Dr. Tyrone C. Malloy M.D.

 The transcript from lower court exonnerating Tyrone malloy from doing anything illegal. judge teate residing    

 

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JUDGE TEATE:  Are the parties ready?  All right.  Today is July 26, 2010.  My name is Steven Teate.  I’m an Administrative Law Judge at the Office of State Administrative Hearings.  We’re here today in the case of Tyrone Cecil Malloy, M.D., Petitioner, v. Georgia Department of Community Health, Respondent, Docket No. 1032811, Agency Reference No. R10-060.  Agency is represented by Tara Dickerson.  It appears that the Petitioner is acting pro se.  We’re here today at the request of Petitioner in response to adverse Agency action whereby the Agency has withheld status of the Petitioner’s Medicaid number.  Issues identified for the Hearing are: 

1.      Services are billed to Medicaid that are

related to an abortion;

2.      Documentation reflects that these services

were rendered in conjunction with an abortion;

3.      Effective October 1, 2005, § 904.2 of the

DCH, parts II – Policies and Procedure Manuals, uh, states abortions, the relief of request is that, um, my Medicaid provider number be released so that I may continue to provide the gynecology services that have been granted me by the Department of

Community Health.

Inasmuch as this appears to be a revocation of some sort of his provider license – is that correct?

TARA DICKERSON:  It’s his provider number, Your Honor.

JUDGE TEATE:  It’s his provider number?

TARA DICKERSON:  Right.

JUDGE TEATE:  But, in other words, he had an existing provider number?

TARA DICKERSON:  Correct, Your Honor.

JUDGE TEATE:  All right.

TARA DICKERSON:  His provider number is being withheld so no payments will be made with [overlapping conversation].

JUDGE TEATE:  This is not pursuant to an application though?  This is - -

TARA DICKERSON:  No.

JUDGE TEATE:  - - this – he was an existing number?

TARA DICKERSON:  Correct.

JUDGE TEATE:  Okay.  Well, then I’m gonna place the burden on the Agency.

TARA DICKERSON:  Correct, Your Honor.

JUDGE TEATE:  So I’ll hear first from the Agency.  You’ll have an opportunity for cross-examination.  Following that, I’ll hear the Petitioner’s case in response and, of course, the same right of cross-examination.  Either side may make opening or closing statements if they choose to do so.  Uh, evidentiary standards preponderance of the evidence presented and I would think that there would probably be a need to sequester witnesses?

TARA DICKERSON:  We would invoke the rule, Your Honor.

JUDGE TEATE:  All right.  All parties that are witnesses to the proceeding, uh, with the exception of the Petitioner and whoever’s here just to assist the, um, Ms. Dickerson and, um, who’s assisting you?

TARA DICKERSON:  My main witness, uh, is an auditor, Your Honor.

JUDGE TEATE:  Is she gonna be the first witness?

TARA DICKERSON:  No, she won’t be the first witness, Your Honor.

JUDGE TEATE:  Okay.  Um, well, even sequester her then - -

TARA DICKERSON:  Okay.  You can take [overlapping conversation].

JUDGE TEATE:  - - for that [indistinct].  All right.  If all witnesses would step out into the lobby, you’ll be called by, uh, council as

appropriate.

TARA DICKERSON:  And, Your Honor, at this juncture, we would try to have presented Mr., uh, Dr. Malloy with, uh, evidence that, as we see it in this case, and I was giving him an opportunity to look that over to see if we could stipulate to that.

JUDGE TEATE:  Okay.

TARA DICKERSON:  It’s primarily letters, correspondence to and from him and the Department, as well as medical records created by his office, and then the actual billing which, um, is just a documentation of what he actually billed and, of course, he would be aware of that.  So I wanted to know if he wanted to stipulate to the, um, Exhibits as listed on the Exhibit List and provided to him.

DR. MALLOY:  Yes.

TARA DICKERSON:  Okay.

JUDGE TEATE:  All right, sir.

TARA DICKERSON:  Your Honor, so I’m gonna go ahead on and present you your copy of everything.

JUDGE TEATE:  All right.

TARA DICKERSON:  And I did have a list, Your Honor, which I could get to you later, but it was password-protected and I forgot the password because I was gonna give it to you in court.

JUDGE TEATE:  This is a copy of the Exhibit List?

TARA DICKERSON:  Right.

JUDGE TEATE:  Okay.  All right.

TARA DICKERSON:  I don’t know if you need it.

JUDGE TEATE:  You can just supply that later.

TARA DICKERSON:  And that’s – the Exhibit List is on top.

JUDGE TEATE:  Did you wish to make opening or did you wish to just - -

TARA DICKERSON:  Yes, I was gonna – Dr. Malloy, we, um, I think, and he can agree or disagree), but I was trying to get a understanding of the primary issue is there’s no doubt that you were provided – - you have been a licensed provider – - for quite some time.  The only issue that you raised that I saw was whether the billing practice that you did related to the, um, member services was in compliance or out of compliance in conjunction with the Hyde Amendment and as stipulated in the Policies and Procedures, if you see some other issue besides that issue?

DR. MALLOY:  Well, I - -

JUDGE TEATE:  Go ahead, sir.

DR. MALLOY:  Uh, I don’t feel that the – - my billing has anything to do with the Hyde Amendment, okay, because the Hyde Amendment’s directly related to federal funding for abortions.  And so my billing has nothing to do with federal funding for abortions, so that is the discrepancy.

TARA DICKERSON:  Okay.  All right.  Your Honor [overlapping conversation].

JUDGE TEATE:  And I think the parties have stipulated to the admission of these documents?  Is that correct?

DR. MALLOY:  Yes, Your Honor.

JUDGE TEATE:  [Indistinct] on the Exhibit List, so that would be Exhibit A through – looks like it goes through A through K and then begins AA through - -

TARA DICKERSON:  Forty-eight, Your Honor.

JUDGE TEATE:  - - 48?  Okay.  All right, those are admitted into the record.

TARA DICKERSON:  Thank you, Your Honor.

