PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth Model Medicaid Fraud Complaint-Qui Tam Lawsuit

Please go to the web-site at the bottom of this post and file your complaint's!

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Law Project for
Psychiatric Rights

PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth
Model Medicaid Fraud Complaint


Summary
Analysis
Medicaid
False Claims Act

Model Qui Tam Complaint

Links

Utah Attorney General Correspondence

Current Cases

Current Cases

United States ex rel Law Project for Psychiatric Rights v. Matsutani, et al.
United States ex rel Griffin v. Martino, Family Centered Services & Safeway
Summary

The massive psychiatric drugging of America's children, particularly poor, disadvantaged children & youth through Medicaid and in foster care is an unfolding public health catastrophe of massive proportions. This catastrophe is being caused by the fraudulent promotion of these harmful practices by pharmaceutical companies sacrificing children and youth's health, futures and lives on the altar of corporate profits. In 2009, Eli Lilly agreed to pay $1.4 Billion in criminal and civil penalties for such off-label promotion of Zyprexa and Pfizer agreed to pay $2.3 Billion for the illegal off-label promotion of Geodon and other drugs. In May of 2010, Astra-Zeneca agreed to pay $520 million for the illegal off-label promotion of Seroquel for use in children. However, despite these large penalties by the drug companies, the practice has not stopped. It is merely a cost of doing business to these pharmaceutical Goliaths and, in fact, caps their liability for these crimes. Most importantly, these settlements have not stopped the practice of child psychiatrists and other prescribers giving these drugs to children and youth and Medicaid continuing to pay for these fraudulent claims.

PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth is designed to address this problem by having lawsuits brought against the doctors prescribing these harmful, ineffective drugs, their employers, and the pharmacies filling these prescriptions and submitting them to Medicaid for reimbursement. Once one sues over specific offending prescriptions, all of such prescriptions can be brought in, which means that any psychiatrist on the losing end of such a lawsuit will almost certainly be bankrupted, because each offending prescription carries a penalty of between $5,500 and $11,000. This is why it is expected that once this financial exposure becomes known to the prescribers they will quit the practice. Each prescriber may have a million dollars or few, at most, to lose, but the pharmacies' financial exposure can run into the hundreds of millions of dollars and it is hoped this will attract attorneys to take these cases. Anyone with knowledge of specific offending prescriptions can sue on behalf of the government to recover for such Medicaid Fraud, and receive a percentage of the recovery, if any.

Of course, it can be expected that the defendants will vigorously contest everything, and there are no guarantees of success. However, PsychRights believes what is presented here is accurate. PsychRights has published a PowerPoint Presentation that goes through the requirements and identifies the major issues.

The Model Qui Tam Complaint PsychRights has put together is set up for former foster youth to sue the doctors who prescribed the drugs to them, their employers, and the pharmacy(ies) submitting the false claims, but it can be easily modified for anyone else to file such a complaint, such as parents, teachers, therapists, etc. PsychRights stands ready to to help people interested in bringing such suits and interested people can e-mail us, or call at (907) 274-7686, or write to 406 G Street, Suite 206, Anchorage, AK 99501.

Analysis

Medicaid

In 42 USC 1396R-8(k)(3), as relevant here, Congress prohibited reimbursement under Medicaid for any outpatient drugs "used for a medical indication which is not a medically accepted indication." 42 USC 1396R-8(k)(6) then defines "medically accepted indication" as follows:

The term “medically accepted indication” means any use for a covered outpatient drug which is approved under the Federal Food, Drug, and Cosmetic Act [21 U.S.C.A. § 301 et seq.], or the use of which is supported by one or more citations included or approved for inclusion in any of the compendia described in subsection (g)(1)(B)(i) of this section.

42 USC 1396R-8(g)(1)(B)(i), in turn, designates the Compendia as:

(I) American Hospital Formulary Service Drug Information;
(II) United States Pharmacopeia-Drug Information (or its successor publications); and
(III) the DRUGDEX Information System
An indication not approved by the FDA is often referred to as "off-label." Congress didn't prohibit reimbursement by Medicaid for all off-label prescriptions, but specifically limited reimbursement for off-label prescriptions to those that have sufficient scientific "support," as documented in one of the Compendia. A couple of illustrations: Geodon is not (yet) approved for any use in children and not supported by any citation in any of the Compendia. Thus, any Geodon prescriptions to children and youth submitted to Medicaid constitute fraud. Similarly, I have seen neuroleptics such as Abilify, Risperdal, Seroquel, & Zyprexa, prescribed for "Oppositional Defiant Disorder," and even for sleep. Such prescriptions are not for "medically accepted indications," and thus automatically constitute Medicaid Fraud.

