Showing posts with label Jim Gottstein. Show all posts
Showing posts with label Jim Gottstein. Show all posts

Sunday, October 3, 2010

Alaska Supreme Court Affirms Dismissal of PsychRights v. Alaska

Told you so!



On October 1, 2010, the Alaska Supreme Court affirmed the dismissal of Law Project for 
Psychiatric Rights v. State of Alaska, on the grounds that it lacked standing to bring the lawsuit seeking to stop the state from psychiatrically drugging children and youth unless and until:  
(i) evidence-based psychosocial interventions have been exhausted,  
(ii)  rationally anticipated benefits of psychotropic drug treatment outweigh the risks,  
(iii)  the person or entity authorizing administration of the drug(s) is fully informed, and  
(iv) close monitoring of, and appropriate means of responding to, treatment emergent 
effects are in place. 


Jim Gottstein, President of PsychRights, said, "We are disappointed but will continue our efforts to stop, or even just reduce, the harm to children and youth through inappropriate government subsidized psychiatric drugging. 

"Government officials have abdicated their responsibility to the children of Alaska and with this decision the Alaska Supreme Court has rejected this particular PsychRights efforts to correct the situation."   

The Supreme Court identified a couple of alternative approaches and PsychRights is reviewing its options. 

Thursday, August 26, 2010

No Pro Se Qui Tam

A person cannot and will not represent anyone but his/her self. A mother cannot represent her children in a court of law. That is why there are Guardian Ad Litum. A person shall not represent the United States in a court of law unless they are an officer of the court, meaning an attorney. You have to be an attorney to represent a party to an action, but first, the United States must agree to be a party.

There are SCOTUS decisions clarifying the pro se litigant in a qui tam action but I have better things to do than to teach law right now.

I would normally upload the filing but it contained so many procedural errors, I did not think it economical.

I highly respect the work of Jim Gottstein PsychRights, but sadly, must forecast the dismissal of the action.

Illinois Medicaid Fraud Case Using PsychRights’ Model Complaint Unsealed

The Law Project for Psychiatric Rights (PsychRights®) announces the unsealing of the first Medicaid Fraud case for prescribing psychiatric drugs to children and youth by someone other than PsychRights using PsychRights’ model Qui Tam Complaint.

United States ex rel Linda Nicholson v. Lilian Spigelman, M.D., Hephzibah Children’s Association, and Sears Pharmacy, was filed in Illinois by attorney S. Randolph Kretchmar as a result of PsychRights’ Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth.

Here is a really nice article why qui tam relators cannot represent the United States.

2nd Circuit Addresses Limits on Qui Tam Actions Under False Claims Act

The 2nd U.S. Circuit Court of Appeals has issued two opinions clarifying the law on qui tam actions under the False Claims Act.

The Circuit first ruled that where the United States is not a party to the action, a notice of appeal must be filed within 30 days after the entry of judgment or it is untimely. That decision came in United States of America, ex rel. Irwin Eisenstein v. City of New York, 06-3329-cv.

Second, the court found in United States of America, ex rel. Mergent Services v. Flaherty, 06-3081-cv., that qui tam actions cannot be brought pro se.

Judges Ralph Winter, Roger Miner and Jose Cabranes decided both cases, with Judge Winter writing for the court.

The False Claims Act allows a private person, called a "relator," to bring an action on behalf of the government where the person has knowledge of false or fraudulent claims to the government. Under the act, relators can recover between 15 percent and 25 percent of any award or settlement amount.

In Eisenstein, Irwin Eisenstein and four other New York City employees brought an action as relators on behalf of the United States, claiming it was unlawful for the city to charge nonresident employees a fee equivalent to municipal income taxes paid by city employees who reside in the city.

They claimed a violation of the False Claims Act, 31 U.S.C. §§3729-3733, which imposes civil liability for anyone who "knowingly presents ... a false or fraudulent claim for payment or approval."

Their theory was that since non-resident employees are able to deduct this fee as an expense on their federal tax returns, their taxable income is lower than it would be otherwise and so the city is depriving the federal government of revenue.

Southern District of New York Judge Deborah A. Batts dismissed the action on March 31, 2006, and rendered final judgment on April 12, 2006. Eisenstein filed notice of appeal on June 5, 2006, 53 days later.

In a civil case, notice of appeal must be filed within 30 days under Federal Rule of Appelate Procedure 4(a)(1)(A). But when the United States is a party to the action, Rule 4(a)(1)(B) allows for any party in the action to take 60 days to file notice of appeal.

