Ryan Pfeffer, Ryan.Pfeffer@seiu.org, 614-270-9474
Issued April 18, 2016
Arguing Before the Supreme Court, the US Solicitor General Makes the Case for Preserving Critical Whistleblower Tools to Hold Providers Like Universal Health Services Accountable for Breaking the Law
Washington, DC —The U.S. Solicitor General and attorneys for a whistleblowing family argue before the Supreme Court of the United States in Universal Health Services, Inc. v. United States ex rel. Escobar on April 19 to preserve a valuable tool for holding law-breaking healthcare providers accountable. The Service Employees International Union (SEIU), joined by nationally recognized mental health advocates, Mental Health America and the Judge David L. Bazelon Center for Mental Health Law, filed an amici curiae brief in support of the family.
The family seeks to hold Universal Health Services (UHS) accountable under the False Claims Act (FCA) for claiming Medicaid payments even though UHS’s care failed to meet minimum licensure and supervision requirements for mental health services. The family’s teenage daughter tragically passed away while under the care of unlicensed and unsupervised staff at a UHS facility in Massachusetts. UHS is the largest provider of behavioral health services in the country, operating 1 out of every 5 psychiatric beds nationally, and is the subject of an ongoing federal fraud investigation involving at least 25 facilities. The underlying allegations and the briefs submitted in support of the family show UHS’s record of violating patient-care requirements throughout the country and demonstrate how vibrant whistleblower tools and claims like the one brought by the family play an important role in protecting patients.
Yarushka Rivera was a 17-year-old girl living with a psychiatric disability who sought care at a UHS facility. The teen was treated by unlicensed and inadequately supervised staff. UHS’s staff prescribed a medication for Ms. Rivera that allegedly led her to develop seizures and she died a few months later of a seizure. UHS then billed the Massachusetts Medicaid program for the girl’s care. Upon investigation of these events, the state’s Department of Public Health and Division of Licensure confirmed that care was provided by unsupervised staff in violation of state law.
“If we commit to taking action before mental illnesses reach Stage 4, then the moment that brings a family into contact with a health care provider is a critical moment for intervention,” said Paul Gionfriddo, President and CEO of Mental Health America. Gionfriddo continued, “And if we don’t provide families and individuals with quality care at that time, then we’ve failed them. And that is something we can’t afford to do, if we’re serious about treating mental illnesses the same as we treat other serious health conditions.”
UHS seeks to limit potential liability under the FCA, which could reduce the scrutiny of their operations and have a chilling effect on future whistleblowers. UHS is making hundreds of millions of dollars in profits while its facilities violate state and federal rules designed to protect mental health patients.
“It is appalling that a company with such a disturbing track record of care would be pushing for the Supreme Court to rewrite the law to silence patients, families, and care providers in the reporting of any potential fraud in our healthcare system,” said Leslie Frane, Division Director, SEIU Healthcare.
A decision by the Court is expected this summer.
SEIU Healthcare is the healthcare arm of SEIU, representing 1 million members who work in healthcare and mental health settings. SEIU Healthcare members work in UHS facilities across the country and are dedicated to protecting patients and improving quality of care.