There are a a lot of technical requirements that must be met, such as the lawsuit must be based on "non-public" information, which in this case is satisfied by having knowledge of offending prescriptions and the cases must initially be filed under seal (in secret).

False Claims Act

Under the False Claims Act:

It is a False Claim to knowingly (A) present, or cause to be presented, a false or fraudulent claim for payment or approval, or (B) make, use, or cause to be made or used, a false record or statement material to a false or fraudulent claim to the Federal Government. 31 USC §3729(a)(1)

"Knowingly" is defined as (i) actual knowledge; (ii) deliberate ignorance of the truth or falsity; or (iii) reckless disregard of the truth or falsity, and no proof of intent to defraud is required. 31 U.S.C. §3729(b)(1)(a)
Every Medicaid provider is presumed to know what Medicaid's billing and coverage policies require. Heckler v. Community Health Services, 467 U.S. 51, 63-64 (1984).
Claims of ignorance are an untenable bases for the doctor's failure to live up to his duty to familiarize himself with the Medicaid requirements and observe his legal duty to submit truthful claims. United States v. Nazon, 940 F.2d 255, 259 (7th Cir. 1991).
"The applicant for public funds has a duty to read the regulations or be otherwise informed of the basic requirements of eligibility." Coop. Grain, 476 F.2d 47, 55-60.
Links

Video: Robert Whitaker, Psychotropic Drugs and Children, June 15, 2010.
PowerPoint Presentation: PsychRights' Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth.
Medically Accepted Indications Chart
CriticalThinkRx Curriculum
Report on Mental Health Services and Foster Care, by Facing Foster Care in Alaska.
PsychRights Launches Campaign Against Medicaid Fraud With Model Lawsuit, July 27, 2009.
Model Qui Tam Complaint
Microsoft Word Version
Massive Medicaid Fraud Exposed: PsychRights Calls on Members of Congress for Assistance, May 5, 2009.
Letter to Senator Charles Grassly
Letter to Senator Herb Kohl
Letter to Congressman Henry Waxman
Letter to Congressman Bart Stupak
Letter to Congressman John Dingell
Letter to Congressman Barney Frank
Utah Attorney General's Office Correspondence

October 22, 2007, letter from Utah Assistant Attorney General David Stallard to the Centers for Medicare & Medicaid Services (Medicaid)
December 6, 2007, response from Medicaid to Utah Assistant Attorney General David Stallard
December 17, 2007, follow-up letter from Utah Assistant Attorney General David Stallard to Medicaid
January 30, response from Medicaid to Utah Assistant Attorney General David Stallard
Last modified 7/11/2010
Copyright © 2009 -- 2010 Law Project for Psychiatric Rights. All Rights Reserved

http://psychrights.org/Education/ModelQuiTam/ModelQuiTam.htm

Foster carer caught on film attacking toddler-Don't you love how CPS protects our Children?

Foster carer caught on film attacking toddler
Mike Keegan
July 25, 2010


Glynis Liley was filmed attacking a toddler
A foster parent was caught on film kicking and force-feeding a toddler.

Glynis Liley was arrested after neighbours, appalled by her cruelty, set up a camcorder outside her home to catch her in the act.

They filmed her kicking the tot while it was on the floor and brutally force-feeding the child at her home in Heywood.

But despite pleading guilty to two charges of child cruelty, Liley was only handed a community sentence at Bolton Crown Court after a judge heard she was awaiting an operation and had been taking morphine and sleeping pills when she carried out the attacks.

The 48-year-old, who was working for Rochdale council at the time, was arrested after neighbours on Wilson Avenue showed police footage they had taken over two days through the house windows. Officers were so appalled at the clips that they went straight to Liley’s house to arrest her.

Gary Woodhall, prosecuting, said neighbour Damian Cosgrove decided to act after spotting Liley through the window hitting the child in the face with a mobile phone.

Mr Cosgrove said he also saw Liley make the child stand in one spot in the middle of the floor. When he returned to the street over an hour and a half later he noticed the child was still stood silently in the same spot, the court heard.

After Liley’s arrest, the child was examined by a doctor and found with bruising to its forehead, cheeks, knee and thigh and scratches on its neck – which indicated it had been ‘handled roughly’ said Mr Woodhall.

