction for years. The Court of Appeals finally resolved the multiple disputes and applied an appropriate sanction and suspension of his license. He should consider himself lucky that he was not prosecuted criminally by the state and the US Government accepted his plea. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk

AMERICA IS A SOVEREIGN CONSTITUTIONAL REPUBLIC! NOT A DEMOCRACY! DON'T LET THEM STEAL OUR RIGHTS! 🔥 FIRST OF ALL..... No matter what form of "government" the #Corporation of the United States claims to be... IT REQUIRES YOUR CONSENT TO HAVE ANY AUTHORITY OVER YOU! What you have in the US is a CORPORATION operating under a #Fraud based system of "Maritime Admiralty Law." It's NOT a "government" at all! It's a CORPORATION And every city, state, town, and #Police Department / #Sheriff's Office is a SUBSIDIARY CORPORATION! It's basically a "Private Society" in which you have been deceived into "Consenting" to become a member, which puts you under their #Jurisdiction! YOU must claim to be a "Citizen" of their PRIVATE SOCIETY or else "Consent" expressly or IMPLIED, to being a "citizen" for them to have ANY AUTHORITY OVER YOU The "Implied Consent Doctrine" is used by them to claim you have consented, because you were silent when you should have spoken up! ANYTHING can be used to claim that you "consent" Your ACTIONS or "LACK OF ACTIONS" can be used to claim that you consent by these criminals You need to learn about "Consent" and "Implied Consent" Because YOU are a sovereign MAN or WOMAN who does not have to give ANYONE authority over you! Until this point you have done it out of ignorance! Well the time for ignorance is OVER! DO NOT CONSENT! CHALLENGE ANY STATEMENTS WHICH CLAIMS THAT YOU DO CHALLENGE ANY STATEMENTS CLAIMING THEY HAVE AUTHORITY OVER YOU! https://old.bitchute.com/video/ujczVBFOK6Mp/

https://www.youtube.com/watch?v=nNaqR1q3i7E We’ve talked about the 300,00 missing kids under Biden, Jim where are the missing 16 milion American voters? Obama got around 65 million votes both times. Kamala got around 65 million votes. Biden gets 81 million. Did Kamala really get 16 million votes less? There is alot of talk about Trump going after the 51 intelligence agents that lied about the Hunter Biden lap top and then the rest of the intelligence agencies and permanent class in DC. Thoughts on this? We are only a few days into Trumps landslide win. The Houthis say they are ready to stop fighting. Ukraine is being forced to the table, Trump ripping off band aid of tax payer money to Zelensky, Putin is now saying he will speak with Trump and Putin said Russia won’t abandon the US dollar and wants to do trade deals. What is happening. The world has changed in less than a week just by knowing a new leaders in coming into office. Thoughts please. Senator Mitch McConnell held back money from Trump endorsed house reps and senate races. In some cases putting money against them. Now he’s stepping down and Senator John Thune who wants to run the senate on behalf of Republicans is telling Trump to stay out of the senate majority leader discussion. Why and then why wouldn’t Trump want John Thune who betrayed trump over and over again? Texas Secretary of State Jane Nelson just announced a large-scale audit of the 2024 election that will include hand counting of ballots in certain races. Any fraud identified will get prosecuted. Two part question. What few things does Trump need to make good on for America to make us great again. What things does Trump need to do to set up the next republican nominee in 2028 so we can keep the white house for more time?

