Losing the Best: AUSA--James Sheehan

April 6, 2007, 5:03 pm
Gov. Spitzer Snags Top Health-Care Fraud Buster
Wall Street Journal Blog: Posted by Paul Davies
Signaling his intention to root out Medicare fraud, New York Gov. Eliot Spitzer has snagged one of the top health-care fraud busters from the Justice Department.
Gov. Spitzer has nominated James Sheehan to be state’s Medicaid Inspector General. Sheehan will be in charge of rooting out fraud and abuse in New York’s $50 billion Medicaid program.

Sheehan, a career prosecutor, is an associate U.S. Attorney in Philadelphia, where he has worked since 1980. He has handled more than 500 health-care fraud matters, including the federal government’s investigation of Medco systems, which resulted in a $155 million recovery. Sheehan (Swarthmore, Harvard Law) was also the lead counsel in a case against SmithKline Beecham that resulted in a $332 million recovery.

“As a career prosecutor specializing in complex health care enforcement and recovery matters, Mr. Sheehan has experience rooting out fraud that dramatically drives up costs and severely threatens the efficiency and delivery of health care services,” Gov. Spitzer said in a statement. “New York State’s health care spending is the highest in the nation and our system requires dramatic reform. “

So what is happening here? Well, as far as I can recall, it appears to be the exit --from the Justice Department --of one of the top class, top dollar, health care fraud fighters in the world, not just the country. Mr. Sheehan was the go to guy in the U.S. Attorney's office for health care fraud, not just for cases in his area, but for legal opinions, precedent, and just about everything that the United States Government had in the way of health care fraud expertise at the AUSA level.

Alberto did you even know him?

I'd guess he will have recovered over 1 Billion by the time gets to New York and starts working for Mr. Spitzer. Mr. Sheehan joined the AUSA in 1980? OK--so that means he's been there through Reagan, Bush, Clinton and Bush Bush administrations....all this time developing a fine niche and lobbing back in some of the big money lost to health care fraud, lately in bigger and bigger hunks....

It may not be voter fraud, but hey... perhaps has kept our parents and grandparents in health care a few months longer.

This guy is a friend of whistleblowers. Word on the street is – if you have a False Claims Act case, call Mr. Sheehan. The False Claims Act says to citizens of the United States – if you have information about fraud against the federal government, come forward, tell federal prosecutors about it, and if federal prosecutors can verify your claim, they will join with you and sue the corporation to recover the amount of money that the corporation defrauded from the United States. Can you say Qui Tam? If they do prove your case, and the government recovers the defrauded money, then you, ordinary citizen, will get a cut of the recovery – anywhere from 15 to 30 percent. And so, whistleblowers with the inside scoop call Sheehan.

And he has expertise in health care fraud on a grand scale second to one.

Alberto have you noticed this? Or do you even recall, can you even begin to comprehend, how badly you've messed this all up.....

Why did he leave? Do we know? Will we ever know? Probably not. He is too much of a class act to say anything public. Aside from those who were "asked to no longer serve at the pleasure of the president," how many others will leave or have left because of the politics of this mess and the fact that they just want to prosecute violations of the law?

When will this administration stop ruining this country?

Best wishes Mr. Sheehan --and Mr. Spitzer.