Florida Health Care Fraud Lawsuit Settled

On September 30, 2013, a press release was issued announcing that a lawsuit filed on behalf of the United States against Winter Park Urology Associates, P.A., Radiation Oncology Consultants, P.A., and three of the latter’s physicians – Steven G. Lester, M.D., John D. Looper, M.D., and Maneesh Gossain, M.D. – has been settled.  The qui tam lawsuit was filed by Carlo Santa Ana on May 19, 2010, against the aforementioned defendants in the United States District Court for the Middle District of Florida.  It alleges that they presented false or fraudulent claims for payment to federal healthcare programs and used false records to present these claims.  As alleged, the false and fraudulent claims amounted to more than $20 million.

Winter Park Urology Associates is a physician-owned practice located in Orlando, Florida.  It operates the Orlando Cancer Institute.  Radiation Oncology Consultants, P.A., through three of its physicians—Dr. Lester, Dr. Looper, and Dr. Gossain—supervised the administration and operation of the Orlando Cancer Institute.  From June 2008 through March 2010, Mr. Santa Ana was the Director of Medical Physics for the Orlando Cancer Institute.  Mr. Santa Ana was also Department Manager for the Orlando Cancer Institute from April 2009 through March 2010.  He was terminated by Winter Park Urology Associates in March 2010.

The Complaint alleges that the Orlando Cancer Institute submitted thousands of claims for image-guided radiation therapy and intensity modulated radiation therapy, despite the fact that the therapy was performed without a supervising physician, as required for reimbursement by Medicare.  Specifically, the Complaint sets forth that radiation therapists performed services and read image-guided radiation therapy images without any involvement from a radiation oncologist.  Images were not reviewed by a radiation oncologist until long after treatment was provided, if at all, based on allegations in the Complaint. According to the Complaint, Orlando Cancer Institute also submitted claims for intensity modulated radiation therapy that were not medically necessary.

The Complaint further alleges that Orlando Cancer Institute developed a policy of submitting add-on claims for special procedures, which such procedures were almost never adequately justified.  These procedures included medical radiation physics consultations and special treatment procedures.

In addition, the Complaint claims that Winter Park Urology Associates violated the Florida Patient Self-Referral Act, which prohibits a physician from referring to entities in which the referring physician holds an interest, subject to certain exceptions.   The violations occurred when Winter Park Urology Associates referred patients to the Orlando Cancer Center.  Finally, the Complaint alleges that Winter Park Urology Associates retaliated against Mr. Santa Ana by terminating him due to his complaints about the wrongdoing alleged in the Complaint.

Radiation Oncology Consultants, Dr. Lester, Dr. Looper, and Dr. Gossain were dismissed from the lawsuit as part of the settlement.  Winter Park Urology Associates has agreed to settle the matter, but the financial details of the settlement have not yet been made public.  The United States Department of Justice will have to approve the terms of the settlement agreement before it can be finalized.

If you are an employee and find yourself in a situation in which you have been retaliated against for complaints about practices by your employer, Barrett Law PLLC, can help you understand your rights and the protections to which you may be entitled.  We have a long history of protecting the rights of whistleblowers, and intend to continue protecting the rights of whistleblowers into the future.  Contact us today at (800) 707-9577 to schedule an initial consultation.

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Ex-Dean Wins Lawsuit Against Globe University

Plaintiff Heidi Weber sued Globe University in 2011, alleging it retaliated against her by firing her after she raised concerns about the school’s admissions and other practices.  On August 15, 2013, she finally received the vindication she had been seeking for over two years.  After a week-long trial, the jury in Washington County, Minnesota, returned a verdict in favor of Ms. Weber and against Globe University.  The jury awarded Ms. Weber $395,000 in damages, which was comprised of $205,000 in lost wages, as she has been unable to secure employment since her termination, and $190,000 for emotional distress.  The jury deliberated for only ten hours before reaching its verdict.

