A whistleblower has accused the New York City Department of Education of submitting false claims to Medicaid, and the U.S. Attorney has agreed to pursue the case. If the case results in money being returned to Medicaid, the whistleblower will be entitled to a reward. The federal government's lawsuit alleges that the New York City Department of Education submitted false claims to Medicaid for psychological counseling services to special education students in the New York City public schools. Medicaid pays the Department of Education a flat fee of $223 for each student who receives at least two psychological counseling sessions in a month. However, Medicaid pays nothing if an individual student receives fewer than two counseling sessions in a month. The complaint alleges that the Department of Education knowingly billed Medicaid for counseling services to students even though it provided fewer than two counseling sessions per month to individual students. In one instance, the Department of Education requested reimbursement from Medicaid for psychological counseling provided to a student for 15 months during the 2001-02 and 2002-03 school years, even though the Department's own records indicated that the student received fewer than two counseling sessions in 12 of those months. The lawsuit seeks treble damages, penalties and costs from the Department of Education in an amount believed to exceed $2 million. The whistleblower who alerted the government will be entitled to a reward of between 15% and 25% of the amount the federal government recovers under the qui tam provisions of the False Claims Act. If you are aware of a government entity or private business that is submitting false claims to Medicaid or Medicare, then you should consult with an experienced health care lawyer immediately. To schedule a free and confidential consultation by telephone or in person, call my office today at (917) 652-6504 or click here to communicate with me via email. John Howley New York, New York The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.
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A whistleblower has earned a $17 million reward for bringing a qui tam action against Boehringer Ingelheim Pharmaceuticals Inc. under the federal False Claims Act. The lawsuit was commenced by Robert Heiden, a former sales representative for Boehringer. He alleged that his former employer improperly promoted several drugs for indications that were not FDA approved, made unsubstantiated claims about the efficacy of one of the drugs, and paid kickbacks to health care professionals to induce them to prescribe the drugs. Under the False Claims Act, an individual whistleblower, called a relator, may commence such a lawsuit on behalf of the U.S. Government. The case is initially filed under seal (i.e., in secret) to give the local U.S. Attorney an opportunity to review the allegations and the relator's evidence. After such a review, the Government may decide to intervene in the case or to allow the relator to pursue the case on its behalf. In this case, the U.S. Government decided to intervene in the action, which resulted in settlement negotiations and ultimately an agreement by Boehringer to pay $95 million to resolve the allegations. The whistleblower, or qui tam, provisions of the False Claims Act provide that the relator who commenced the action is entitled to a percentage of that recovery. In this case, the relator will be paid more than $17 million. The drugs at issue in the lawsuit were the stroke-prevention drug Aggrenox, the chronic obstructive pulmonary disease (COPD) drugs Atrovent and Combivent, and the hypertension drug Micardis. The U.S. Department of Justice Press Release announcing the settlement is available here. If you have information that a pharmaceutical company is paying kickbacks or promoting its drugs for off-label uses, then you should consult with an experienced lawyer immediately. To schedule a free and confidential consultation by telephone or in person, call my office today at (917) 652-6504 or click here to communicate with me via email. John Howley New York, New York The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.
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John Howley, Esq.
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