Medicaid “False Claims” Settlement Yields $10 Million To Whistleblower

The state of New York and New York City have agreed to pay $540 million to settle allegations that they knowingly submitted, or caused to be submitted, false claims for reimbursement for school-based health care services, primarily speech therapy and transportation, provided to Medicaid eligible children from 1990 to 2001, according to the U.S. Department of Justice. The settlement is a record federal recovery by the Justice Department for the Medicaid Program.

 
There is an interesting aspect of the settlement tucked away towards the end of the federal government’s announcement: the DOJ became involved after a speech therapist who provided services to preschool children in upstate New York alleged that New York State and its school districts submitted false claims for speech services that did not qualify for Medicaid reimbursement.
 
And, the therapist will receive $10 million from the settlement!
 
So called “qui tam” or whistleblower statutes seek to have people who know of fraud bring it to the attention of the authorities. It apparently worked quite well in this case.