Ms. Weber was Dean of the Medical Assistant Program at Globe University, at its Sioux Falls, South Dakota, campus.  Ms. Weber accused the university of falsifying job placement prospects, targeting students who had little to no prospects of acceptance at other universities because of criminal backgrounds and related issues, and changing accreditation agencies without informing the student body of this change in status.  When she raised these concerns with Globe University, rather than addressing Ms. Weber’s concerns, Globe University fired her.  As a result, Ms. Weber filed suit against Globe University under Minnesota’s whistleblower protection laws.

According to Ms. Weber, the university’s only focus was increasing enrollment to the detriment of the student body, and exposing this was her goal in brining the lawsuit.  Globe University argued that Ms. Weber was terminated for poor job performance.   Additionally, its attorneys argued that Ms. Weber did not prove that the allegations she raised against Globe University constituted violations of the Minnesota whistleblower protection laws and that irrelevant and prejudicial evidence was allowed in, which improperly affected its deliberations.

In a similar lawsuit, which remains pending in Hennepin County, Minnesota, Jeanne St. Clair sued Globe University for firing her after she complained that it was exaggerating its job-placement rate.  Ms. St. Clair is also a former dean at the university.  She was employed by Globe University from January 2009 through October 2011, at various campus locations in Minnesota.  The Complaint alleges that Ms. St. Clair likewise raised concerns over Globe University’s inflation of graduation and placement rates, as well as misleading students about its accreditation status.  The lawsuit is scheduled to proceed to trial next year.

Globe University is a university with both on-campus programs (multiple locations in Minnesota, Wisconsin, and South Dakota), as well as on-line programs.  It is based on Woodbury, Minnesota, and offers degrees in over forty different areas.

Several weeks after the verdict in favor of Ms. Weber, on October 2, 2013, her attorneys filed a class-action lawsuit against Globe University on behalf of former and current students.  The lawsuit alleges that Globe University misleads potential students in an effort to increase enrollment; admits students based on their financial resources rather than educational qualifications; misleads students about or obscures its accreditation status; misleads students about the transferability of credits; misleads students about its placement rates; and misleads students of post-graduation salary expectations.

If you are an employee who has been terminated or otherwise suffered from an adverse action because you raised concerns about the illegality or impropriety of your employer’s actions, Barrett Law PLLC, can help.  We help protect the rights of whistleblowers as well as their legal interests.   Contact us today at (800) 707-9577 to schedule an initial consultation.

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United States Department of Labor Orders Clean Diesel Technologies, Inc., to Pay Whistleblower

On September 30, 2013, the United States Department of Labor, through its extension – the Occupational Safety and Health Administration (OSHA) – issued a press release regarding whistleblower and related retaliation allegations that had been brought against Clean Diesel Technologies, Inc., by its former Chief Financial Officer, whose identity remains undisclosed.

The former Chief Financial Officer of Clean Diesel Technologies, Inc., voiced concerns to Clean Diesel Technologies, Inc.’s board of directors about ethical and financial issues related to a proposed merger of the company.  Specifically, the former employee raised concerns about a conflict of interest affecting the Chairman of the Board of Directors, as well as concerns that the merger was not in the best interests of the company and that the conflict of the Chairman of the Board of Directors violated internal company ethics and Securities Exchange Commission required policies.  This reporting occurred in March 2010.  Clean Diesel Technologies, Inc., terminated the former Chief Financial Officer in April 2010.

One week after the termination, the former employee brought a whistleblower complaint with OSHA against Clean Diesel Technologies, Inc.  OSHA found the complaint to be valid and awarded the former employee $1.9 million in damages.  The damages include:  $486,000 in lost wages, bonuses, severance pay, and stock options; and $1.4 million in compensatory damages for pain and suffering, lost 401(k) matching, and damage to career prospects and reputation.  Clean Diesel Technologies, Inc., must also expunge its records of disciplinary actions related to the former Chief Financial Officer’s termination.