"The government played no role in this litigation until filing an amicus brief ordered by the court," Winter said at the Circuit. "Because we conclude that the United States is not a 'party' to this action for the purposes of Fed. R. App. P. 4(a)(1)(A) and (B), we further conclude that Eisenstein's notice of appeal was untimely," and the court was without jurisdiction.

Even though the action was ostensibly brought to vindicate the interests of the federal government, Winter said, "In our view, the United States is not a party for these purposes to a qui tam action when the government fails to intervene or to raise or resist any legal claim."

Eisenstein had argued that the 60-day period should apply because the United States was the "real party in interest" in the case. The court disagreed.

Winter said that, as used in Rule 4(a)(1), "the word 'party' refers to the person participating in the proceedings with control over the litigation."

The court then noted the "underlying intent" of the 60-day rule: to "account for the slow machinery of government when the United States is the party responsible for prosecuting the action."

The holding puts the court at odds with three other circuits: the 5th, 7th and 9th. Only the 10th Circuit views the issue the same way as the 2nd Circuit, describing the involvement of the United States as "tangential or nominal" in United States ex rel. Petrofsky v. Van Cott, 588 F.2d 1327 (1978).

Lewis D. Zirogiannis of Hughes Hubbard & Reed represented Eisenstein. Assistant Corporation Counsel Andrew G. Lipkin represented the city.

PRO SE CLAIM

In the second opinion, John Bal and his company, Mergent Services, claimed Marie Flaherty failed to pay Bal for air-purifying equipment he provided her, but she nonetheless submitted a false receipt for reimbursement of $1,750 to New York state's Individual and Family Grant Program, which is funded in part by the Federal Emergency Management Agency to assist New Yorkers with disaster-related needs following the 9/11 terror attacks.

Southern District of New York Judge Harold Baer dismissed the case, concluding that Bal is not an attorney and was "not qualified to represent the interests of the United States.

The 2nd Circuit agreed, with Winter saying, "The circumstances under which civil litigants may appear without counsel are limited by statute," 28 U.S.C. §1654, which permits parties only to "plead and conduct their own cases personally."

In Machadio v. Apfel, 276 F.3d 103, (2002), the 2nd Circuit held that, under the statute, "an individual who is not licensed as an attorney 'may not appear on another person's behalf in the other's cause.'"

Examples of this rule "abound in our case law," Winter said, including that "a laymen cannot represent a corporation even if the sole shareholder"; a "non-lawyer general partner may not represent the partnership"; and "a layman may not appear pro se on behalf of his minor child."

"These rulings not only are called for by the text of 28 U.S.C. 1654," he said, " ... but also constitute good policy for both litigants and the courts."

The only place a pro se is found in a qui tam action is in the original latin text:

qui tam pro domino rege quam pro se ipso in hac parte sequitur

Sometimes I speculate that these "qui tam" templates is a marketing technique for PsychRights to generate publicity and fees. A person can file these template complaints and then he swoops in for the right amount of money to save the day. I do not know but I have to put it out there because the pro se qui tam template is only good for raising awareness to the fact that Medicaid fraud in child welfare is alive and thriving.

Better legal advice would be to refer an individual to their respective State Legislation and Attorney General Office to file under its False Claims Act. Illinois Whistleblower Reward and Protection Act III. Comp. Stat. $$175/1-178/8.

The mechanisms exist.  Let's use them.

Wednesday, January 27, 2010

In the name of the U.S. and us: stop fraud now

Now that all the excitement in the child welfare reform movement has died down, it's my time to step in.

The Law Project for Psychiatric Rights (PsychRights®) announced the unsealing of a major Medicaid Fraud lawsuit against psychiatrists, their employers, pharmacies, state officials, and a medical education and publishing company for their roles in submitting fraudulent claims to Medicaid.

Great.

So why do I have the authority to analyze Jim Gottstein's actions? Well, because I have been there, done that and bought the rhinestone t-shirt.

Interestingly, Gottstein brought the suit as a corporate individual PsychRights®, but did not clarify the authority of PsychRights® nor its standing to bring forth the action. As a corporate individual, does he meet the criteria as an original source? I doubt it because it was never addressed in the original complaint.

PsychRights®, owned and represented by Gottstein, did not submit any proofs, which, normally, would get him kicked right out when the defendants file their motion to dismiss for failure to state a claim, which the complaint fails.

