Blowing the Whistle

Qui Tam: An abbreviated version of the Latin phrase Qui Tam pro domino rege quam pro si ipso in hac parte sequitur, which means “Who sues on behalf of the King, as well as for Himself.”

Whistleblower (also whistle-blower): One who reveals wrongdoing to the public or to those in positions of authority; probably an allusion to a police officer blowing a whistle on observing a violation of the law.

In Qui Tam litigation a private citizen (the whistleblower) who knows of fraud committed against the government may, through his own privately retained lawyers, file a law suit in his own name and in the name of the United States, to recover the losses caused by the government fraud. The federal False Claims Act [31 U.S.C.A. § 3729] provides huge financial incentives to citizen whistleblowers to retain attorneys and come forward, prosecute these lawsuits and fight government fraud.

Blowing the whistle on health care fraud, particularly mental health care fraud, can be scary for one who has never done this before. Fear of retaliation and the stigma associated with being a “troublemaker” contribute to the underreporting of fraud in health care. Anyone contemplating such a qui tam action may need guidance to decide whether to report, how to report, and what they should do to protect themselves when they do report.

What constitutes fraud in mental health care?

The massive psychiatric drugging of America’s children, particularly poor, disadvantaged children and 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 psychiatrists and pharmaceutical companies sacrificing children and youth’s health, futures and lives on the altar of corporate profits. An example as it pertains to Medicaid recipients can be described as:

Psychiatrist (or other medical doctor) prescribes a psychotropic drug that is not for a medically accepted indication. The pharmacy presents the prescription to Medicaid for reimbursement. This is a false claim because 42 USC 1396R-8(k)(3) prohibits reimbursement under Medicaid for any outpatient drugs “used for a medical indication which is not a medically accepted indication.”

An overview of statistics on fraud recoveries by the US government during the period October 1, 1986 to September 30, 2008 can be found here: http://www.justice.gov/opa/pr/2008/November/fraud-statistics1986-2008.htm.

Other kinds of psychiatric fraud can be found here [http://www.cchrstl.org/fraud.shtml].

What about psychiatric abuse?

While qui tam law suits are only for fraud, there may be cases where reporting abuse is either warranted or required.

For example, the Missouri Revised Statutes (Chapter 210 Section 210.115) basically state that when anyone engaged in the care or treatment of children has reasonable cause to suspect that a child has been subjected to abuse, that person must immediately report such to the Division of Family Services [http://www.dss.mo.gov/cd/rptcan.htm].

Examples of psychiatric abuse can be found here [http://www.cchrstl.org/abuse.shtml].

Whistleblower guidelines and protection

The references below identify steps for blowing the whistle on fraud or abuse, and make numerous suggestions for learning how to do this and carrying it through.

CCHR also recommends preparing Living Wills [http://www.cchrstl.org/takeaction.shtml#LivingWill] for yourself and your family. A Living Will lets you specify decisions about one’s own health care treatment in advance. Should you be in a position where you are to be subject to unwanted psychiatric hospitalization and/or mental or medical treatment, this Letter of Protection from Psychiatric Incarceration and/or Treatment directs that such incarceration, hospitalization, treatment or procedures not be imposed, committed or used on you.

Of course, you can also report psychiatric drug side effects to the U.S. Food and Drug Administration [http://www.fda.gov/medwatch/], and you can report psychiatric abuse to CCHR [http://www.cchr.org/take-action/psychiatric-abuse-report-form.html].

Whistleblowing is certainly one of society’s best lines of defense against psychiatric fraud and abuse, which have been eroding our mental health care system for many years. CCHR, with your support, works toward the day when whistleblowing is no longer needed. You can express your support by volunteering your time, or giving someone for whom you care a membership in CCHR St. Louis.

References:

1. “Preparing to Blow the Whistle, A Survival Guide for Nurses”; Nayna C. Philipsen, JD; Donald Soeken, LCSW-C; MedScape posted 11/18/2011 [http://www.medscape.com/viewarticle/751347]; Journal for Nurse Practitioners 2011;7(9):740-746. © Elsevier Science, Inc.

2. PsychRights’ Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth [http://psychrights.org/education/ModelQuiTam/ModelQuiTam.htm]

3. Whistle Blower – Qui Tam, Ashcraft & Gerel LLP [http://www.ashcraftandgerel.com/practiceareas/whistle-blower-qui-tam/]

4. The Free Dictionary [http://legal-dictionary.thefreedictionary.com/whistleblower]

5. Taxpayers Against Fraud Education Fund – a nonprofit, public interest organization dedicated to combating fraud against the Federal Government through the promotion and use of the Federal False Claims Act and its qui tam provisions. [http://taf.org]

6. The National Whistleblowers Center (NWC) is a non-profit, non-partisan organization dedicated to protecting employees’ lawful disclosure of waste, fraud, and abuse. [http://www.whistleblowers.org]

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