Law Project for Psychiatric Rights: PsychRights

United States and the State of Wisconsin ex rel. Dr. Toby Watson v. Jennifer King-Vassel
Case No. 12-3671, UNited States Court of Appeals for the Seventh Circuit
Case No. 2:11-cv-00236-JPS, United States District Court for the Eastern District of Wisconsin

See, PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth for Background. 

On October 23, 2012, the trial court issued an Order dismissing the case on the grounds that the relator (plaintiff on behalf of the government) needed an expert to (a) explain the mysterious black-box like mechanism whereby a prescription written for a Medicaid patient ends up being paid by Medicaid, and (b) what constitutes a medically accepted indication.  However, the court ruled in the relator's favor that he qualified for whistleblower status, which is directly the opposite of what happened in the Alaska case, United States ex rel Law Project for Psychiatric Rights v. Matsutani, et al.  The dismissal was appealed. James B. (Jim) Gottstein of PsychRights handled the appeal. 

  On August, 28, 2013, the United States Court of Appeals for the Seventh Circut (7th Circuit) issued its Opinion, reversing the trial court's dismissal.  In doing so, the 7th Circuit held (a) off-label prescriptions that do not have "support" in one of three drug references known as "compendia," (not a "medically accepted indication") submitted to Medicaid for payment are (generally) false claims, and (b) doctors knowingly cause the false claims by writing such prescriptions if they know the patient is a Medicaid recipient (unless they come forward with evidence to the contrary).   In other words, the 7th Circuit confirmed that doctors writing prescriptions for use in children and youth that are not for a medically accepted are liable under the False Claims Act.  This essentially confirms that doctors writing such prescriptions are wittingly or unwittingly participating in the Fraudulent Scheme depicted below at Step 2.

The Fraudulent Scheme

 

 

The trial in ex rel Watson v. King-Vassel was then scheduled to begin December 9, 2013.  However, at the December 3, 2013, Pretrial Conference, the judge threatened Dr. Watson with a substantial award of attorneys' fees against him if he went forward and he decided to dismiss the case.  Below is Dr. Watson's Statement regarding his decision to dismiss the case in the face of this threat.

 


Court Documents

Appeal

District Court


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3/7/2014

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