JUDGE TEATE:  Sir, you can be seated and she’ll - -

TARA DICKERSON:  Your Honor, I’m just gonna do an initial opening, a brief opening statement.  Your Honor, my name is Tara Dickerson.  I represent the Department of Community Health as it relates to the action of Tyrone – - Dr. Tyrone C. Malloy v. the Department of Community Health as stated by Your Honor in the record with regard to the case number.  Your Honor, this case stems from a Utilization Review that was done, uh, with regard to a location operated and managed by, uh, Dr. Malloy at his, um, Old National Gynecology located at 6210 Old National Highway, College Park, Georgia.  Uh, the Utilization Review was done pursuant to the procedures outlined in the Part I – Policies and Procedures Manual, PeachCare for Kids Manual, and this particular re – review, Your Honor, covered the span of October 1, 2008, through January 15, 2010.  So, thus, the appropriate manuals that would be at issue for Part I, of course, would be those running from October 2008 to January 2010.  And we have provided the Court with, um, the October Manual 2008 and the January 15, 2010, part that’s relevant to the matters at issue here and the Court will see that there have been no changes that would affect, um, the policy as rendered pursuant to this time period.

Also, Your Honor, with regard to this matter, another particular, um, manual at issue will be the Part II Manual which relates in particularly, Your Honor, to the actual Policies and Procedures Manual for Physician Services and, in particular, § 600 which deals with special conditions of participation and § 904.2 – Service Restrictions, abortions in particular.  And we also provided the Court with, uh, the manuals, the section covering this particular area, from October 1, 2008, and January 15, 2010.  And, again, the Court will see that there have been no changes or updates to reflect anything new from those [indistinct] manuals that, uh, may have been [indistinct] for the Court to read.

Your Honor, as it relates to this matter, back on January 25, 2010, pursuant to Exhibit RA, the Court would note that an actual letter was sent out to this particular location addressed to Dr. Malloy, and there is no dispute that he did receive this information, indicating that an audit would take place.  This letter informed, uh, Dr. Malloy of what was to be expected, and the review team that was coming out, what they would need and what they would need to have access to and the assistance and cooperation that they would need.  And one of the things listed was a list of the employees, um, with regard to services billed to your provider number and license certifications; the medical records, uh, which are, of course, what is actually looked at with regard to whether the services provided were in fact services that would be paid and services that were billed; and then a sample of the provider’s printed name and handwritten initial and signature and electronic signature; and any other documents that they may have needed with regard to the audit.  This particular letter was sent out indicating that there would be a review of 75 member records at the facility, and it also indicated that the time that they would actually be coming out, which was January 27, 2010, and they expected to be completed – - they expected the review to be complete – by January 28, 2010.

Your Honor, the review was in fact held and, uh, with regard to that review, um, certain things were noted, records were copied, and an assessment of the situation was garnered by Wylene Moore.  She’s an RN, she has a Bachelor of Science in Nursing, and she’s a Compliance and Monitor Auditor with the Unit of Program Integrity.  This review was done, Your Honor, and, with regard to that review, uh, those people employed, particularly the admitting [indistinct] staff, were actually interviewed and, um, they included the office manager, as well as, um, a medical assistant and a certified medical personnel.  And those, um, parties were interviewed and the records were received and copied.

Your Honor, then a result of that review was sent

out to Dr. Malloy, and this was pursuant to a letter that was sent to him dated March 12, 2010, which is our Exhibit RB.  And, in that letter, Your Honor, it indicates, based upon the review, that at that time that the Department had decided it would hold reimbursement for the following reasons, and that’s listed on the first page of that letter.  And one thing that was noted was that the Division received the reliable evidence of fraud or willful misrepresentation concerning the provision of services under the Medicaid PeachCare for Kids.  With regard to this, Your Honor, the letter also cited the particular policy that indicated a possible fraud or willful misrepresentation which was found in Part I, § 506, of the Policies and Procedures Manual, Part I – Medicaid PeachCare for Kids dealing with abortions, and, in that, it stated that:  In accordance with federal regulations and the recent Congressionally-enacted revision of the Hyde Amendment, the Division will reimburse for abortions performed on Medicaid-eligible patients if the life of the mother would be in danger if the fetus were carried to term or if the mother was victim of rape or incest.  Then this particular section goes on to show what needs to be submitted when paying for – - when submitting a request for payment for – abortion along with those services, which is a Form DMA-311.

Your Honor, the peculiar thing about this case is there is no indication, and Mr. – Dr. – Malloy will indicate this and we’re not in disagreement with him, that he at any time submitted this particular form, the DMA-311 Form, which is a form that you must complete if the abortion procedure is, in fact, performed in accordance with one of the criteria listed above to get reimbursement for the abortion.  It is strictly our position, Your Honor, is that Dr. Malloy, his staff, his office completed everything related to the abortion and, in fact, did the abortion, and what we are calling, for lack of a better word, split the billing.  The services rendered prior to the actual abortion were those services billed to Medicaid.  This would include lab tests, ultrasounds, pregnancy tests or whatever those services were prior to the actual procedure of the abortion.  And then Dr. Malloy would, in fact, charge the Medicaid patient – which, of course, he has the right to do since Medicaid does not pay for an abortion unless it’s under one of those conditions – for the actual abortion procedure.  So what we are saying to the Court, Your Honor, is that Dr. Malloy made a concerted effort – a thought-out effort – to actually split this billing in such a way as to, on the one hand, present it as some type of benefit to the member because they’re not paying for those initial services that are required prior to the actual procedure, and then strictly billing the Medicaid member for the abortion-only procedure.  So therein lies the conflict that we have, Your Honor, related to this matter.

Thereafter, Dr. Malloy did respond by indicating that he never filed a claim for an abortion and the procedure code he listed with regard to the R-C, which is Respondent C, which is a letter he sent to Shirley Benson who is the Unit - - Program Integrity Director back on March 16, 2010, and in his letter – and we are in agreement with his letter, and he does attach a, uh, an attachment to that letter indicating Pregnancy Verification Form, Old National GYN – and it goes through the various pre-type tests that would have been done that were, in fact, billed to Medicaid, to the Medicaid member.  And then, with regard to whether the person wanted to terminate the pregnancy of continue the pregnancy, if they checked terminate the pregnancy, then the individual member would pay through whatever resources or however for the actual

abortion procedure.