The philosopher Friedrich Nietzsche once said, “I’m not upset that you lied to me, I’m upset that from now on I can’t believe you.” Those words came to mind as leading scientific and media figures lost any semblance of restraint or neutrality in bemoaning the results of the presidential election. After regaining their composure, the public was told to ignore what they had just seen. It was once said that “chumps prefer a beautiful lie to an ugly truth.” The problem is that, if this election proved one thing, it is that many voters clearly felt like they are being played as chumps by the Corrupt MSM and Political Establishment. https://jonathanturley.org/2024/11/10/curtain-pull-how-trumps-election-produced-a-moment-of-unintended-honesty/

No Breach of Contract no Bad Faith Happy Veterans Day to My Fellow Veterans Some Claims Proper Some Not Read the full article at https://www.linkedin.com/pulse/happy-veterans-day-my-fellow-barry-zalma-esq-cfe-ovpec, shttps://www.linkedin.com/pulse/happy-veterans-day-my-fellow-barry-zalma-esq-cfe-ovpec and at https://zalma.com/blog plus more than 4900 posts. Post 4929 Vepo Design Corporation and its officers (collectively, “Vepo”) appealed the district court’s grant of summary judgment on their breach of contract and bad faith claims against American Economy Insurance Company (“AEIC”). Vepo’s claims relate to AEIC’s denial of coverage following a fire in a laundromat, known as the “Central Laundromat,” which Vepo was developing. In Vepo Design Corporation, et al. v. American Economy Insurance Company, No. 23-55634, United States Court of Appeals, Ninth Circuit (November 4, 2024) the issues were resolved serially. DECISIONS Business Income The Ninth Circuit reversed the district court’s grant of summary judgment in favor of AEIC on Vepo’s business income claim, which concerns income Vepo contends it would have earned operating the Central Laundromat if the fire had not occurred. AEIC argued that Vepo’s claim for lost income was too speculative given that the Central Laundromat was still under construction and Vepo had not secured additional financing to own and operate it. Construing the facts in the light most favorable to Vepo as the non-moving party the Ninth Circuit concluded that there is sufficient evidence to create a genuine dispute of material fact and that Vepo’s claim for lost business income is not unduly speculative. There is evidence that Vepo was contemplating an arrangement under which it would own and operate the Central Laundromat for a period of time before selling it, and that Vepo later engaged in similar arrangements for other laundromats. Vepo, which was experienced in the laundromat industry, also demonstrated that it had a history of securing financing for its laundromat projects and that it intended to refinance the Central Laundromat once a certificate of occupancy was received. Although Vepo had not secured refinancing for the Central Laundromat as of the time of the fire, Vepo’s Principal Owner stated in her declaration and confirmed at her deposition that it was too early to do so in the project timeline. That Vepo had yet to refinance does not render its claim too speculative as a matter of law and its losses are for a jury to decide. Extra Expense The Ninth Circuit affirmed the district court’s grant of summary judgment in favor of AEIC for the extra expenses that Vepo allegedly incurred in storing laundry equipment in a warehouse owned by Vepo’s sister company following the fire. While the policy only required the expense to be incurred, not paid, there was insufficient evidence to create a triable issue over whether the expense was incurred at all. No payment changed hands between the two entities, and there is no accounting record showing that Vepo was liable for the storage amount. When the same person signed as representative of both entities, does not create a genuine dispute of material fact. Lost Profits The Ninth Circuit concluded that the district court properly granted summary judgment on Vepo’s claim for lost profits on the prospective sale of the laundromat. Even assuming that such a loss would be covered under the policy, the claim fails because the policy limited coverage to losses that occur within one year of the incident. Vepo’s plan called for it to own and operate the Central Laundromat for at least one year after opening, which would place any hypothetical sale more than a year after the pre-opening fire. Individual Personal Property Claims The Ninth Circuit affirmed summary judgment for AEIC on the claims by the individual plaintiffs for their own personal property that was allegedly lost in the fire. As the district court correctly found, Vepo did not identify what individual property was lost or its worth. The individual plaintiffs’ claims were too unsupported to create a triable issue. Bad Faith The Ninth Circuit partially reversed the district court’s grant of summary judgment on Vepo’s bad faith claim, to the extent of the single insurance claim it allowed to go forward-the business income claim. The district court may permit any further motions practice on the bad faith claim as it deems appropriate. However, it affirmed the district court’s grant of summary judgment on the bad faith claim insofar as that claim is premised on any of the other breach of contract claims to which AEIC is entitled to judgment as a matter of law. There is never a claim for breach of the implied duty of good faith and fair dealing if there was no improper denial of coverage under the policy. ZALMA OPINION The importance of this case is the reiteration of the law that there can never be a viable tort of bad faith if there is no improper denial of a claim by breach of the insurance contract. If the one cause of action remaining was breached in bad faith and there was no genuine dispute over coverage, that cause can be brought for bad faith damages. The other decisions of the Ninth Circuit were obvious and well reasoned. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk

https://thewashingtonstandard.com/the-american-interim-magdeburg-applied-to-today/