Many individuals associate OSHA with setting and enforcing workplace safety and health standards and providing training and outreach assistance to employees and employers.  However, OSHA is also responsible for administering twenty-one federal whistleblower protection laws.  These include:  the Asbestos Hazard Emergency Response Act; the Clean Air Act; the Comprehensive Environmental Response, Compensation and Liability Act; the Consumer Financial Protection Act of 2010; the Consumer Product Safety Improvement Act; the Energy Reorganization Act; the Federal Railroad Safety Act; the Federal Water Pollution Control Act; the International Safe Container Act; the Moving Ahead for Progress in the 21st Century Act; the National Transit Systems Security Act; the Occupational Safety and Health Act; the Pipeline Safety Improvement Act; the Safe Drinking Water Act; the Sarbanes-Oxley Act; the Seaman’s Protection Act; portions of the Food Safety Modernization Act; portions of the Affordable Care Act; the Solid Waste Disposal Act; the Surface Transportation Assistance Act; the Toxic Substances Control Act; and the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century.

Retaliation actions that OSHA, via the whistleblower protection laws, has authority over include termination or laying-off; demoting; blacklisting; denying promotion or overtime; disciplining; denying benefits; failing to hire or rehire; making threats; intimidating; reassigning, which affects promotion prospects; and reducing pay or hours.

If you are a federal employee and have been terminated or otherwise suffered adverse action because you raised concerns about the illegality or impropriety of your employer’s actions, Barrett Law PLLC, can help.  Please be aware that there are relatively short and absolute deadlines for filing complaints with OSHA regarding whistleblowing allegations.  As such, if you have suffered such an action, please contact us immediately to set up your initial consultation.  We have a history of helping to protect the rights of whistleblowers, and stand by ready to help you.  Our firm can be reached at (800) 707-9577.

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New Concerns Raised About Staffing at G.V. Montgomery VAMC in Jackson, Mississippi

Over the span of the past several years, beginning in 2009, serious complaints about the management of G.V. Montgomery Veterans Affairs Medical Center located in Jackson, Mississippi, have surfaced.  The issue boiled over earlier this year when, in March, the United States Office of Special Counsel sent a letter to the White House indicating that the Office of Special Counsel had found a pattern of problems at G.V. Montgomery Veterans Affairs Medical Center.

The United States Office of Special Counsel is an independent federal agency responsible for receiving whistleblower complaints and prosecuting claims under the Whistleblower Protection Act.  It received the complaints in question.  The Office of Special Counsel conducted interviews and ultimately issued the letter to the White House mentioned above.  The complaints involved a wide array of issues, from improper sterilization practices, poor staffing, and missed diagnoses.  Furthermore, the complaints indicated that these issues occurred over a lengthy span of time—six years.

The first of the complaints, dating to 2009, involved allegations that the VAMC failed to properly sterilize equipment.  In 2011, another employee made allegations that sterilization workers were not following proper procedure, including wearing protective clothing.  In 2012, a primary care doctor made allegations that nurses were prescribing medications that they were not authorized to prescribe.  Dr. Phyllis Hollenbeck also complained that, because of inadequate physician staffing in the primary care unit, nurses were providing care that they were not licensed to provide.  Finally, in 2013, a retired ophthalmologist complained that a former radiologist at the VAMC regularly marked images as read when, in fact, they were not.

In response to the whistleblowers’ complaints and the letter from the Office of Special Counsel, the United States Department of Veterans Affairs opened an investigation.  The public disclosure of the details of the complaints by the Office of Special Counsel, which was highly unusual, also lead to an outcry by patients at the VAMC.   The VAMC and the Department of Veterans Affairs attempted to assuage concerns by holding open meeting with patients on April 3, 2013.

Earlier this year, Joe Battle, the director of G.V. Montgomery Veterans Affairs Medical Center, hired a new assistant director, who started in May.  In June, Mr. Battle also issued statements indicating that he would be recruiting a new chief of staff and nurse director.  However, despite his attempts to remedy the problem, one of the key whistleblowers—Dr. Hollenbeck—indicated that the VAMC remains seriously understaffed.  Dr. Hollenbeck’s continued concerns also came amidst statements from Representative Jeff Miller of the House Committee on Veterans Affairs that G.V. Montgomery Veterans Affairs Medical Center needing to be taking more aggressive action to remedy problems plaguing it.