So it’s our position that, Your Honor, the splitting of the billing in this manner would actually just defeat the purpose of the Amendment.  And this was a way for him to go around the Amendment.  And, in response to that, your Honor, um, he requested an Administrative Review.  An Administrative Review was done and a letter was sent to him, which is our R-D, on April 14, 2010, maintaining our prior position that we would withhold the, um, Medicaid provider number.

Thereafter, in a timely manner, Your Honor, Dr. Malloy did, in fact, submit a Request for a Hearing, which would be our R-E.  This would be his letter dated May 1, 2010, wherein he asked for a Hearing to aspeal - - to appeal the issues with regard to services are billed to Medicaid that are related to an abortion, documentation of such that these services were rendered in conjunction with an abortion, and effected with regard to the particular policy at issue that states that Medicaid will not pay for an abortion unless it is under those specific circumstances.

So those, Your Honor, are the particulars as it relates to, uh, the matter at hand for this, um, case.  And we, Your Honor, believe that we were correct in our decision to withhold the, um, provider Medicaid number inasmuch as it appears, based upon the records and everything that we reviewed, that Dr. Lamore(sic) did willfully attempt to, um, split the bill so that he could receive payment for services that would normally not be paid by Medicaid inasmuch as these services were definitely related to an abortion.  And that’s our position, Your Honor.

JUDGE TEATE:  Dr. Malloy, do you wish to make an opening?

DR. MALLOY:  Yes. 

JUDGE TEATE:  Sir, you are acting pro se, so I would caution you at this time it’s not the time to present testimony; it’s simply time to outline your position.

DR. MALLOY:  Yes, sir.  Um, thank you, Your Honor, and Ms. Dickerson.  Um, first of all, I would like to say that, um, I really appreciate, um, everything that – that Medicaid has – has done.  They’ve been, uh, I think very thorough, um, in their investigation.  I’ve been a Medicaid provider for 29 years and I have never had an audit of any of my offices, uh, for any, um, willful misrepresentation or fraud. 

Uh, my stance on this and the reason why I asked for this Administrative Hearing, um, because I tried to outline in letters to the Department that I felt that it was an error in their interpretation of the Amendment.  Um, the letter, as was already mentioned, about evidence of fraud or willful misrepresentation – - and Ms. Dickerson clearly outlined, um, the provisions of the Hyde Amendment and she makes provisions of where I, um, tried to, I guess another word, another term would be unbundle, um, the services – - but I simply was explaining to, um, Division was that when a, uh, patient, um, comes to my office, well, I was trying to show that if she’s coming for confirmation of pregnancy, which is provided, um, that’s something that she is able to have provided to her by a gynecologist or one of my assistants, if she’s coming for confirmation of pregnancy that in confirming the pregnancy, we are able to provide certain services which have already been outlined.  Those services being laboratory tests, ultrasounds.  Okay, that is a, um, right that the Medicaid-eligible, uh, recipient has as far as family planning or as even in obstetrical services.  All I was doing was confirming the pregnancy, dating the distinctional age, and letting her know whether or not she was pregnant.  Not everyone who comes to my office with an absence of a menses is indeed pregnant.

Once that service has been done – once that is completed, okay, the provider – - excuse me, the, uh, eligible recipient – then has the option of deciding to either terminate the pregnancy or, if she’s not pregnant, maintain some form of contraception or, if she is pregnant, she may decide to maintain the pregnancy.  Um, what she decides to do is on her own freewill, under no coercion.  But because I am a gynecologist and because I am allowed by the state of Georgia with my license to perform abortions up to 14 weeks in my private office, if she so elects to stay there and terminate the pregnancy, she is given a Pregnancy Verification Form that specifically states -– and it is bold - – that Medicaid does not pay for an abortion.  Okay?  That she has the right to maintain or she may have the abortion.  She can either have it with me, she could leave and have it with someone else, that she can make that decision.  And only at that time, okay, do we proceed with the abortion.  Everything up until that time is confirmation of pregnancy based on either her lacking a period, having an unusual period, okay, or just not sure what’s going on with her body.  This is something that we have done for 29 years.  And there are facilities not only within the city of Atlanta, within the state of Georgia, that have employed this same process.  I found it very strange that for the first time in 29 years, someone was saying that what I was doing was wrong.

To add to that, um, I also did – - I asked from, uh, the actual field reps, okay, if what I was doing was in compliance and, again, I’m not going to present any evidence at this point; this is my opening statement - - that the field reps representing the Georgia, um, Division of – of Community Health said that what I was doing was in compliance as long as I had a form that specifically stated that they realized that Medicaid was not paying for an abortion; that everything that I did up until that time was basically confirmation of pregnancy to let the woman know if she is indeed pregnant, how far along she is, and then the decision that she makes from that point on is entirely separate from the laboratory data that I obtained before then.  This is what we’ve been doing for 29 years.  It has never been, um, said that it was a violation of the Amendment.  And I’m going to, during testimony, I’m going to make mention of some of the documents, um, that, um, uh, the attorney has presented to show how I feel they have misinterpreted exactly what the Amendment is actually saying.  Uh, you cannot bundle, okay, services for Medicaid.  Okay?  You cannot.  And I will make some comment to that – -testimony to that - - later on.  But taking that aside, I think that there’s just been a true misinterpretation of the law, okay, that has me standing here now in front of you, Administrative Law Judge.

Again, I have nothing against Medicaid.  I think they – - have done an excellent job.  I think there’s just been a misinterpretation, and my evidence during the course of this trial will be to show that misinterpretation.

JUDGE TEATE:  Okay.  Your first witness, Ms. Dickerson?

TARA DICKERSON:  Your Honor, we’re gonna call Kathy Warner.

JUDGE TEATE:  Okay.  If you’ll go get her?  Okay.  And if you’ll come up here and, if you would, [indistinct] take a seat if you would, please.  Raise your right hand.  All right.  Do you solemnly, uh, swear that the testimony you’re about to give is the whole truth and nothing but the truth, so help you God?