PRESIDENT TRUMP video! THE END OF THE DEEP STATE: President Trump’s Plan to Dismantle the Deep State and Return Power to the American People. Here's my plan to dismantle the deep state and reclaim our democracy from Washington corruption once and for all, and corruption it is. First, I will immediately re-issue my 2020 Executive Order restoring the President's authority to remove rogue bureaucrats. And I will wield that power very aggressively. Second, we will clean out all of the corrupt actors in our National Security and Intelligence apparatus, and there are plenty of them. The departments and agencies that have been weaponized will be completely overhauled so that faceless bureaucrats will never again be able to target and persecute conservatives, Christians, or the left's political enemies, which they're doing now at a level that nobody can believe even possible. Third, we will totally reform FISA courts which are so corrupt that the judges seemingly do not care when they are lied to in warrant applications. So many judges have seen so many applications that they know were wrong, or at least they must have known. They do nothing about it, they're lied to. Fourth, to expose the hoaxes and abuses of power that have been tearing our country apart, we will establish a Truth and Reconciliation Commission to declassify and publish all documents on Deep State spying, censorship, and corruption, and there are plenty of them. Fifth, we will launch a major crackdown on government leakers who collude with the fake news to deliberately weave false narratives and to subvert our government and our democracy. When possible, we will press criminal charges. Sixth, we will make every Inspector General's Office independent and physically separated from the departments they oversee so they do not become the protectors of the Deep State. Seventh, I will ask Congress to establish an independent auditing system to continually monitor our intelligence agencies to ensure they are not spying on our citizens or running disinformation campaigns against the American people, or that they are not spying on someone's campaign like they spied on my campaign. Eighth, we will continue the effort launched by the Trump administration to move parts of the sprawling federal bureaucracy to new locations outside the Washington Swamp. Just as I moved the Bureau of Land Management to Colorado, as many as 100,000 government positions can be moved out. And I mean immediately out of Washington to places filled with patriots who love America, and they really do love America. Ninth, I will work to ban federal bureaucrats from taking jobs at the companies they deal with and that they regulate. So they deal with these companies and they regulate these companies and then they want to take jobs from these companies. Doesn't work that way—such a public display cannot go on and it's taking place all the time, like with Big Pharma. Finally, I will push a constitutional amendment to impose term limits on members of Congress. This is how I will shatter the deep state and restore government that is controlled by the people and for the people. Thank you very much. https://substack.com/@randpaulreview/note/c-76114041

