Pennsylvania Hospital Faces False Claims Act, Wrongful Retaliation Allegations

Pennsylvania Hospital Faces False Claims Act, Wrongful Retaliation Allegations

In a False Claims Act and wrongful retaliation lawsuit filed earlier this year, a former Montgomery County laboratory technician is making startling allegations against Abington Hospital and its administration, including the assertion that she was unfairly threatened with termination following her decision to expose alleged billing discrepancies. The cause of action, which alleges counts under the federal False Claims Act and the Pennsylvania Whistleblower Law, seeks not only actual damages caused by the wrongful conduct, but punitive damages, as well.

Details of False Claims Act Allegations Against Abington Hospital

The whistleblower in this case is a former patient access manager for Abington Hospital, where she also served as a staff member in the Registrar’s office. According to her allegations, blood testing and analysis for hospital patients was routinely performed on-site at the hospital pursuant to a specific coding and labeling procedure. However, any blood work or laboratory testing to be evaluated for a Medicare or Medicaid patient was to be sent to an outside laboratory, and clearly labeled as a specimen belonging to a Medicare or Medicaid patient.

According to Medicare and Medicaid rules, reimbursement for laboratory testing within the hospital would be possible only in the event of an emergency situation. In other words, if a patient was in need of emergency services, the government would reimburse on-site testing as opposed to making the hospital wait for the results from an off-site facility.

Allegedly, Abington Hospital began engaging in the routine practice of labeling nearly all specimens as in need of emergency evaluations, thereby triggering allowable reimbursement. The relator, who began to notice this practice in 2013, brought it to the attention of the administration as an unlawful billing procedure possibly triggering liability under the False Claims Act. From there, she routinely brought the issue up at weekly meetings with administration, and was continually told the issue would be fixed. After several months, the relator overheard members of the nursing and laboratory staff instructing one another to label all specimens with the word “STAT,” at which point she alerted those higher in the chain of command.

Not only were the relator’s claims ultimately ignored, but she was accused of violating HIPAA laws and threatened with termination. After an “internal review,” the relator was eventually cleared of these allegations, but informed she would not be returning to her previous position. When asked for her resignation, the relator refused – prompting immediate termination of her employment position. The relator asserts she had maintained a spotless employment record since 1988, and asserts that her termination was the result of her exposure of the unlawful billing practices.

Contact a Reputable Whistleblower Attorney Today

If you are facing a similar situation in your workplace, please know that you are protected from wrongful termination or demotion based on your exposure of fraudulent business practices. For more information about a False Claims Act lawsuit, please contact Berger Montague today.

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By |2022-04-22T06:39:53-04:00August 25th, 2014|Healthcare Fraud|