CATHY WARNER:  Yes.

JUDGE TEATE:  All right.  Be seated, ma’am and

please state your name for the record.

CATHY WARNER:  It’s Cathy Warner.

JUDGE TEATE:  And is that Kathy with a C or - -

CATHY WARNER:  Yes.

JUDGE TEATE:  - - a K?

CATHY WARNER:  With a C.

JUDGE TEATE:  All right.  Your witness, Ms. Dickerson.

TARA DICKERSON:  Thank you, Your Honor.  Good morning, Ms. Warner.  I’m attorney Tara Dickerson.

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  And I represent the Department of Community Health.  Could you please tell the Court your current job title?

CATHY WARNER:  I’m the Office Manager at Old National GYN.

TARA DICKERSON:  And how long have you worked in that capacity?

CATHY WARNER:  Close to 20 years.

TARA DICKERSON:  Have you worked at that particular facility for 20 years?

CATHY WARNER:  Um, not that particular office.  That particular office, we moved there in 2 – in 2004.

TARA DICKERSON:  So you’ve actually been a Office Manager for close to 20 years?

CATHY WARNER:  Yes.

TARA DICKERSON:  And in that entire time - -

CATHY WARNER:  At that practice now.  At that Old National practice.

TARA DICKERSON:  What are your current duties and responsibilities as Office Manager?

CATHY WARNER:  Um, I oversee the office as far as, um, my staff, uh, making sure that, um, everything is up to par as far as, um, to co - - to, um, to maintain a GYN office.

TARA DICKERSON:  Currently, how many people are employed at that particular location?

CATHY WARNER:  Seven, including myself.

TARA DICKERSON:  Could you tell the Court who those persons are?

CATHY WARNER:  Um, Trina Thompson.

TARA DICKERSON:  And what is her title?

CATHY WARNER:  Sonographer.  Quinetta Clemson[phonetic].

TARA DICKERSON:  And what is her title?

CATHY WARNER:  She’s my supervisor.  Damika Sinclair[phonetic].  She’s an MA.

TARA DICKERSON:  And is that medical assistant?

CATHY WARNER:  Yes.  Britney Fields, and she’s an MA.  Joy Dickson, and she’s an MA.  And Sheryl Genius,

and she’s an MA.

TARA DICKERSON:  What, if any, physicians work out of that location?

CATHY WARNER:  Dr. Malloy, Dr. Phillip Hadley and Dr. Peter Johnson.

TARA DICKERSON:  Now since you’ve been working at this location since 2004, could you tell the Court whether you were present back on January 27, 2010, when a Utilization Review Audit began?

CATHY WARNER:  Yes.

TARA DICKERSON:  Share with the Court, to your knowledge, what happened on that day.

CATHY WARNER:  Um, can you just repeat the question one more time?

TARA DICKERSON:  With regard to the Utilization Review that was conducted on January 27th - -

CATHY WARNER:  Uh-huh?

TARA DICKERSON:  - - you indicated you were present at that time.

CATHY WARNER:  Yes.

TARA DICKERSON: Did you, in fact, speak with anybody from that audit?

CATHY WARNER:  Yes, yes.

TARA DICKERSON:  Okay.

CATHY WARNER:  Um, I believe it was four agents

that came in.

TARA DICKERSON:  Uh-huh.

CATHY WARNER:  And, um, I remember the – the head nurse – her name was Wylene, I believe – that she had given me a card and, um, they conducted the interview in one of our rooms.

TARA DICKERSON:  Now when you say interview, did you mean interview of the actual employees who were present at that location?

CATHY WARNER:  Yes.

TARA DICKERSON:  And you were, in fact, interviewed, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  What is the primary business at this particular location?

CATHY WARNER:  It’s an O – - it’s a gynecology office.

TARA DICKERSON:  And what primary procedures are done in this location?

CATHY WARNER:  GYN and we do terminations.

TARA DICKERSON:  What percentage of your work – of – of the business there would you say would be abortions, terminations?  As far as actual procedures.

CATHY WARNER:  About 50 percent.

TARA DICKERSON:  And do you all, in fact, see

Medicaid members?

CATHY WARNER:  Yes, we see Medicaid patients.

TARA DICKERSON:  Could you share with the Court the procedures that are taken, to your knowledge, if someone comes in seeking an abortion?  Or termination.

CATHY WARNER:  Um, first of all, uh, we have to make an appointment for the patient, which is 24 hours prior to their visit.  And some of the patients, um, definitely know that they’re pregnant and want to have an abortion.  Some are not sure if they’re pregnant; they want to come in to find out.

TARA DICKERSON:  Okay.  Let’s take the member who knows that they’re pregnant.

CATHY WARNER:  Uh-huh?

TARA DICKERSON:  Can I – can they – can that person just come in and just have an abortion procedure and that’s all?

CATHY WARNER:  Yes.

TARA DICKERSON:  So you don’t have to do the ultrasound, the lab tests, any of that work?  You can just come in and say, I’m pregnant and I want an abortion?

CATHY WARNER:  No.  No, it doesn’t work like that.

TARA DICKERSON:  Could the tell the Court how it

works?

CATHY WARNER:  Okay.  Um, like I said, they have to make an appointment prior to their visit, which is recorded.  Um, once they come in, they have to sign the Women’s Right to Know to say that we did make the appointment 24 hours prior to that.  Um, they have a driver that has to sign to say they’re responsible for them.  And, at that point, they get paperwork.

TARA DICKERSON:  So you’re indicating that they have a driver.  What’s the purpose of having a driver at this initial appointment?

CATHY WARNER:  Um, because we do the procedures locally, and that means they’re sedated slightly.  Uh, we need to make sure that they have someone that’s responsible to take them home.

TARA DICKERSON:  Okay.  I’m gonna show you what’s already been admitted into evidence as Respondent’s Exhibit AA.  And, Your Honor, I do want to state for the record, for purposes of these, um, records, we have attached the HIPAA Protected Health Information to Keep Under Seal at All Times as it relates to these records, and we did make an effort to, um, mark out any photos of any persons due to a lot of the records have the actual driver’s license attached, as well as an effort to, uh, particularly on the first page to mark out if they were employed, the location of their employment and, um, on that first page with regard to their patient information, their social security number and any type of, uh, email addresses, whatever.

