PsychRights^®
                   Law Project for
              Psychiatric Rights

Update: Big PsychRights Medicaid Fraud Case

May 11, 2010
 

On January 25, 2010, the United States District Court for Alaska unsealed PsychRights' big Medicaid Fraud case, PsychRights v. Matsutani et al.,  against child psychiatrist Osamu Matsutani, other psychiatrists, mental health agencies, pharmacies, and state officials.   The basis of the case is that it is Medicaid Fraud for psychiatrists to write "off-label" prescriptions for psychiatric drugs for use in children and youth to be billed to Medicaid unless it is "supported" by scientific evidence as cited in specified references.  It is also Medicaid Fraud for the other types of defendants to go along with the fraudulent claims being submitted to Medicaid.  This is a pre-cursor case to PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth, in which we developed a Model Complaint for use by attorneys around the country.  This is PsychRights' strategy to stop, or at least reduce, the massive, harmful, psychiatric drugging of America's children and youth.  Each offending prescription carries a minimum penalty of $5,500 and since most psychiatrists have written thousands of such prescriptions, they face financial ruin if they become a defendant in one of these suits.   Making psychiatrists (and other prescribers) realize this is the cornerstone of the effort because it is our expectation that once they realize they face financial ruin by continuing the practice, they will stop. 

 

The lawsuit has been brought under the Federal False Claims Act, also known as Qui Tam, or "whistleblower," lawsuits because anyone with "non-public" knowledge, such as offending prescriptions, can bring such a case and share in the recovery if any.  There is comprehensive information on this at  PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth.    

 

There are a lot of technicalities to these lawsuits and, as expected, the defendants filed a number of motions to have the case dismissed (thrown out of court).  Our responses were due yesterday and the motions and responses, plus the First Amended Complaint, can be downloaded from the Internet:

 

Complaint Versions

• Complaint,
• First Amended Complaint

 

Motion That PsychRights Should Be Thrown Out of Court Because Medicaid Doesn't Restricts Drug Coverage As PsychRights Says

• Motion to Dismiss for Failure to State a Claim Upon Which Relief May be Granted (Rule 12(b)(6))
  • Request by Providence, Matsutani, Anchorage Community Mental Health Services, Curtiss and Clark Asking the Court to Not Decide Whether What they are Doing is Medicaid Fraud
• Opposition to Motion to Dismiss for Failure to State a Claim May be Granted (Rule 12(b)(6))

 

Motion That PsychRights Should Be Thrown Out of Court Because the Complaint is Not Specific Enough

• Rule 9(b)Motion to Dismiss by All Defendants ("particularity")
• Opposition to Rule 9(b)Motion to Dismiss by All Defendants ("particularity")

 

Motion That PsychRights Should Be Thrown Out of Court Because Everyone Already Knows All This Medicaid Fraud Is Going On

• Motion to Dismiss Under Public Disclosure Jurisdictional Bar (with exhibits)  (8 Megabytes)
  • Motion to Dismiss Under Public Disclosure Bar without Exhibits.
• Opposition to Motion to Dismiss Under Public Disclosure Jurisdictional Bar

 

Motion That PsychRights Case Against State of Alaska Officials Should Be Thrown Out of Court Because They Can Commit Medicaid Fraud With Impunity

• Motion to Dismiss by Defendants Hogan, Sandoval, McComb & Streur (Alaska State Officials)
• Opposition to Motion to Dismiss by Defendants Hogan, Sandoval, McComb & Streur (Alaska State Officials)