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.


Your comment will be posted after it is approved.

Leave a Reply