JUDGE TEATE:  I’ll note that these documents still contain significant amounts of medical information and they will be sealed.

TARA DICKERSON:  Thank you, Your Honor.  Could you take a look at those records, please?

CATHY WARNER:  Okay.

TARA DICKERSON:  And, with regard to the first page, it states Old National GYN.  Is that a typical form that you all use with regard to patient information?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  And, uh, on this particular page, um, what is the actual date on the top of the form?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  And with regard to the purpose of the visit, what does the member list as the purpose of the visit?

CATHY WARNER:  Abortion.

TARA DICKERSON:  And could you turn to the next page?  And this page also has Old National GYN.  Do you recognize this as a standard form used as one of the paperwork that you all complete?

CATHY WARNER:  Yes.

TARA DICKERSON:  And could you state the, um, um, with regard to DOS on the top right-hand corner, does that stand for Date of Service?

CATHY WARNER:  Yes.

TARA DICKERSON:  And what particular date is listed on there?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  And the balance with regard to the payment, what amount is listed?

CATHY WARNER:  Zero.

TARA DICKERSON:  And what was the previous balance?

CATHY WARNER:  $250.

TARA DICKERSON:  And the insurance company listed?

CATHY WARNER:  Medicaid.

TARA DICKERSON:  Okay.  And with regard to the $250, is that the standard fee that you all charge for Medicaid patients?

CATHY WARNER:  At that particular time, yes.

TARA DICKERSON:  Okay.  Could you turn to the next page?  On this page, it has your same title, Old

National GYN Pregnancy Verification Form.

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  Is this one of the standard forms that you all use at that location?

CATHY WARNER:  Yes.

TARA DICKERSON:  And on this particular form, what is the date on the form at the bottom?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  And what particular procedures or tests were done on this particular – that – that are marked on this form?

CATHY WARNER:  Uh, a positive pregnancy test, um, and hematocrit and urinalysis.

DR. MALLOY:  Excuse me.  Where – where are you [indistinct]?

TARA DICKERSON:  I asked did you get the, um [indistinct]?

DR. MALLOY:  Oh.  I thought I was - -

TARA DICKERSON:  Look right here.

DR. MALLOY:  Okay, I’m sorry.

TARA DICKERSON:  Oh, it’s no problem.  It’s just that - -

DR. MALLOY:  Okay.

TARA DICKERSON:  - - you don’t have one big and one little one.

DR. MALLOY:  Okay.

TARA DICKERSON:  You see that?

DR. MALLOY:  Okay.  So where – where are you now?

TARA DICKERSON:  We’re right here on AA here [indistinct] and we’re right here.  We’re right here.

DR. MALLOY:  Okay, fine.  Thank you.

TARA DICKERSON:  No problem.

DR. MALLOY:  Sorry, Your Honor.

JUDGE TEATE:  That’s quite all right.

TARA DICKERSON:  And is ultrasound also marked on that page?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  So, based upon this page, what tests were – would have been done?  What – what tests were actually done based upon what’s marked on this page?

CATHY WARNER:  Okay.  We did a, um, a hematocrit - -

TARA DICKERSON:  Okay.

CATHY WARNER:  - - on the patient.  A urinalysis was done.  A pregnancy test was done.  And then we had an ultrasound done by sonographer.

TARA DICKERSON:  Okay.  And the date on this is 4/25/09 as well, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And it’s indicated that, um, the person wants to terminate the pregnancy, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And this is consistent with the actual patient information that lists the purpose of the visit, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  Could you turn to the next page?  And it states Old National GYN.  This is one of the standard forms that you all use?

CATHY WARNER:  Yes.

TARA DICKERSON:  All right.  And with regard to this form, what particular tests or procedures does it indicate were done?

CATHY WARNER:  That the patient had, um, Rh factor done, hematocrit done, blood pressure, temp, pulse, height and weight.

TARA DICKERSON:  And then she also had a physical exam?

CATHY WARNER:  Yes.

TARA DICKERSON:  And then what’s the operative summary?  What does that mean?

CATHY WARNER:  Once, um, she’s had an abortion, then this information is – is applied.

TARA DICKERSON:  Okay.  And what is the date

listed there?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  All right.  Could you turn to the next page, please?  And this page is actually shows(sic) ultrasound, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And there’s actually a picture of an ultrasound, the actual image, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And do you see the actual date listed on the top left-hand corner noted on that?

CATHY WARNER:  I do.

TARA DICKERSON:  And what is the date of that?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  And 4/25/09 was the date she came in, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  The date she had the test done, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  The date she had the operative procedure to terminate the pregnancy, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  The date the ultrasound was done, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And with regard to the next page, could you turn to that page?  And this page is actually showing the actual write-up of the procedure to verify what was done, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  You can turn.  And then on the last page is the follow-up page, right?

CATHY WARNER:  Yes.

TARA DICKERSON:  And the purpose of this particular page is just to follow up just in case there’s any issue or complications or something isn’t right that they can follow up and come back to the office to get checked out again, correct?

CATHY WARNER:  Yes, they need to have an appointment.

TARA DICKERSON:  And what was the date of this particular?

CATHY WARNER:  4/25/09.

TARA DICKERSON:  So when the patient came in, everything was done on that day at that time, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  Now with regard to what was actually billed to Medicaid, to your knowledge based upon the records presented here, what was that you

billed to Medicaid?

CATHY WARNER:  An office visit, an ultrasound, and a hematocrit and a pregnancy test.

TARA DICKERSON:  And all of that was billed to Medicaid?

CATHY WARNER:  Yes.

TARA DICKERSON:  And then the member – and this is a Medicaid member – paid for the actual abortion costs?

CATHY WARNER:  Yes.

TARA DICKERSON:  And that cost was the $250 that was shown as the payment that had been made?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  Okay, let me show you what’s been marked as – - do you have BB with you?