Earlier this month, the Department of Veterans Affairs issued findings that G.V. Montgomery Veterans Affairs Medical Center did not have adequate physician staffing in its primary care unit, leading to nurses being responsible for too many patients.  The findings also suggested that further investigation may be necessary.

Although it does not appear that the whistleblowers in this situation suffered retaliation by G.V. Montgomery Veterans Affairs Medical Center for voicing their complaints, such is not always the case.  Unfortunately, whistleblowers often face retaliation, including termination, harassment, demotions, and the like.  There are federal laws preventing this type of retaliation if you are a federal employee.  Certain protections for private employees also exist in Mississippi.

If you are an employee and find yourself in a situation in which you have voiced or believe you need to voice complaints about practices by your employer and are facing retaliation or have concerns about potential retaliation, Barrett Law, PLLC can help you understand your rights and the protections to which you may be entitled.  We have a long history of protecting the rights of whistleblowers.  Contact us today at (800) 707-9577 to schedule an initial consultation.

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New Concerns Raised About Staffing at G.V. Montgomery VAMC in Jackson, Mississippi

Over the span of the past several years, beginning in 2009, serious complaints about the management of G.V. Montgomery Veterans Affairs Medical Center located in Jackson, Mississippi, have surfaced.  The issue boiled over earlier this year when, in March, the United States Office of Special Counsel sent a letter to the White House indicating that the Office of Special Counsel had found a pattern of problems at G.V. Montgomery Veterans Affairs Medical Center.

The United States Office of Special Counsel is an independent federal agency responsible for receiving whistleblower complaints and prosecuting claims under the Whistleblower Protection Act.  It received the complaints in question.  The Office of Special Counsel conducted interviews and ultimately issued the letter to the White House mentioned above.  The complaints involved a wide array of issues, from improper sterilization practices, poor staffing, and missed diagnoses.  Furthermore, the complaints indicated that these issues occurred over a lengthy span of time—six years.

The first of the complaints, dating to 2009, involved allegations that the VAMC failed to properly sterilize equipment.  In 2011, another employee made allegations that sterilization workers were not following proper procedure, including wearing protective clothing.  In 2012, a primary care doctor made allegations that nurses were prescribing medications that they were not authorized to prescribe.  Dr. Phyllis Hollenbeck also complained that, because of inadequate physician staffing in the primary care unit, nurses were providing care that they were not licensed to provide.  Finally, in 2013, a retired ophthalmologist complained that a former radiologist at the VAMC regularly marked images as read when, in fact, they were not.

In response to the whistleblowers’ complaints and the letter from the Office of Special Counsel, the United States Department of Veterans Affairs opened an investigation.  The public disclosure of the details of the complaints by the Office of Special Counsel, which was highly unusual, also lead to an outcry by patients at the VAMC.   The VAMC and the Department of Veterans Affairs attempted to assuage concerns by holding open meeting with patients on April 3, 2013.

Earlier this year, Joe Battle, the director of G.V. Montgomery Veterans Affairs Medical Center, hired a new assistant director, who started in May.  In June, Mr. Battle also issued statements indicating that he would be recruiting a new chief of staff and nurse director.  However, despite his attempts to remedy the problem, one of the key whistleblowers—Dr. Hollenbeck—indicated that the VAMC remains seriously understaffed.  Dr. Hollenbeck’s continued concerns also came amidst statements from Representative Jeff Miller of the House Committee on Veterans Affairs that G.V. Montgomery Veterans Affairs Medical Center needing to be taking more aggressive action to remedy problems plaguing it.

Earlier this month, the Department of Veterans Affairs issued findings that G.V. Montgomery Veterans Affairs Medical Center did not have adequate physician staffing in its primary care unit, leading to nurses being responsible for too many patients.  The findings also suggested that further investigation may be necessary.

