clearly and who represent this is a recording device so it's not a microphone so keep your voice up so that we can hear you please remember that we read the briefs we've read everything so get your strongest and most important arguments system obviously is of the medicaid system and and who is here today with us that's all she ever wanted to do and what she did for twenty years she worked for various clinics and unfortunately records keeping and medical records as become an industry unto itself hundreds of millions of dollars are now spent on medical records and keeping up medical records and making sure medical records are secure and correct and the best way to keep medical records secure and accurate is to have them in one place with a professional organization with someone who's been trained to keep those records doctors they put the information into the records that information has to be accurate that's exactly what i think that said i left that i think i was their current status so they still in business you know they've been out of business for years to file a bankruptcy i think that much i don't know i know they're out of business i know that one of the crippling things that happened was that they lied and said that my client was a seventy percent ownership and they did that so they could have avoided all sorts of acquirements become a clinic when my plan thing quit and  i doubt it the fact that it factors this is also it was was also good but in into the briefs what happened was my client went to high stop over and over again she was barred access to the records but she was very persistent she went there over twenty times she was eventually when the owner of my stop this reverend was no longer there one day she was actually able to sneak in and get the records and there was testimony in the record from a friend of hers and also a doctor who said that retirement letter wound up in the it wind up in the hearing officer it didn't wind up with the hearing officer and didn't wind up at yale j i can't i can't say whether or not you know she she ok and not the question she worked for two other and two other entities that provided medical services through medicaid patients were those two and these owned by the same person no by the same entity no sheets they would not consider the signage sheets as evidence now if you take a look at the you take a look at the rules and regulations here they say that they are supposed to simply look at sign in sheet the same as a medical record in your opinion i think that stench and is is one it is one without point because there is no there is no requirement for my client to keep a separate set of medical records nobody said anything about separate but according to their reading there is a requirement for her to have her medical records that are in compliance with the department standards and be able to produce them when the department asked one and judge i would gave that incorrectly there's there's two sections one is three zero five section five slash twelve dash or point two five he one what it really says is that they have grants that my require stuff my client we are friends timely access to my client maintain proper records yes he did the problem is she couldn't get accepted she was literally bar access to them and then they were destroyed just now he signed the agreement that records and she was to make sure that those records went to the clinic so that they were properly maintained that is good and that is good practice and that's good procedure and that's exactly what she did but it doesn't administrative rules put upon doctors that's not an e s u generally in the medical area and in hospitals clinics where doctors maintain separate records of their clients or the patients no and that's illegal i believe that's one hundred percent  legal you can only have one if this if this court could imagine for a second if that eval sudden came to pass as you suggested but it was as was suggested to the a l j there was someone from the from the department that came in and actually said with no support whatsoever that the doctors are supposed to keep it abstract of records that is that that should make any lawyer a scream because if we can only imagine the craziness that would ensue early in the hospital didn't and which which which set of records is accurate and you only imagine a medical malpractise case for car accident if we had sorts of different information all over the place has been different records all over the place that's what they're suggesting so your suggestion is that what she greed to and the documents authored by the department is what is a standard of reasonableness as to what she hospitals and hospitals and doctors to keep medical records private and at the same time have them being kept by every single doctor who sees a patient that is it that would keep the sheer insanity and is not a workable system i talk about records here is what's going on but she claims that she was and that she was never able to present and information because she was prevented from joining him the pissed up and the owner of that clinic as a necessary part  and here's the best i can figure out from the record on the record it seems that the l j at essentially said we don't care what i stop does we don't care what this reverend does we don't care how they maintain their race we don't care if they back the records she's being held strictly liable therefore what's the point of subpoenaing this or this person what's the point of subpoenaing the records because we know they represent exist at this point because she's already been to the facility and the records no longer exist that's number one number two we know that this reverend griffin isn't even if he did show up the l j isn't going to listen to him anyway because she's bad strictly liable so what's the difference what asked to say you know she thought she was working with the she was thought she was working with a special organization she thought she was working with people that she could trust everything was going fine and then all of a sudden one day she found out they had lied and said that she was a seventy percent owner so that they could get skirt for lunch of rules and regulations and get around a whole bunch of stuff you know unfortunately like any like any business