CATHY WARNER:  I’m sorry?

TARA DICKERSON:  Do you have any other records after that?

CATHY WARNER:  Yes, I have another chart here.

TARA DICKERSON:  BB?  Does it indicate R then two B’s?  At the bottom.

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  And this is just – we don’t have to go through every record, but I want to make this clear to the Court.  Could you state that, uh, this is, once again, is a Patient Information Sheet, correct?

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  And this is your sheet, correct?

CATHY WARNER:  Yes, it is.

TARA DICKERSON:  And what date did this particular person come in?

CATHY WARNER:  2/17/09.

TARA DICKERSON:  Okay.  And going back to the next page, which is the Pregnancy Verification Form?

CATHY WARNER:  Yes.

TARA DICKERSON:  And those same type of tests with regard to what we just looked at, what date were they done for this member?

CATHY WARNER:  2/17/09.

TARA DICKERSON:  Okay.  But on this particular note, the person wants to continue with the pregnancy, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  And with regard to that particular, uh, record, in this case what was actually billed to Medicaid? If you turn to the - -

CATHY WARNER:  I don’t see a bill in here.

TARA DICKERSON:  What would have been billed to

Medicaid, since she wanted to continue with the

pregnancy based upon the tests that were done?

CATHY WARNER:  An ultrasound and hematocrit, a urinalysis and, um, a pregnancy test.

SPEAKER:  Correct.

TARA DICKERSON:  Okay.  [Indistinct] one more, Your Honor.  Let’s go to CC.  With regard to this member, what date did this member come in?

CATHY WARNER:  2/10/09.

SPEAKER:  I’m sorry.

TARA DICKERSON:  And she also came in on 2/3/09, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And, at that time, what happened?  If you turn to the next page, what happened in her case?  Did she, in fact, make a payment towards this, uh, procedure?

CATHY WARNER:  Yes, she did.  She - -

TARA DICKERSON:  And then she came in again; it’s the reference to the 2/10/09 if you turn the page to the next form.  And, at that time, she made the final payment, correct?

CATHY WARNER:  Right.

TARA DICKERSON:  So with regard to this particular person, they came back after the payment was made in full, correct?  When they made the payment in full – when they had the full amount of money that was due – that’s when they came back, correct?

CATHY WARNER:  That’s when they had the procedure done, yes.

TARA DICKERSON:  Right.  And with regard to the Medicaid member, since you’re going to bill Medicaid, there is no need for them to come back because you would do the billing on behalf of the company to Medicaid, correct?  With regard to Medicaid members.

CATHY WARNER:  Okay.

TARA DICKERSON:  They’re not paying – if they’re paying you just for the - -

CATHY WARNER:  Abortion?

TARA DICKERSON:  - - the abortion - -

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  - - and they have the money, then they don’t have to come back because they don’t have any more money to pay, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  All right.  So with regard to this member, she came back once she had the full amount that was due and she had the procedure on that same day, correct?

CATHY WARNER:  That’s not the reason why she came back.

TARA DICKERSON:  Why did she come back?

CATHY WARNER:  Um, she had an ultrasound because, um, okay, just let me – can I just explain something with this one?

TARA DICKERSON:  Sure.

CATHY WARNER:  Okay.  I see, um, this is a regular patient that – that we call a regular patient.  Cash – cash-paying patient.  And the first time she came, she had an ultrasound, so when she came, um, for the ultrasound - -

TARA DICKERSON:  And the first time being 2/3/09, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  But she also paid $100 [overlapping conversation]?

CATHY WARNER:  Yes, a hundred dollars, and that’s the fee for an ultrasound.

TARA DICKERSON:  Okay.  And then what, she came back?

CATHY WARNER:  Right.  Now if a patient, um, pays for an ultrasound, some cases they’re either too early, sometimes they change their mind, they want to think about it, and then they come back.  So - -

TARA DICKERSON:  Okay.  So she came back on 2/10/09, correct?

CATHY WARNER:  Right.  And she paid the difference for the total procedure.

TARA DICKERSON:  And on that day, she actually had the procedure, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  But she is not a Medicaid member, correct?

CATHY WARNER:  No, she’s not.

TARA DICKERSON:  Okay.  Okay, let’s look at one more, EE. 

DR. MALLOY:  You said EE or BE?

TARA DICKERSON:  EE.  Now with regard to this member, what date – Medicaid member; I know you said [indistinct] – what date did she come in?

CATHY WARNER:  2/3/09.

TARA DICKERSON:  And what was the purpose of her visit at that time?  As indicated on the Patient Information Sheet.

CATHY WARNER:  She wanted an abortion.

TARA DICKERSON:  And the insurance at issue for her was Georgia Medicaid, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  So, in conjunction with that, her fee, as it is for Medicaid abortions, is $250, correct?

CATHY WARNER:  For the abortion, yes.

TARA DICKERSON:  Right.  So when you show this previous balance, that means that she would have to pay this money, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And could you turn to the next and then you actually have just a copy of her Medicaid card showing that she has regular Medicaid?

CATHY WARNER:  Okay.

TARA DICKERSON:  And then the next page, what date is on that – the Pregnancy Verification Form?

CATHY WARNER:  2/3/09.

TARA DICKERSON:  And what tests were done at that time?

CATHY WARNER:  An, uh, urinalysis, hematocrit, pregnancy test, ultrasound.

TARA DICKERSON:  And, at this time, she’s indicated she’s going to terminate the pregnancy, right?

CATHY WARNER:  Yes.

TARA DICKERSON:  Which is consistent with her purpose for the actual visit?

CATHY WARNER:  Yes.

TARA DICKERSON:  Right?  Okay.  Which was – and then you actually show the actual ultrasound on the

next page?

CATHY WARNER:  Yes.

TARA DICKERSON:  That was taken on 2/3/09 as well, correct?

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  And, if you turn to the next page, that’s just the actual procedure that was done, documenting that, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  And then you have the actual follow-up notation again which was also 2/3/09, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  So with regard to the normal procedure in your office, when you come into the office, would you say that the Patient Information Sheet is completed, all the other paperwork is completed, tests are done, if they want to terminate the pregnancy, they do it at the same – on the same date?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  And with regard to your practice, what is it – how do you – do you cut Medicaid patients a discount?  Is there some special rate for them?