Although it does not appear that the whistleblowers in this situation suffered retaliation by G.V. Montgomery Veterans Affairs Medical Center for voicing their complaints, such is not always the case.  Unfortunately, whistleblowers often face retaliation, including termination, harassment, demotions, and the like.  There are federal laws preventing this type of retaliation if you are a federal employee.  Certain protections for private employees also exist in Mississippi.

If you are an employee and find yourself in a situation in which you have voiced or believe you need to voice complaints about practices by your employer and are facing retaliation or have concerns about potential retaliation, Barrett Law, PLLC can help you understand your rights and the protections to which you may be entitled.  We have a long history of protecting the rights of whistleblowers.  Contact us today at (800) 707-9577 to schedule an initial consultation.

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OSHA Ordered Reinstatement and Awarded Damages to a Former Employee of Signature Condominiums, LLC

On September 5, 2013, the United States Department of Labor, Office of Public Affairs issued a press release announcing that one of its enforcement arms, the Occupational Safety and Health Administration (OSHA), ordered reinstatement and awarded damages to a former employee of Signature Condominiums, LLC.  Signature Condominiums, LLC, does business as The Signature at MGM Grand, which is a subsidiary of MGM Resorts International.  The Signature at MGM Grand is a condominium-hotel, specializing in high-end condominium units that can be rented as hotel suites when not occupied by the owner.  The Signature at MGM Grand is located in Las Vegas.

The employee, whose identity is not provided in the press release, disclosed that employees were engaging in actions that violated the Sarbanes-Oxley Act.  The Sarbanes-Oxley Act was passed in 2002 and established and enhanced requirements for publicly-traded companies boards of directors and management, as well as public accounting firms providing services for such companies.  The Act requires, among other things, that individuals must certify the accuracy of financial information.  It was passed in response to corporate collapses and scandals, including Enron, Tyco International, Adelphia, and WorldCom.  The Act has whistleblower protections built into it.

Specifically, the individual disclosed that employees of The Signature at MGM Grand were engaging in forecasting.  Forecasting involved the employees providing expected revenue and occupancy rates for the condominiums to potential buyers.  This type of activity is restricted to security brokers, and the employees in question were not duly-licensed as security brokers.  The individual reported the activities to OSHA, which investigated the charges.  After the individual reported the activities, The Signature at MGM Grand terminated the employment relationship.

OSHA ordered The Signature at MGM Grand to reinstate the individual’s employment.  It also awarded the individual monetary compensation in the amount of $325,000, ordered The Signature at MGM Grand to delete negative information from the individual’s personnel record, and ordered it to post notices regarding employees’ whistleblower rights under the Sarbanes-Oxley Act.  News releases have indicated that The Signature at MGM Grand is expected to appeal the ruling.  The appeal, however, will not stay the enforcement of OSHA’s order.

OSHA’s order highlights the breadth of remedial and other actions that are afforded to prosecuting agencies under whistleblower protection laws.  While a wide variety of whistleblower protection laws exist, including provisions in Sarbanes-Oxley Act; Occupational Safety & Health Act; Clean Air Act, Safe Drinking Water Act; and Comprehensive Environmental Response, Compensation & Liability Act, they all have several features in common.  The provisions protect employees who report violations, who initiate proceedings under any of the Acts in question, who testify at proceedings, or who assist in investigations.

The provisions generally also provide that any individual who believes he or she has been retaliated against for any of the aforementioned actions can report the violation to OSHA.  Depending upon the Act under which the violation occurred, the employee has thirty, sixty, ninety or one hundred eighty days to report the retaliation action.   Upon receipt of a complaint, OSHA notifies the employer.  If conciliation efforts are unsuccessful, OSHA will then move to an investigation phase.  If OSHA determines that there has been a violation, it can order reinstatement, payment of back wages, and reimbursement to the employee for attorneys’ fees.  It can also order additional actions it finds necessary to provide relief.  More detailed information about the various Acts and whistleblower protections they afford, as well as OSHA’s role in whistleblower investigations, can be found at http://www.dol.gov/compliance/laws/comp-whistleblower.htm.

