Fired Employee Files Medicare Fraud Lawsuit Against Medical Center

An employee who says she was fired after bringing to light falsified records by the Nebraska Medical Center has filed a Medicare fraud lawsuit against the Center.

Whistleblower Roberta H. alleges in her Medicare fraud lawsuit that Nebraska Medical Center retaliated against her when she tried to tell leadership about falsified Medicare submissions by the Center. In addition to Medicare fraud, the plaintiff says that the Center violated Nebraska state employment law.

According to the Medicare fraud lawsuit, Nebraska Medical Center “submitted false claims to Medicare by relying on bills that were never signed by the provider, including billings for services that were not rendered.” The plaintiff says that in 2015 she learned that a cardiologist at the practice had given members of his staff his electronic password to sign off on medical procedures and tests.

The doctor “falsely certified, on behalf of NMC, that Medicare services were provided in compliance with regulations. Each statement and certification submitted by NMC, which was required to be certified by [the doctor] was both false and fraudulent because the forms were not certified by [the doctor], but by staff assistants, sonographers and others,” Roberta alleges in the Medicare fraud lawsuit.

Employee Claims Illegal Retaliation for Reporting Medicare Fraud

The plaintiff states that she reported the illegal practice to the Nebraska Medical Center’s Medical Director who told her to report it to the plaintiff’s manager. The plaintiff’s manager said that she would investigate, alleges the Medicare fraud lawsuit, but never told the plaintiff the result of the investigation.

However, after reporting the alleged Medicare fraud, the plaintiff says she was targeted by her supervisor in weekly meetings in which her manager confronted her about trivial matters. The plaintiff says she had never been targeted for such monitoring since she began her employment at the Medical Center in 1982.

“This practice continued throughout the remainder of [her] employment,” the Medicare fraud lawsuit states. “[She] had never been subjected to such frequent monitoring until after she reported [the doctor’s] practice of allowing staff members to forge his electronic signature on submissions to the CMS for payment from Medicare and Medicaid.”

The whistleblower plaintiff alleges Nebraska Medical Center committed Medicare fraud by knowingly creating false billing records for the government, presenting these false bills for payment from the government, and conspiring to commit the fraud.

In addition to the alleged Medicare fraud, the whistleblower plaintiff alleges that the Nebraska Medical Center unlawfully retaliated against her for reporting – violations of the False Claims Act and FEPA (Fair Employment Practices Agencies), committing age and sex discrimination, and harming the ability for the employee to do her job.

This practice allegedly continued throughout the remainder of her employment. The plaintiff claims she had never been subjected to such frequent monitoring until after she reported the doctor’s practice of allowing staff members to forge his electronic signature on submissions to the CMS for payment from Medicare and Medicaid.

Reporting Medicare Fraud

Medicare and Medicaid fraud robs the government and tax payers of desperately needed healthcare funds used to support programs across the country. Fraud can include false bills submitted to the government for services not provided or submitting bills that solicit overpayment for services.

Employees who have evidence of Medicare fraud or other illegal activities may be hesitant to bring this information to their employers for fear of retaliation; however, the courageous employees who blow the whistle on their employers’ illegal activities should know that they are protected from retaliation under various federal and state laws.

Additionally, employees who go on to file a successful whistleblower lawsuit on behalf of the government are typically provided between 15 percent and 30 percent of any damages or settlement awards. Many whistleblower awards run into the millions, so the amount that the whistleblower may get could be substantial.

If you have evidence or suspect Medicare fraud at your place of employment, an experienced whistleblower attorney can help guide you through the process and stop the illegal activity that defrauds our government.

The whistleblower attorneys at Bradley/Grombacher can help. Fill out the form on this page for a free and confidential review of your whistleblower claims. If you have a case, they will contact you to discuss your next steps in a free, no-obligation consultation.