New York City Defeats Whistleblower’s Medicaid Fraud Claims

New York City defeated a False Claims Act lawsuit alleging the submission of false claims for reimbursement under the Medicaid program, with a ruling by the Second Circuit.

Whistleblower Andrew Gelbman failed to allege with adequate specificity that the city engaged in a scheme to get Medicaid to overpay the city by more than $14 billion, the U.S. Court of Appeals for the Second Circuit said.

Gelbman didn’t identify specific expense reports that the city actually submitted to the federal government, the court said.

Gelbman’s complaint left open the possibility that the city fully disclosed to the government potential defects ...