Permanent Punishment for Conviction for One Ounce of Cocaine Improper Government Overreach and Abuse Reversed Post 4927 Read the full article at https://www.linkedin.com/pulse/permanent-punishment-conviction-one-ounce-cocaine-zalma-esq-cfe-geq1c, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. After Recovery From Cocaine Abuse Dr. Regained License to Practice CMS Refused to Allow Dr. White to Bill Medicare for Services Dr. Stephen White challenged two unfavorable decisions made by the Secretary for the United States Department of Health and Human Services (the “Secretary”) that denied and revoked his Medicare enrollment. The decisions, rendered by the Appellate Division of the Departmental Appeals Board (“Board”), were based on Dr. White’s 2010 guilty plea and deferred prosecution for possession of less than 1 gram of cocaine, which occurred in Texas in 2007. In Stephen White, M.D. v. Xavier Becerra, Secretary for the United States Department of Health and Human Services, No. 2:19-CV-00037-SAB, United States District Court, E.D. Washington (October 28, 2024) the USDC applied entered a judgment reversing the decision of the Secretary [42 U.S.C. § 405(g).] SUMMARY JUDGMENT Summary judgment is appropriate if the movant shows that there is no genuine dispute as to any material fact. BACKGROUND Dr. White is an orthopedic surgeon. In 2006 and 2007, he was arrested and charged with possession of cocaine in Texas. He was able to rehab and become clean of his problem with the drug. The Texas Medical Board revoked his license, but then monitored his recovery and compliance and allowed him to practice again. Dr. White had no violations for nine years following his arrest. He is currently practicing medicine in Washington state and is an enrolled Medicare supplier. The Administrative Law Judge (ALJ) sustained the denial, finding that CMS had a legitimate basis because Dr. White was convicted of a felony offense. The Board affirmed the ALJ’s decision and Dr. White appealed that decision to the USDC. OVERVIEW OF MEDICARE PROGRAM The Medicare program provides health insurance benefits to people sixty-five years old or older and to eligible disabled persons. Suppliers, such as Dr. White, must be enrolled in the Medicare program and be granted billing privileges to be eligible to receive payment for care and services rendered to a Medicare-eligible beneficiary. DENIALS CMS may deny a supplier’s enrollment for any reason stated in federal statutes that allow that CMS may deny a provider’s or supplier’s enrollment in the Medicare program for the some of the following reasons: Felonies such as insurance fraud and similar crimes. REVOCATIONS The ALJ found CMS had a legitimate basis because White was convicted of a felony offense that CMS determined to be detrimental to the bests interest of the Medicare program and its beneficiaries. Dr. White’s presented equitable arguments to the ALJ that 1 he self-reported and was not practicing; 2 using his self-report to deny would encourage other physicians to not self-report, 3 he has fully complied with the terms of the modified license, and eventually he was allowed to practice medicine without limitations. The Board affirmed the ALJ’s decision, upholding CMS’ denial of Dr. White’s Medicare enrollment and rejected Dr. White’s argument that the timing of the revocation action by CMS was clearly retaliatory and intended to apply pressure on Dr. White for additional monetary penalties. ANALYSIS The USDC found CMS’ decisions to deny Dr. White enrollment in Medicare and revoke his privileges, and the subsequent Board’s affirmations were arbitrary and capricious and not supported substantial evidence. CMS did not have a legitimate reason to deny enrollment or revoke because the record does not support CMS’ assertions that Dr. White’s 2010 conviction for simple possession of a small amount of cocaine was detrimental to the best interest of the Medicare program and its beneficiaries. The USDC understood the deference it owed to administrative agencies as they adjudicate numerous complex cases before them. Yet, a court may not simply act as a rubber stamp for agency decisions. Because CMS failed to provide a reasonable basis for denying Dr. White his enrollment in Medicare or revoking his Medicare privileges, the decision of the Secretary is reversed. ZALMA OPINION A doctor should never get involved or addicted to illegal substances like Cocaine. The Fact that a doctor self reports his involvement with the drug, was rehabilitated, clean for nine years, and practices medicine legally, does not pose a danger to Medicare as do those doctors who are arrested every year for fraud. The decision of Becerra, the ALJ and the Board was clearly retaliatory and abusive and the USDC had no choice but to reverse the Board and let the doctor continue to practice medicine and charge Medicare for his services. Overreach by the administrative agency was stopped by the court. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk

LIZ CROKIN @LizCrokin I’ve been reporting for 8 years now that elites — Hillary Clinton, John Podesta, Jay Z, Lady Gaga and many more! —engage in Satanic ritual spirit cooking dinners. We exposed this in Out of Shadows — watch for free here on X below!👇🏻 Pizzagate is and always was real — the entire MSM and conservative media lied to you! https://x.com/LizCrokin/status/1838663374059848178

How many people started forgetting about the insurrection lies with all the craziness going on? Never forget it! https://www.glennbeck.com/radio/videos-january-6th-committee-lied