CATHY WARNER:  Yes, it is.

TARA DICKERSON:  And what would that be?

CATHY WARNER:  Um, the 250.

TARA DICKERSON:  And what’s the normal cost if I’m not on Medicaid or if I don’t have any insurance; I’m just gonna pay you out of my pocket?

CATHY WARNER:  It’s 390 now.

TARA DICKERSON:  It’s 390 now?  Do you know what it was back in 2008, 2009?

CATHY WARNER:  Hmm, probably was 350.

TARA DICKERSON:  Okay.  So with regard to these Medicaid members, when they come in, it’s your testimony that if they’re going to have an abortion, the tests are done at that time – the tests that, those general tests that you just talked about – the procedure is done at that time, they will pay for the procedure themselves by whatever means they are going to pay, and then you all strictly bill Medicaid for these preliminary type tests?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.

CATHY WARNER:  But can I just add something to that?

TARA DICKERSON:  Sure.

CATHY WARNER:  Um, [sighing] when patients call

to make an appointment, whether patients have Medicaid or not – ‘cause some do and some don’t – um, they – they know from just, um, hearsay or seeing ads in the papers and all that it’s a law that it has to be a 24-hour notification.  So say, for instance, if it’s a Medicaid patient that’s coming to us that wants to know if they’re pregnant because either the period is late, um, it’s – they’re having, um problems as far as spotting or whatever, then – and they know that they’re gonna come in and see us and they want to take care of – of this the same day versus coming in and finding out they’re – if they’re pregnant or not from an ultrasound office visit and – and lab work, then they’re gonna go ahead and set the appointment up for a procedure.  That’s what they normally do.  They – they set it up for that and then once they come in and we do what we have to do to confirm the pregnancy and then the doctor sees the patient, then, at that point, they sign the papers to say, yes, they want to do an abortion and then they pay for the abortion part.

TARA DICKERSON:  Right.  And we’re not – we’re not disputing that you all don’t do the proper 24-hour notification; that’s not our issue.  So we recognize that you all are in compliance with that.  I just want you to understand that’s not our issue.

CATHY WARNER:  Okay.  Well, I – I – from the way that, um, you’re asking me questions and all, it – it just seems like, um, that part was kind of left out and ‘cause you’re – you’re telling me that the patients only make an appointment because they want to have this abortion, but it’s not like that all the time and especially when it’s with Medicaid patients.

TARA DICKERSON:  And with regard to what I’m saying to you is, in this case, we’re looking at the fact that they had the procedures, you all sent paperwork to Medicaid to pay for these preliminary procedures - -

CATHY WARNER:  Uh-huh.

TARA DICKERSON:  - - they had the abortion, and the Medicaid member paid for the abortion, correct?

CATHY WARNER:  Yes.  Yes, they did.

TARA DICKERSON:  And this all happened during this – at – like within the one-, two-, three-hour time frame, correct?

CATHY WARNER:  Yes.

TARA DICKERSON:  So this isn’t a situation where, you know, they come in today, like you said, and they want to get a test, they come back a month later?  It’s nothing like that?  Everything is done on the same day, correct?

CATHY WARNER:  Yes, it’s done on the same day.

TARA DICKERSON:  No other questions for her, Your Honor.

JUDGE TEATE:  All right.  Cross-examination?

DR. MALLOY:  Um, yes.  [Indistinct] good morning, Ms. Warner.

CATHY WARNER:  Morning.

DR. MALLOY:  [Indistinct; pages rustling in background throughout cross] I – I’ll make that cross brief.  [Clearing throat]  And I – and I – you’re actually less nervous than me, which is [chuckling] is good.  Um, I’m – I’m not gonna go through each and every one of the, um, um, patients that has been mention, but I do want to bring, uh, draw attention to, um, on it was Exhibit R-BE.  Um, I’m sorry.  I’m sorry.  [Indistinct]  Yes, R-BD.  Um, and it – it, on R-BD, um, if you, on the very first page is patient information.

CATHY WARNER:  Yes.

DR. MALLOY:  Um, and it says, um, purpose of visit, um, and it says – could you please read what it says there?

CATHY WARNER:  To get a termination or proc – of pregnancy.

DR. MALLOY:  Oh, okay.  Now let’s go to the next

page and, on the next page, which is the Pregnancy Verification Form, um, what did this particular patient decide to do?

CATHY WARNER:  Continue the pregnancy.

DR. MALLOY:  Okay.  Um, so am I correct when I ask you whether a patient puts on here to get a pregnancy termination, that it doesn’t always mean that they will definitely have a pregnancy termination?

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  And – and you made a comment about 24 hours, um, that, um, the law – the Woman’s(sic) Right to Know Act - -

CATHY WARNER:  Uh-huh.

DR. MALLOY:  - -um, states that they have to notify a facility, uh, at least 24 hours in advance and there are certain, uh, questions that have to be addressed, um, before they can undergo a pregnancy termination?

CATHY WARNER:  Yes.

DR. MALLOY:  So some of the patients are well aware of that ‘cause that is the law - -

CATHY WARNER:  Right.

DR. MALLOY:  - - um, whether it’s at our facility or any other facility, so if indeed they’re coming in to find out if they’re pregnant, is it correct in a – is it correct in that they will put down that they’re going to have an abortion if they find out that they are pregnant?

CATHY WARNER:  Yes.

DR. MALLOY:  But it also doesn’t mean that every one of them will definitely have an abortion?

CATHY WARNER:  Right, yes.

DR. MALLOY:  And – and is it also correct – and let – let me just keep going.  Um, now Ms.-Ms.-Ms. Dickerson, um, asked you and you made – you may want to correct [indistinct] ask you to correct so I can understand, when they come in for the lab work, uh, is the lab work in preliminary to the abortion or the lab work to confirm indeed the gestation of the pregnancy?