Just because the case was unsealed does not mean the case will proceed, as we do not know if there were any other filing or pending motions before the court.

The U.S. government failure to intervene in the matter is not a serious issue, as it preserves the right, at any time to intervene. It is best, at times for the government to not intervene, giving the relator, the person who is the whistleblower, grounds for the highest level of percentage of the bounty, being 30%. The more the feds step in and intervene, the lower the percentage ratio.

I am betting the feds did not intervene for possibly two reasons:

(1)PsychRights® has no legal standing as an original source, even beyond the open and obvious issue of self-representation;

(2)The feds are currently learning how to approach the issues of Medicaid fraud in child welfare. I know DHHS OIG is only beginning to identify and understand the fraud schemes in child welfare, (the purpose of this blog) but it is still in the initial phases. The federal government is a slow yet deliberate process of handling matters. The purpose being, once they do anything, it will be done effectively. Currently, there is the federal task force of H.E.A.T., the joint partnership with DOJ and DHHS OIG developing its tasks forces to attack Medicaid fraud in child welfare. They will approach from a different angle, leaving a stronger punishment by deterrence message upon the public.

Fraud detection and prevention in health care (Medicaid, Medicare, Tricare, Children's Health Insurance Program) is an industry that has the potential to create a massive number of jobs. The push in the direction of informational technology will only enhance the ancient mechanism called the writ of qui tam.

Qui tam pro domino rege quam pro se ipso in hac parte sequitur
,

meaning,

"[he] who sues in this matter for the king as [well as] for himself."


Actions such as this benefits all of us, all taxpayers as it is taxpayer monies that are being taken, threatening our economic security, which is our national treasure. The feds cannot be everywhere at all times, contrary to most beliefs; the feds rely upon us, the taxpayer to communicate and to blow the whistle when we know of fraud schemes. The qui tam was created within the platform of the Magna Carta to do just that. President Lincoln reanimated this ancient writ, as well as a few others like habeus corpus, to fight the war within the Civil war, and that was the war on businesses defrauding the federal government. It was called the False Claims Act.

The only setback to the qui tam is the language of the False Claims Act statute, which has been ambiguously interpreted by the Supreme Court to make it impossible for an individual to bring an action without an attorney.

PsychRights® and Gottstien have once again pushed this envelope back in the face of the judicial community.

Just as we had in the financial industry with the likes of the ponzi scheme, there are similar, yet far more intricate fraud schemes in child welfare. Child welfare is an industry that has never been regulated as there is no transparency nor accountability. The con artists in child welfare are far more sophisticated when it comes to public awareness campaigns of abuse and neglect, and the subsequent fundraisers.

It takes individuals such as Gottstein and his non-profit PsychRights® to remind the people that we are the ones who possess the power of government, and can call it in at any time through the extraordinary writs.

I wish him, PsychRights®, the Department of Justice and the Department of Health and Human Services the best of luck in their fight to end Medicaid fraud in child welfare.

Tuesday, January 26, 2010

Massive Child Welfare Medicaid Fraud Lawsuit Unsealed

I told you so!

FOR IMMEDIATE RELEASE

CONTACT Jim Gottstein
907-274-7686 jim.gottstein@psychrights.org

Massive Medicaid Fraud Lawsuit Unsealed

The Law Project for Psychiatric Rights (PsychRights®) announces the unsealing today of a major Medicaid Fraud lawsuit against psychiatrists, their employers, pharmacies, state officials, and a medical education and publishing company for their roles in submitting fraudulent claims to Medicaid. The defendants are:

* Osamu H. Matsutani, M.D.
* William Hogan, Commissioner Of the Alaska Department Of Health And Social Services
* Tammy Sandoval, Director Of The Alaska Office Of Children's, Services
* Steve McComb, Director Of The Alaska Division Of Juvenile Justice
* William Streur, Director Of The Alaska Division Of Health Care Services
* Juneau Youth Services, Inc.
* Providence Health & Services,
* Elizabeth Baisi, M.D.
* Ruth Dukoff, M.D.
* Charter North Star Behavioral Health System
* Kerry Ozer, M.D.
* Claudia Phillips, M.D.
* Southcentral Foundation
* Sheila Clark, M.D.
* Hugh Starks, M.D.
* Lina Judith Bautista, M.D.
* Heidi F. Lopez-Coonjohn, M.D.
* Robert D. Schults, M.D.
* Mark H. Stauffer, M.D.
* Ronald A. Martino, M.D.
* Irvin Rothrock, M.D.
* Jan Kiele, M.D.
* Alternatives Community Mental Health Services, D/B/A Denali Family Services
* Anchorage Community Mental Health Services
* Lucy Curtis, M.D.
* Fairbanks Psychiatric And Neurologic Clinic, Pc
* Peninsula Community Health Services Of Alaska, Inc.
* Bartlett Regional Hospital Foundation, Inc.
* Thomson Reuters (Healthcare), Inc.
* Wal-Mart Stores, Inc.
* Safeway, Inc.
* Fred Meyer Stores, Inc.