If you are in a retaliatory situation due to your raising of concerns about practices by your employer and live in Mississippi, Barrett Law, PLLC can help you understand your rights and the protections to which you may be entitled.  Our firm has extensive helping individuals obtain the protections to which they are entitled.  Contact us today at (800) 707-9577 to schedule an initial consultation.

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OSHA Ordered Reinstatement and Awarded Damages to a Former Employee of Signature Condominiums, LLC

On September 5, 2013, the United States Department of Labor, Office of Public Affairs issued a press release announcing that one of its enforcement arms, the Occupational Safety and Health Administration (OSHA), ordered reinstatement and awarded damages to a former employee of Signature Condominiums, LLC.  Signature Condominiums, LLC, does business as The Signature at MGM Grand, which is a subsidiary of MGM Resorts International.  The Signature at MGM Grand is a condominium-hotel, specializing in high-end condominium units that can be rented as hotel suites when not occupied by the owner.  The Signature at MGM Grand is located in Las Vegas.

The employee, whose identity is not provided in the press release, disclosed that employees were engaging in actions that violated the Sarbanes-Oxley Act.  The Sarbanes-Oxley Act was passed in 2002 and established and enhanced requirements for publicly-traded companies boards of directors and management, as well as public accounting firms providing services for such companies.  The Act requires, among other things, that individuals must certify the accuracy of financial information.  It was passed in response to corporate collapses and scandals, including Enron, Tyco International, Adelphia, and WorldCom.  The Act has whistleblower protections built into it.

Specifically, the individual disclosed that employees of The Signature at MGM Grand were engaging in forecasting.  Forecasting involved the employees providing expected revenue and occupancy rates for the condominiums to potential buyers.  This type of activity is restricted to security brokers, and the employees in question were not duly-licensed as security brokers.  The individual reported the activities to OSHA, which investigated the charges.  After the individual reported the activities, The Signature at MGM Grand terminated the employment relationship.

OSHA ordered The Signature at MGM Grand to reinstate the individual’s employment.  It also awarded the individual monetary compensation in the amount of $325,000, ordered The Signature at MGM Grand to delete negative information from the individual’s personnel record, and ordered it to post notices regarding employees’ whistleblower rights under the Sarbanes-Oxley Act.  News releases have indicated that The Signature at MGM Grand is expected to appeal the ruling.  The appeal, however, will not stay the enforcement of OSHA’s order.

OSHA’s order highlights the breadth of remedial and other actions that are afforded to prosecuting agencies under whistleblower protection laws.  While a wide variety of whistleblower protection laws exist, including provisions in Sarbanes-Oxley Act; Occupational Safety & Health Act; Clean Air Act, Safe Drinking Water Act; and Comprehensive Environmental Response, Compensation & Liability Act, they all have several features in common.  The provisions protect employees who report violations, who initiate proceedings under any of the Acts in question, who testify at proceedings, or who assist in investigations.

The provisions generally also provide that any individual who believes he or she has been retaliated against for any of the aforementioned actions can report the violation to OSHA.  Depending upon the Act under which the violation occurred, the employee has thirty, sixty, ninety or one hundred eighty days to report the retaliation action.   Upon receipt of a complaint, OSHA notifies the employer.  If conciliation efforts are unsuccessful, OSHA will then move to an investigation phase.  If OSHA determines that there has been a violation, it can order reinstatement, payment of back wages, and reimbursement to the employee for attorneys’ fees.  It can also order additional actions it finds necessary to provide relief.  More detailed information about the various Acts and whistleblower protections they afford, as well as OSHA’s role in whistleblower investigations, can be found at http://www.dol.gov/compliance/laws/comp-whistleblower.htm.

If you are in a retaliatory situation due to your raising of concerns about practices by your employer and live in Mississippi, Barrett Law, PLLC can help you understand your rights and the protections to which you may be entitled.  Our firm has extensive helping individuals obtain the protections to which they are entitled.  Contact us today at (800) 707-9577 to schedule an initial consultation.

