Upstate New York Whistleblower Sparked Record-Breaking Half-Billion-Dollar-Plus Settlement in America's Biggest Government Medicaid False Claims Case, New York Whistleblower Attorney David A. Koenigsberg Reveals

Friday, September 18, 2009 General News
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SYRACUSE, N.Y., July 21 When New York State and City agreed on July 20th to repay the federal government nearly $540 million to settle whistleblower-sparked Medicaid false claims allegations, it ended a lone whistleblower's long struggle to correct speech therapy billing problems in an upstate New York county and across the state. When improper billing wasn't corrected, the whistleblower sued on behalf of the federal government under the qui tam provisions of the federal False Claims Act ("FCA"), New York City qui tam whistleblower attorney David A. Koenigsberg of Menz Bonner & Komar LLP revealed.

"The information and cooperation that my client provided led directly to the U.S. Department of Health and Human Services' audits that ultimately confirmed the state-wide billing problems that are the subject of this historic settlement," Koenigsberg said.

"As a result, New York State and City agreed to pay the seventh largest whistleblower settlement in the largest government False Claims Act Medicaid case in United States history," Koenigsberg added. "The value of whistleblower law in repatriating federal dollars back to United States taxpayers should be crystal clear."

An April 2000 report by the former U.S. General Accounting Office, now called the Government Accountability Office, stated that Illinois, Michigan, and New York accounted for more than 60 percent of total school-based medical claims, while New York accounted for 44 percent of that total. When the Inspector General's audits were released New York officials loudly criticized the agency's methodology and conclusions. With today's settlement the city and state did not admit liability, nor did the federal government concede that its claims were not well founded.

Under the agreement settling allegations of improperly billed pre-school and older students' speech, physical and occupational therapy, psychological counseling and transportation over a seven-year period, New York State will pay approximately $331,879,000 and allow the federal government to retain approximately $108,000,000 of nearly $303,000,000 it withheld for questionable billing during a seven-year period ending in December 2008. New York City will pay $100,000,000.

Additionally, New York State agreed to enter into a "Program Compliance Agreement" with the federal Centers for Medicare & Medicaid Services ("CMS") governing the manner in which the state Department of Education offers future School and Preschool Supportive Health Services Programs. This agreement is believed to be the first of its kind between the federal government and a state or local government. It is similar to Corporate Integrity Agreements reached with private entities settling Medicaid fraud allegations.

"Billions and billions of stimulus, bailout, TARP and related recovery dollars are being pumped into the economy now by the federal government. In the years to come, the money-saving value of the False Claims Act and concerned-citizen qui tam whistleblowers who step forward to do the right thing will be proven again and again," John Menz, name partner of Koenigsberg's firm predicted.

Federal lawsuits unsealed in the United States District for the Northern District of New York with the settlement:

98-CV-1929 (TJM) (DEP), U.S. ex rel. Cirrincione v. Larry D. Tingley, et al.; and 99 CV 2082 (TJM) (DEP), U.S. ex rel.. Cirrincione v. Thomas Hamel, et al.

The complete Menz Bonner & Komar LLP news release will be posted at and on a new Menz Bonner & Komar LLP Web site to be launched in the near future.

About Menz Bonner & Komar LLP

With offices in New York and New Jersey, Menz Bonner & Komar LLP is a boutique litigation law firm representing both plaintiffs and defendants in complex commercial litigation, including qui tam whistleblowers in False Claims Act cases.

Contact: David A. Koenigsberg, Esq. Menz Bonner & Komar LLP 444 Madison Avenue, 39th Floor New York, NY 10022 212-223-2100 - 914-819-8469 Mobile

SOURCE Menz Bonner & Komar LLP

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