A hospital billing manager has filed a Medicare fraud whistleblower and retaliation suit following her termination after she raised questions about the hospital's billing practices. The billing manager, Joanne Cleighton, a 26 year employee, raised questions about the hospital's frequent practice of labeling blood samples as urgent in order to keep them in-house so the hospital could bill for them. The hospital was supposed to send routine blood work to a third-party under its Medicare and Medicaid contract. Cleighton was fired the same day she was scheduled to meet with the hospital's compliance officer.
As is usually the case where the employer has acted wrongfully, the hospital has had a hard time figuring out its reason for firing Cleighton, who was a 26 year employee with an excellent record. First the hospital claimed Cleighton was fired for violating patient privacy and for using a racial slur. But when it found out those reasons would not stand up, it switched to a new and third explanation, an email that Cleighton had sent some 6 months earlier.
Source: Philadelphia Inquirer
The main claim of interest in this case is under the anti-retaliation provisions of the False Claims Act. That law protects employees that take good-faith action to stop fraudulent practices or, in this case, fraudulent billing practices that gain money wrongfully from Medicare and/or Medicaid.
Lexington, Kentucky whistleblower lawyer Robert Abell represents individuals and employees in whistleblower cases including Medicare fraud cases under the False Claims Act; contact him at 859-254-7076.