Unlicensed Staff and Client's Death Led to False Claims Suit, US Supreme Court rules on case

The parents of a patient who died while in the care of Arbour Counseling Services sued the facility and related companies under the federal False Claims Act, alleging that the facility violated that law by presenting claims for reimbursement from MassHealth (Medicaid) based on services rendered by providers employed by Arbour Counseling Services who were not licensed, not supervised, and/or not qualified to provide services to patients. The parents (Relators) allege that the reimbursement claims made by these practitioners were false, and that claims made by the clinic were false due to non-compliance with core staffing requirements. According to their Complaint, one practitioner prescribed medication, despite not being permitted to do so unless under the direct supervision of a board certified psychiatrist. The Complaint also alleges that a side effect of this medication, Trileptal, caused the Relator’s daughter to develop seizures, and ultimately led to her death.

The district court judge dismissed the case after finding that, although “[t]he allegations of this complaint raise serious questions about the quality of care provided,” the False Claims Act was not the proper vehicle for pursuing these claims. The Relators asked an appellate court to review the decision to dismiss the case. 

The case made its way through the courts before the US Supreme Court. Ultimately, the Unanimous Supreme Court Rejects Industry Attempts to Limit Whistleblowers.