United States Sues NY City and Computer Sciences Corp

The United States on Monday joined a lawsuit accusing New York City and Computer Sciences Corp of defrauding Medicaid into making millions of dollars of improper reimbursements by exploiting a computerized billing system that the company designed.

According to the complaint filed in U.S. District Court in Manhattan, the defendants took advantage of the system's automatic defaulting capabilities, enabling the city to boost the amount and speed of reimbursements for services provided to infants and toddlers with developmental delays.

The U.S. attorney for Manhattan, Preet Bharara, said the fraud led to the city and Computer Sciences' submitting tens of thousands of false claims to Medicaid from 2008 to 2012.

Originally filed by a whistleblower, Vincent Forcier, the lawsuit seeks restitution, civil penalties and triple damages for violations of the federal False Claims Act.

That law allows whistleblowers to sue on the government's behalf and share in recoveries. The government is not required to get involved in False Claims Act lawsuits, but sometimes intervenes in cases it considers stronger.

"We are in the process of reviewing the complaint," said Richard Adamonis, a spokesman for Computer Sciences, which is based in Falls Church, Virginia.

New York state plans to bring a related case against Computer Sciences, court records show. A spokeswoman for New York Attorney General Eric Schneiderman declined to comment.

The lawsuit concerns early intervention program services, which are provided to children under 3 years old who have developmental delays, or medical conditions such as autism and low birth weight that are associated with such delays.

According to the government, the city and Computer Sciences engaged in three fraud schemes.

In two, the defendants allegedly circumvented Medicaid's "secondary payor" requirement that they exhaust private insurance coverage before submitting claims.

The third scheme allegedly involved the defendants' changing diagnostic codes that were used by medical providers to a generic code that they knew would result in payment by Medicaid.