Liley repeatedly denied the offences, but changed her plea shortly before a trial was due to take place.

Katherine Pierpoint, defending, said Liley was ‘deeply ashamed’ of her behaviour.

Sentencing Liley, who had been a foster carer for 11 years, Judge Charles Bloom QC said: "This child was in desperate need of your warmth, your cherishing, your loving. You failed it. I accept that you are thoroughly ashamed of yourself and this was not sadism but impatience."

Liley will never be allowed to foster children again.

On her way out of court, Liley stopped to hurl abuse at Mr Cosgrove, 40, and his wife.

Det Con Alicia Smith, of Rochdale’s public protection unit, said: "Liley was in a position of trust, a position she clearly abused. Her rough and reckless approach to childcare was far too aggressive, and completely unacceptable"

http://menmedia.co.uk/manchestereveningnews/news/s/1305600_foster_carer_caught_on_film_attacking_toddler?rss=yes

Grandparents rights and custody

Grandparents rights and custody

Jul 26th, 2010 | By neil | Category: grandparents rights
Some grandparents may be surprised to know that they can actually be awarded legal custody of their grandchildren, but that does happen in some cases. Usually you see this situation in the event that neither of a child’s parents can provide them a safe and adequate home.

Many grandparents know that after the Troxell Supreme Court decision in 2000 grandparents suffered a set-back in regards to what their grandparents rights were. However, this decision did not eliminate the idea of grandparents rights or custody at all. It simply meant that in cases of custody grandparents can only be awarded their rights when neither parent can present anything like a decent home.

This can occur when there are legitimate concerns about safety due to known instances of drug use or child abuse or extreme poverty. It can also occur after the death of a child’s parent(s) or if a parent has to go to jail.

It is important to remember that in any case a grandparent has the responsibility in these situations to identify themselves as a potential custodial parent and to go to the courts and follow up on this to obtain their proper grandparents rights. In some situations, parents might concede to a grandparents wishes for custody, but those situations may also need to be taken to the courts.

If grandparents can prove to the courts that their home offers adequate resources for raising a child then they will be strongly considered. Overall, grandparent custody is a generally preferred alternative in most every state to foster care.

The bottom line is that grandparents do still have rights and do receive consideration when it comes to custody and their grandchildren. The courts do recognize them as an integral part of the family support system. The key however is for grandparent’s to make their wishes known and get involved with custody process.

The Custody Center is a wonderful, updated resource for finding out just how and when to exercise your grandparent rights regarding custody.

NEIL

http://www.caringgrandparents.com/grandparents-rights/grandparents-rights-and-custody

Crews searching for 2-year-old pre-adopted boy who went missing from northern AZ campground

Crews searching for 2-year-old boy who went missing from northern AZ campground

2-year-old goes missing from campground


Posted: 07/25/2010
Last Updated: 5 hours and 38 minutes ago

By: Katie Fisher
RIMROCK, AZ - Search and rescue crews looking for a 2-year-old boy who vanished from a northern Arizona campground early Sunday are delving deeper into the mystery of his disappearance.

Yavapai County Sheriff's Office spokesman Dwight D'Evelyn said Syler Newton was last seen around midnight inside a tent while sleeping with family members. The family was reportedly camping at the Beaver Creek Campground southeast of Highway 179 off Interstate 17.

According to D'Evelyn, around 1:45 a.m. the family discovered Syler was missing from his sleeping bag. Family members reportedly searched the area before calling 911 for assistance.

Officials said the woman who reported Syler missing claimed to be the boy’s mother, but it was later discovered she is his adoptive mother and is currently in the process of gaining custody.

Deputies do not believe any of Syler’s biological relatives were in the area at the time of his disappearance, but authorities are trying to contact the boy’s biological family. Officials said there are no signs of foul play.

D'Evelyn said more than 50 personnel have responded to the scene as part of the coordinated search effort. A DPS helicopter was also called in on Sunday to do flyovers in the surrounding area.

Syler is described as a white male, with light brown hair, blue eyes, approximately 3 feet tall and weighing about 20 pounds. He was wearing only a diaper when he disappeared from the campground.

Anyone with information is asked to contact the Sheriff's Office immediately via 911 or 928-771-3260.

http://www.abc15.com/dpp/news/region_northern_az/other/crews-searching-for-2-year-old-boy-who-went-missing-from-northern-az-campground

PEOPLE CALLING FOR 400 US JUDGES TO BE ARRESTED FOR CORRUPTION-Any NH Judge's included?

