Consumer Fraud

Whistleblower Says Kansas Hospital Falsified Records For Bigger Government Reimbursements

whistleblower 3 370x210 Whistleblower Says Kansas Hospital Falsified Records For Bigger Government ReimbursementsAn emergency room nurse in Lawrence, Kan.,has filed a whistleblower lawsuit against Lawrence Memorial Hospital, alleging it routinely falsified patients’ medical records to obtain bigger payouts from Medicare and Medicaid.

Megen Duffy filed the lawsuit in a Kansas City, Kan., federal court under the False Claims Act, alleging that the hospital’s top executives were aware of the fraudulent practices and threatened to terminate employees who challenged them.

According to Ms. Duffy’s complaint, Lawrence Memorial “designed a system to submit false records and reports that violated best practices, jeopardized patient safety, and defrauded the federal government.”

In this scheme, the complaint alleges, emergency room personnel were ordered to record the time that potential heart attack patients were hooked up to an EKG as their actual arrival time at the ER. By doing this, Lawrence Memorial was able to conceal “any time the patient spent in the waiting room, at registration or in triage.”

Altering the records of Medicare and Medicaid patients to make it appear as though they were connected to an EKG the minute they arrived at the ER significantly boosted the hospital’s performance data. The falsely inflated scores then qualified Lawrence Memorial to receive higher Medicare and Medicaid reimbursements under a federal law intended to reward hospitals for good performance and incentivize better care.

Ms. Duffy worked at the Lawrence Memorial Hospital ER from August 2009 to October 2013. She alleges she was fired for objecting to the misconduct and that the hospital fabricated a reason for her termination, saying she had threatened another employee.

Ms. Duffy seeks an unspecified amount of damages on behalf of the U.S. government. “We’ve got some strong witnesses and some strong evidence to move forward with,” the plaintiff’s attorney told the Salina Post.

Source: Salina Post