Consumer Fraud

U.S. backs whistleblower nurse’s claims of fraud against Florida hospital

osha whistle U.S. backs whistleblower nurse’s claims of fraud against Florida hospitalDAYTONA BEACH, FL – A Florida nurse-turned-whistleblower who is suing her employer for allegedly performing unnecessary surgeries and putting patients’ lives at risk in order to overcharge Medicare and Medicaid will have her case heard in November.

Elin Baklid-Kunz, a nurse at Halifax Health Medical Center, filed the whistleblower lawsuit in 2009, accusing the hospital of providing illegal kickbacks to doctors, inappropriately admitting patients, and performing unnecessary spinal surgeries.

Ms. Baklid-Kunz filed the lawsuit under the False Claims Act (FCA), which has a Qui Tam provision that allows private individuals to sue on behalf of the U.S. government when they witness financial fraud, waste, mismanagement, and other wrongdoing. The U.S. Justice Department decided to join the case 2011 after investigating the claims.

According to the lawsuit, one investigation of the hospital’s practices found that a neurosurgeon had been performing surgeries that weren’t medically necessary. When the hospital was made aware of the situation, it failed to take corrective action and did not notify patients who had the surgery, nor did it notify the government.

Ms. Baklid-Kunz told WFTV that she realized she had to put her career in jeopardy and blow the whistle when she discovered that the hospital was admitting patients who didn’t need to be admitted, and that one doctor was performing spinal fusion surgeries on patients who did not need them. The wrongdoing, she alleges in her lawsuit, was all done for money.

“Everyone knew about all of these things, but they just weren’t doing anything about them,” Ms. Baklid-Kunz’s lawyer told WFTV. As a result, the hospital was overbilling Medicare and Medicaid hundreds of millions of dollars.

Patients who are concerned they may have received an unnecessary spinal fusion surgery at Halifax Health may obtain their medical records and seek legal representation, WFTV reported.

The U.S. Justice Department wants Halifax Health to pay between $350 million and $600 million in penalties and damages for defrauding government programs designed to assist the poor and elderly.

If the case against Halifax Health is argued successfully, Ms. Baklid-Kunz will receive a percentage of the federal government’s recovery as a reward for bringing the case. Whistleblowers who help the U.S. recover vital taxpayer funds typically share between 15 and 25 percent of the total recovery.

Sources:

WFTV
The Daytona Beach News-Journal