relationship you can roll or personal question you know things only go so far and then you find out about the lie and  at that time have jurisdiction to allow the joining us in this absolutely there's a there's a rule right on point that says that they can join any necessary party and i  absolute abuse of discretion because because because ultimately any any tribe you know if it's going to comply with basic due process and fairness has to hold up as to have have everyone who's liable everyone who is is potentially at all in one room to figure it out and if you don't have all the parties then you know there's going to be a fundamental unfairness which is point two which is going to you know wind up being a huge mistake  join the third party my understanding from the record is that what the l j said is it doesn't matter because she's strictly libel it doesn't matter if we join this party or not because we can put all her burden on her it doesn't what other people did because we can all put it on her even though shelly made forty thousand dollars a year we can put all her half million dollars on her because at the end it doesn't matter if we bring in other people committed fraud who committed to see we did any of this stuff i ask you to trip because yeah i mean frankly the only thing i can come up with is that it ministry of laziness this is these rules were created to make it administrative leave easier and to deny justice deny justice at the expense of to come down so you're saying the agency worked on the promises we don't care who's the real wrongdoers who we're just going to do something to wrap this up that's right yeah that's exactly what  but there was never any it was never any investigation as to how much money she had if she had the you know if she was how much money she was made i'm sure it was mentioned during the hearing that she only made about forty thousand dollars a year i mean we of any iris reports or any and in the financials as far as her and it's a situation i know that there was a testimony i don't think there was actual documents from the i r s raid that was never taken into account it didn't matter to abstracts of what of what occurred i think they would have found they were just a there was a discrepancy stipulated to right but as far as further evidence presented that it was an over bill line but let's have something that's absent there's no or there's no never given the entire record and she was never able to see all the records that that that would that they were kept by i stop she can't do an exact match up of exactly here sac number but it is far as we can tell as far she can tell it could have been fraud on the part i stopped work would have just been high stop was a lost their records over billing in terms of the department's definition is anything that the paid for and you bill forty dollars but that's not what over believe me in this business that's correct they they they they took an all encompassing of approach which is fundamentally unfair that they pay the building a discrepancy would be something like in this in this particular situation there's no evidence that my court that my client didn't didn't form the services and didn't do them correctly and didn't tell them i think the i think the feeling was by the trial attorney at the time and now obviously it wasn't me that if i didn't accept that perhaps that the the issue really is whether or not it's the whole document i think if he is responsible given the fact that she did everything she good here he work in good faith and she bent over backwards to try to get these records and i mean even during the was acting in good faith and therefore she should not have been terminated from the program she should not be made to pay half but over half a million dollars for which she is not responsible and in and that necessar gun you saying she should have a continuance practically when should she have done that she should probably should have done it beforehand but she certainly should have done it when the a ok suggested that she do it he told her this process is available to you you can  believe he said this i don't have his his ruling in front of me your honor to the best of my recollection he said and i can't remember it but i believe he said that she's the liable and it she is the one who contract it with the department she is the one who said i will be responsible for all the billings that go out under my provider never me not my son and so responsible for the medical records whose responsibility is that that's a different ok the doctors agree when they become medicaid providers that they will be responsible for the medical records and they will provide them to the department i don't write in that i read the passage to you so you know i know that but i didn't yes he knew how does this how how this department practically expect this to be carried out ok but there are very few of these sorts of advisable and it is actually so recommends it in the physician's handbook at two o two point four one for one example that for doctors whose patient records are kept in a facility that is outside the doctor's physical custody and control  those positions keep an abstract and that abstract is to include a diagnosis a treatment program the dates and times the services were provided and the recommendations and that is back up on two fronts you're under those protection not only for the doctor in a case like this but also for the patient because it ensures patient continuity of care because what if there's a fire where the charts are is that are those patients supposed to be out of luck now because nobody bothered to make an abstract i mean  squire and then you know if you go to university of chicago or some other hospital with care they have a abstract house someplace else and set the standard of care there is what an abstract is what's records personally in her own home or wherever it is that she may keep them that are from the facility in which she's actually treating the patients when you say that not so as long as they are keeping those records securely there is no violation of the standard of care to have an abstract or something to protect yourself and protect your patients for example if you're talking about nursing home patients symon not be able to communicate with their