Law Project for Psychiatric Rights v. Matsutani, et al., United States District Court, District of Alaska, Case No. 3:09-cv-0080-TMB.


The lawsuit, which was filed on April 27, 2009, and required to be kept under seal (secret) until now, is brought under the federal False Claims Act, which authorizes private parties to bring fraud actions on behalf of the Government. These cases are also called "whistleblower suits" or "qui tam," actions, and those who file them are entitled to a share in the recovery, if any. Each offending prescription carries a minimum penalty of $5,500.

The Complaint walks through the lack of science supporting the practice and the methods used by the pharmaceutical industry to induce psychiatrists to improperly prescribe these drugs. "Even though the drug companies have been using these methods to induce psychiatrists to prescribe these drugs, it is the psychiatrists' responsibility to base their decisions on the facts, not drug company marketing," said Mr. Gottstein, continuing, "the uncritical acceptance of pharmaceutical company hype represents a massive betrayal of trust by the psychiatrists prescribing these drugs to children and youth."

PsychRights has also developed a streamlined model Qui Tam Complaint for use around the country. See, PsychRights Launches Campaign Against Medicaid Fraud With Model Lawsuit, July 27, 2009. The model Qui Tam Complaint is drafted for former foster youth to bring the lawsuits and receive the whistleblower's share of the recovery, but anyone with knowledge of specific offending prescriptions, such as parents and mental health workers, can bring these suits.

Last fall, Mr. Gottstein gave talks at two national conferences, the National Association for Rights Protection and Advocacy (NARPA), and the International Center for the Study of Psychiatry and Psychology (ICSPP), where he presented on how to bring and conduct these cases. Mr. Gottstein is also giving a presentation in New York City, February 2nd following oral argument in Lilly v. Gottstein.

Mr. Gottstein indicates a number of these cases are percolating around the country. In one that is not as far along as some others, Ted Chabasinski, a Berkeley, California, lawyer, is seeking a former foster youth as a client to bring such a lawsuit in the Bay Area. Any former foster youth in the Bay Area who was given psychiatric drugs within the last 6 years can call Mr. Chabasinski at (510) 843-6372 to talk to him about bringing such a case. "Foster children are singled out for psychiatric drugging because they and their foster parents have almost no legal protections and no way they can refuse these damaging drugs," says Mr. Chabasinski, who as a foster child, was electroshocked at the age of six as part of an experiment involving hundreds of foster children.

While PsychRights and Mr. Chabasinski are not bringing these cases for the money, such cases represent a tremendous financial opportunity for attorneys to do well by doing good.

"These are about as open and shut as cases can get," said Mr. Gottstein, "it is Medicaid fraud to cause or submit prescriptions to Medicaid for reimbursement if they are not for a medically accepted indication. End of story." PsychRights has developed a Medically Accepted Indications Chart showing what is allowable for common psychiatric drugs. Every other use of these drugs in children and youth and submitted to Medicaid is fraudulent. PsychRights conservatively estimates that at least half of psychotropic drug prescriptions to children and youth submitted to Medicaid are not for medically accepted indications and therefore fraudulent.

The Law Project for Psychiatric Rights is a public interest law firm devoted to the defense of people facing the horrors of forced psychiatric drugging and electroshock. PsychRights is further dedicated to exposing the truth about psychiatric interventions and the courts being misled into ordering people subjected to these brain and body damaging drugs against their will. Extensive information about these dangers, and about the tragic damage caused by electroshock, is available on the PsychRights web site: http://psychrights.org/.

# # #

Alaska Psychiatric Rights Unseald Qui Tam

Jim Gottstein, I bow in honor of your strength and tenacity to stop Medicaid fraud in child welfare. I only pray you set of a national trend of False Claims Act filings.

Anyone interested in learning more about these types of extraordinary writs, feel free to contact me.

Beverly Tran
An Original Source
313-522-8213