Fish & Richardson, US DOJ Settle Medicaid Fraud and Abuse of Children Case Against Pennsylvania Psych Facility

From Vince Boehm:

Stefan Kruszewski is a Harrisburg, PA psychiatrist and a personal hero who was hired by the Bureau of Program Integrity in the Pennsylvania Department of Public Welfare.

He was fired in 2003 after he uncovered widespread abuse and fraud in the bureau. His efforts to clarify the causes of death in four children and one adult in the state’s care were blocked when he was denied postmortem or coroner’s reports and hospital records.

Some of the patients were taking as many as five antipsychotic medications at the same time-something Dr Kruszewski says is “hard to justify.” When he warned that off-label use of the drugs was potentially harmful to patients and could expose the state to liability he was told that “it’s none of your business”.

Kruszewski says, “I was terminated because I did my job. It turns out that drug companies and politicians were influencing the drugs prescribed for patients.”

Dr. Kruszewski sued for-profit Youth and Family Centered Services and its subsidiary Southwood Psychiatric Hospital (YFCS) in Pennsylvania for Medicaid fraud and abuse of children at its residential
treatment facility.

This suit was settled yesterday.

Vince
For immediate release:

Fish & Richardson and the U.S. Department of Justice Settle Medicaid Fraud and Abuse Case at Southwood Psychiatric Hospital in Pennsylvania

April 23, 2009 —

PROSPERITY, PA — (Marketwire) — 04/23/09 — Fish & Richardson announced today that it, along with the U.S. Department of Justice, settled a lawsuit that had alleged substantial Medicaid fraud and the abuse of children at for-profit residential treatment facilities operated by Youth and Family Centered Services and its subsidiary Southwood Psychiatric Hospital (YFCS) in Pennsylvania. Fish represented Dr. Stefan P. Kruszewski, a board certified psychiatrist who had discovered and exposed fraud and abuse, but was then fired from his position as a medical consultant for the Bureau of Program Integrity in Pennsylvania’s Department of Public Welfare. The United States government intervened to seek a resolution with regard to certain activities occurring in 2005. Under the settlement, YFCS, in addition to agreeing to pay a $150,000 fine to reimburse federal Medicaid funds, has agreed to implement comprehensive new treatment standards, an extensive compliance program, as well as increased government oversight of their programs. This settlement is the first resolution by the United States of a failure of care case involving Pennsylvania psychiatric residential treatment facilities.

YFCS runs three residential facilities in Pennsylvania for children aged 6 to 18 who have been deemed to require psychiatric care by the state. The government intervened in Dr. Kruszewski’s case to address a wide variety of serious quality of care concerns at these facilities, including woefully inadequate staffing and use of physical restraints which posed significant risks to the health and safety of the children housed in the YFCS facilities. As a result, YFCS allegedly submitted Medicaid reimbursement requests for inadequate or worthless treatment.

“This was a case of the exploitation of children for profit,” said Thomas Halkowski, a principal of Fish & Richardson in the firm’s Wilmington office, who, along with Thomas Melsheimer, a principal in Fish’s Dallas office, represented Dr. Kruszewski in the case. “Dr. Kruszewski should be commended for having the courage to come forward to protect this vulnerable group from further mistreatment. Because of his actions, we now have an agreement that provides a new standard of care to help safeguard the well being of those children in Pennsylvania who are housed in YFCS’s facilities. This agreement should also be a warning shot across the bow of other residential treatment facilities in Pennsylvania of the level of care they should be administering to Pennsylvania’s children.”

Because the Medicaid payments were administered through a joint federal/state Medicaid program, the U.S. government intervened in the case and became a party to the lawsuit and settlement agreement. The federal government has reserved the right to bring criminal charges and to exclude YFCS from Medicaid reimbursement programs in the future.

About the Attorneys

Thomas L. Halkowski is a Principal in the Wilmington, Delaware office of Fish & Richardson, where he focuses his practice on intellectual property and other complex litigation, including False Claims Act litigation. He was previously a Senior Trial Attorney for the United States Department of Justice. Tom Melsheimer is a Principal in and Managing Principal of Fish & Richardson’s Dallas office. His trial practice includes complex civil and criminal litigation in state and federal courts, emphasizing intellectual property, antitrust, and False Claims Act litigation. Mr. Melsheimer was an Assistant United States Attorney for the Northern District of Texas from 1990 to 1993.

About Fish & Richardson

Fish & Richardson is a leading global law firm unlike any other law firm in the world. With 450 lawyers practicing intellectual property, litigation, and corporate law, Fish has redefined IP law for a market that values IP as a fundamental business asset. Fish was recently named one of the leading IP law firms in the U.S. by Managing Intellectual Property magazine (MIP, February 2009). The firm handles more patent litigation than any other law firm, both in federal district courts (IP Law360, January 2009) and the International Trade Commission (IP Law & Business, June 2008); and is the No. 1 patent firm for the world’s most innovative companies (IP Law & Business, November 2008).

Contact:
Amy Blumenthal
Blumenthal & Associates
(617) 879-1511

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