medical history has over their needs are and it's something happens to their chart where it's kept you want to have some kind of back i don't  there's no way you put it well let me ask you another question who is with the l g be interested in why not them you think it wasn't able to produce the records that the department required is the is the why of the situation it certainly bears on whether she made an effort on her own to get those records in there and the hell she recognized the one thing i see the most important or not important has resulted in the the well actually no it wasn't because she testified that she never checked her bills she never checked that anything that went out under her nose and accurate one hundred why she wasn't able was not important if at the end of the day you know it doesn't matter she is strictly liable your honor she agreed here agreeing with your only one on the ask you about now never mind the other two because that's not really the same it's not an issue right now how would she get the records from him to either disprove or challenge the findings of the is the one who agreed with the department that's the one who she is the one who contract with the department we're talking not about a bottomless pot of money your honor we're talking about taxpayer funds not the department could extend scarce resources chasing down high stock or it honor she was the one who contract with the department whether or not he was wronged or she still has the option of going after him filing a third party indemnity complaint but she's the one who agreed to be responsible for this medical records on the public policy issue for sir concerned about this money that he stated i've been cheated out of we would just go after someone who you pretty much know is not going to be able to pay it back what about the deep pocket what about that part of  who have the money out to maybe but why would we go after them because it would have been there these are scarce resources to keep to to expend resources to go after him when you  greater than against a doctor that's making forty thousand a year that that is a leap your honor according to council he was out of business and he had no money he was that his you know his is this is was circling the drain at that point it's she is the one who has you know what federal law when there has been an overpayment ok the state has a year to go after and recover the money and at the end of the year if we haven't recovered it not only are we out whatever we overpaid for the services that we should have been billed for but we also have to give the feds back roughly half of the money so in a case like this we're out two hundred fifty thousand dollars and we have to get back to the federal government because of cases like this that you have any idea when this decision can pay five s as far as i can tell from the record now they're not so what about that how you're going to recover it from the first individual who doesn't have the money either let's assume for the moment that she doesn't have the money i don't know that you don't know that but let's assume how's that going to help the state along the arguments that you are making it helps the state because if she cannot recover if you know if there's a bankruptcy if there's some other if it turns out that the judgment is not collectible that the state will not be liable for that money we had to give it back but there would be adjustment made in the future because the debt is a collective so your argument is it was just easier than going after her so you can go with them decision was made to go after her because she is the one who agreed to be responsible your honor not my son myself for saying that again you because again you say if she if it's part of the cheating i'm physically financially able to pay the judgment there's a difference in what you are the federal government yes you're on that is it forty two c f r for thirty three dot three hundred anything else was in her brief she argued that there's nothing that legally defines what a medical record is that is that is not correct but i think based on the court's discretion of the sign in sheets and what they do and do not show i mean it's a a bunch of names i mean those people might have signed in to play who knows what signed into law signed in for a waiting room it's it is nothing that documents the nature scope details and receipt of any health care provided to those people and your honor also there are instances other doctors and billed under her name there are a number of ways in which there were discrepancies and it all adds up to the one larch stand them and their argument is that they had no access to the records we could not have an january seventeenth that is documented in the record at page seven hundred fifty six because there's a notation it was group it was group therapy it was overbuilt ok it was for a psychiatric diagnostic interview the documentation in the record actually showed nothing more than group agency the department had absolutely no control over high stuff that's ridiculous in fact that's the reason why the reverend who ran high stop reverend reference lied about my client being a seventy percent owner it's because if he much less on a risk if a doctor were charged because now the doctor has all the it's all the responsibility because she's a seventy percent owner turns out she doesn't seventy percent or which is which is the reason why the department requires much more stringent standards much more stringent you know the requirements for these clinics if a doctor is not an owner that's a reason they relied on the paperwork and said that she was a seventy percent owner to get around all those requirements in any event the department would have  off the money stick it to high stop in a second in order to get those records all they needed to do was send a record to high socks and say you have a choice you're going to receive no more money from medicaid we're going to turn over the records they could have they could have assisted in that way they could have they could have done their due diligence they decided not to instead they simply just help my client strictly liable is what they did and they didn't go out of their way at good to get these records they kept procedural rules in here in the