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Shocking Allegations Against Vanderbilt University About Rampant Medicare Fraud

In September 2013, a qui tam lawsuit involving Vanderbilt University was unsealed by the presiding judge in the United States District Court for the District of New Jersey.  (A qui tam lawsuit is one in which a private individual asserts allegations on behalf of a governmental unit against individuals or companies that have violated the law in the performance of a contract with that governmental unit.  The private individuals are entitled to a percentage of the damages awarded.)  The lawsuit was originally filed on January 6, 2011, and had remained under seal since the original filing date.  The lawsuit was brought by three former Vanderbilt University Medical Center physicians against Vanderbilt University, Vanderbilt University Medical Center, and The Vanderbilt Medical Group and Clinic.  The lawsuit alleges a stunning and lengthy conspiracy to defraud the United States of America through a systematic practice of overbilling spanning over a decade.

The lawsuit seeks treble (triple) damages and civil penalties on behalf of the United States of America and double, treble, and civil penalties on behalf of twenty-two states.  Mississippi is not an affected state.  According to the Complaint, the teaching hospital at Vanderbilt University Medical Center receives payments from the United States Government under Medicare Part A for its residents’ training expenses and salaries.  It also receives payments under Medicare Part B for services performed by its attending, teaching physicians.  Under Medicare Part B, an attending, teaching physician is not permitted to bill for his or her services unless he or she is present during the key portion of any service and during surgery or delivery of anesthesia, during all critical portions of the delivery of services.

The Complaint alleges that since 2003, attending physicians have not been present during key portions of services and have not been present during critical portions of surgery or the delivery of anesthesia.  The scheduling practices of Vanderbilt are blamed for the inability of the teaching physicians to be present.  Specifically, the Complaint alleges that surgeons often schedule multiple surgeries at the same time and that Vanderbilt is aware of these practices and of the fact that the practices prohibit surgeons from fulfilling their responsibilities under Medicare Part B.  The Complaint goes on to allege that attending physicians in various intensive care units are charged with administrative tasks during afternoons, nights, and weekends.  This work prevents the attending physicians from being present as required.  The Complaint further alleges that attending physicians are not able to be present during all critical portions of the delivery of anesthesia.

Despite the lack of presence of attending physicians, Vanderbilt routinely, and falsely, bills as if the attending physician was present in order to comply with the requirements of Medicare Part B.  The Complaint goes on to allege that the plaintiffs, called relators in a qui tam suit, have brought these management and false billing issues to the attention of Vanderbilt.  In 2008, Vanderbilt performed an internal audit, which verified many of the relators’ allegations but rather than implementing ways to correct the problems, Vanderbilt covered them up and continued the false practices.   The Complaint includes detailed, specific examples of various attending physicians scheduling and billing for separate services on simultaneous dates and times.

One of the relators, Dr. Alexander Fisher, is also seeking damages for retaliation in response to his whistleblowing actions.  He was employed by Vanderbilt from 2003 to 2008, but two days after voicing his concerns about the staffing and billing practices at Vanderbilt, was told he would need to find another job because his contract would not be renewed.  He was denied the opportunity to appeal the decision, despite the fact that he provided a list of seventeen other physicians that left Vanderbilt due to the false billing issues.  Six months after his initial reported concerns, he was required to leave his employment with Vanderbilt as his contract expired.

Last year, news that Vanderbilt was being investigated for its billing practices surfaced and Vanderbilt issued a statement indicating that it was committed to addressing any concerns that were uncovered.  Vanderbilt has denied the allegations of wrongdoing contained in the Complaint.   The lawsuit will be back in court in October 2013.

Barrett Law, PLLC has significant experience representing individuals in Medicare whistleblower cases.  We have been helping individuals through these matters for 75 years, and will be there to help you, too. Contact us today at (800) 707-9577 to schedule an initial consultation.

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