US citizens who, like UK Citizens, are suffering from an avalanche of injustice are calling for the judges to be arrested. Judges has recently jailed the one man Richard Fines who stood against them and the People of California are calling for him to be freed. http://edition.cnn.com/2010/CRIME/05/24/jailed.lawyer.richard.fine/index.htmlThe people are saying change is Coming. Judges on both sides of the Atlantic are helping Social Services and Police to steal children, they are helping Police and Crown Prosecution Services to steal people's money under the Proceeds of Crime Act. The corruption is spreading throughout the USA and UK and people who grew up in a Democratic Society are rebelling,Activist say "it is time Governments woke up to the serious and pernicious levels of corruption within the Judiciary, the Police, the Prosecuting Authorities and the Social Services. The target and the bonus culture together with plain corruption has seen an unprecedented escalation in injustice, Conversely they are using laws , such as the money laundering laws, to steal money and benefit personally from assets they claim to be money laundering or simply to jail anyone who might expose them""Society , families and western culture is under threat from the growing power of the executive against the people" The USA protesters have started a face book group to free Richard Fine http://www.facebook.com/?sk=events#!/event.php?eid=125897030788335

http://www.allvoices.com/contributed-news/6382453-people-calling-for-400-us-judges-to-be-arrested-for-corruption

Baby LK Report For July 25th 2010

http://www.youtube.com/watch?v=F4b0ECEXSRk

Boy hanged self after visit from LA County workers

Boy hanged self after visit from LA County workers

The Associated Press
Posted: 07/25/2010 11:08:47 AM PDT
Updated: 07/25/2010 03:20:15 PM PDT

LOS ANGELES—Los Angeles County mental health and child abuse investigators looking into an 11-year-old boy's suicide threat said they didn't learn key information about an abusive stepfather who answered the door at his house until after the boy hanged himself, according to a report published Sunday.
The Department of Children and Family Services workers lacked key information on the boy because of communication difficulties at the agency, The Los Angeles Times reported.
On June 11, the workers visited the boy's home in Montebello after he told a school counselor he wanted to kill himself. Los Angeles County records show he hanged himself later that day and died the next day at Long Beach Memorial Medical Center.
The workers did not learn until after the suicide that the stepfather who answered the door had a history of drug abuse and domestic violence and that a court had barred him from living in the home. That information could have prompted officials to remove the boy from the home.
County workers had noted disheveled conditions, drugs, neglect and violence in the houses the boy had lived in since he was a baby. But the social worker who visited him with police officers did not have all of that information.
"This was a very difficult case, and we're still trying to determine what happened," Supervisor Gloria Molina said.
The death is among several recent incidents that underscore communication problems that have plagued
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the department due to lack of funding, unused technology and legal limitations.
The department in 2007 bought 2,400 tablet computers that would have made the information available to the workers by giving them access to the department's entire database, but only 400 wireless cards to make the devices work.
Most of the tablets gather dust desks while workers use only their cell phones to connect with the office.
The county has worked to expand a database where different agencies can share information like the boy's complete history, but efforts have stalled as state legislators attempt to ease restrictions on what information can be shared.
On the day he hanged himself, the fifth-grader had spent the morning at school crying, telling the school counselor life was "unbearable." He said classmates bullied him and his mother hit him while his stepfather held him down, county records showed.
The boy said he wanted to kill himself "because I'm tired of people hitting me all the time," the records said.
The school counselor called the county Department of Mental Health and filed a child abuse report with the Department of Children and Family Services. He warned that the boy had threatened to shoot himself, and in the past had threatened to hang himself with a rope. The social worker who visited the home later that day was told of the gun warning and looked for one, but did not look for a rope.
When the social worker asked about the last time his mother struck him, the boy shrugged his shoulders, and said "no" when asked if he feared her. Records showed that the mother seemed concerned for the boy's welfare that day, and authorities thought it was safe to leave the boy in the home.
The social worker also did not know that the stepfather had been limited to visits to the house, and did not look into whether he was living there.
The mother and other family members declined comment when contacted by the Times.
As his family gathered to watch the Lakers play in the NBA finals, the boy slipped into his mother's bedroom and closed the door, county records showed.
When his mother went to call the boy for dinner, the stepfather heard a scream, and he walked into the room and found her holding the boy's limp body in her arms.
After hours on life support, the boy died at the hospital the next day.
———
Information from: Los Angeles Times, http://www.latimes.com

http://www.mercurynews.com/news/ci_15599460?nclick_check=1