CATHY WARNER:  [Indistinct]

DR. MALLOY:  Um, I – I’ll – I’ll repeat that.  When they come in to have lab work done, is that lab work to confirm and date the pregnancy?

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  So – because some of them, if I’m correct, don’t know for sure that they are pregnant?

CATHY WARNER:  Yes.

DR. MALLOY:  All right.  Some of them have no

clue as to how far along they are?

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  So it’s not that they’re coming in for that lab work to have an abortion, okay?  Am I – so instead they’re coming in to have that lab work to find out if they are pregnant and how far along they are?

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  All right.  So need to get that clear.  Um, let’s see.  Now let’s go to – let’s – and they’re all about the same, but, um, let’s go to, uh, Exhibit R-AA and let’s go to after the ultrasound page, you see this Patient Identification?  Um, it says on the very top, it says, Doctors Only.

CATHY WARNER:  Yes.

DR. MALLOY:  And it says, Patient

Notification.  This is the – correct me if I’m wrong – this is a physical exam page, um, of the medical records?

CATHY WARNER:  Yes.

DR. MALLOY:  Is that correct?  Okay.  So this is what the doctor fills out?

CATHY WARNER:  Yes.

DR. MALLOY:  Is that correct?

CATHY WARNER:  Yes.

DR. MALLOY:  And at the bottom is the doctor’s diagnosis, is that correct?

CATHY WARNER:  Yes.

DR. MALLOY:  And what the treatment plan may be after the physician has done the physical and has had an opportunity to speak with the patient?

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  So this is – this is – this is, um, done, um, before, am I correct?  This is done be - -

CATHY WARNER:  Yes.

DR. MALLOY:  Okay.  So this is not a – this is not like a, some people call it operative report?

CATHY WARNER:  No.

DR. MALLOY:  This is just – okay.  So I just wanted to verify that.  Okay.  Um, let’s see.  Now one more important, um, Ms. Warner, could you – let’s – let’s – let’s stay with R-AA.  Let’s – well, we can to go R – well, let’s go to R-AA again, uh, and let’s go to the page that says, Old National GYN Pregnancy Verification Form.  Um, it’s, um - -

CATHY WARNER:  Okay.

DR. MALLOY:  - - you have it?  Okay.  Could you make – I want to make sure I understand, um, the first paragraph - -

CATHY WARNER:  Uh-huh?

DR. MALLOY:  - - okay?  Could you just read out loud the first sentence of the first paragraph?

CATHY WARNER:  The above-named patient presented herself at Old National GYN with a diagnosis of amenorrhea.

DR. MALLOY:  And could you read the second sentence, please?

CATHY WARNER:  She is desirous of knowing whether she is actually pregnant and, if so, how far along.  She reali [overlapping conversation].

DR. MALLOY:  And – oh, I’m sorry.

CATHY WARNER:  I’m sorry.

DR. MALLOY:  Go on to the third.

CATHY WARNER:  She realizes that there are several options available to her if, indeed, she is pregnant.

DR. MALLOY:  Okay.  So even though the patient has on the Patient Information Form that she is here for an abortion, she is actually here because she hasn’t [overlapping conversation].

TARA DICKERSON:  Objection, Your Honor, speculation.

DR. MALLOY:  Okay.

JUDGE TEATE:  Sustained.

DR. MALLOY:  I’m sorry.  Cathy, what does amenorrhea mean?

CATHY WARNER:  Delayed menses.

DR. MALLOY:  Okay.  Okay.  So when the patient comes in and this verification form, she is coming in with a diagnosis of delayed menses?

CATHY WARNER:  Uh-huh, yes.

DR. MALLOY:  Okay.  All right, all right.  But, as – as you’ve already stated, let me just make sure I understand, the Woman’s(sic) Right to Know Act requires that if they’re going to have a pregnancy termination, this has to be stated, there is a whole form that they have to sign and read stating that they are indeed have been given 24-hours notice and – to have an abortion?

CATHY WARNER:  Yes.

TARA DICKERSON:  [Indistinct]

DR. MALLOY:  Cathy, those are all my – my questions [indistinct].

JUDGE TEATE:  Anything on redirect?

TARA DICKERSON:  With regard to the patient coming into the office, the first form that they get is the Patient Information Form, correct?  That’s what you give them?

CATHY WARNER:  Um, no, not when they first come.

TARA DICKERSON:  What do you give them?

CATHY WARNER:  The – the Women’s Right to Know Form.

TARA DICKERSON:  And then what do you give them after that?

CATHY WARNER:  Give them their chart that has, um, all forms in there.

TARA DICKERSON:  So you have a packet of forms that you give them?

CATHY WARNER:  Yes.

TARA DICKERSON:  Okay.  And with regard to the Patient Information, where – what – what page is that in your packet?

CATHY WARNER:  The first page.

TARA DICKERSON:  Correct.  And with regard to the purpose of the visit, if the person puts on there the purpose of their visit is an abortion - -

CATHY WARNER:  Uh-huh?

TARA DICKERSON:  - - you still have to do those tests, correct, the ultrasound?  You just can’t take their word that they’re pregnant and then do an abortion, correct?

CATHY WARNER:  Yes, correct.

TARA DICKERSON:  No other questions.

JUDGE TEATE:  Anything in re-cross, sir?

DR. MALLOY:  No.

JUDGE TEATE:  All right, you can step down, ma’am.

CATHY WARNER:  Thank you.  Can I go out?

JUDGE TEATE:  Um, will she be needed further?

TARA DICKERSON:  I mean, he may need her.  I won’t.

DR. MALLOY:  I – I [indistinct].

JUDGE TEATE:  You’re gonna need her further? 

CATHY WARNER:  Okay.

JUDGE TEATE:  If you’ll just go out back [indistinct]?

CATHY WARNER:  Do you need these forms, ma’am?

TARA DICKERSON:  Yes, I’ll [indistinct] back, thank you.

JUDGE TEATE:  Ms. Dickerson, if you want to get your next witness?

TARA DICKERSON:  [Indistinct]

[Indistinct conversation in background]

TARA DICKERSON:  Okay, but you – yeah [indistinct].  And this is just the first section?

SPEAKER:  Uh-huh.

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