Alaska child psychiatrists named in Medicaid fraud suit

The Law Project for Psychiatric Rights, an Alaska mental health advocacy group, has sued several Alaska child psychiatrists under the federal False Claims Act. The whistleblower organization, which has fought the pharmaceutical industry for years, claims that doctors committed Medicaid fraud by unnecessarily drugging children with medications not approved for the prescribed purposes. The suit is also directed at pharmacies, health service agencies and state officials.

The advocacy group believes that mental health professionals there have stopped trying to work with mentally disturbed youths and just prescribe drugs instead. According to the whistleblower group, nine of ten children under the care of a psychiatrist are given medication, but less than ten percent of the drugs have actually been approved by the FDA for psychiatric use in children. Further, doctors prescribe powerful antipsychotic drugs for children receiving Medicaid at four times the rate such drugs are given to children covered by private insurance.

There is nothing to prevent doctors from prescribing drugs for unapproved, “off-label” uses to treat childhood and adolescent mental disorders, including schizophrenia and bipolar disorder. But health professionals commit Medicaid fraud if they bill government health programs for psychiatric drugs prescribed for uses not approved by the FDA. Medicaid will only reimburse costs for approved uses of prescription medications. According to the Alaska suit, at least half of psychotropic drugs prescribed for children and adolescents that are billed to Medicaid by the defendants are prescribed for uses not approved by the FDA. Such practices constitute Medicaid fraud, say the whistleblowers.

The False Claims Act lawsuit asks for a separate amount for each false prescription written, which could be a huge sum given that for just three months in 2007, over 12,450 prescription claims were made to Medicaid for psychotropic drugs given to children. Under the False Claims Act, a private individual is authorized to file a fraud claim on behalf of the government. The Qui Tam provisions of the statute allow a whistleblower to receive a designated portion of any recovery made by the government as a result of the lawsuit.

For more information, go to Behavioral Health Central.

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