Consumer Fraud

Oregon Health Care Provider Sued For Medicare Fraud, Whistleblower Retaliation

Pills Stethascope on Money 435x289 Oregon Health Care Provider Sued For Medicare Fraud, Whistleblower RetaliationThe former CEO of Architrave Health, LLC, a major Oregon health care provider, filed a whistleblower lawsuit against the company Tuesday, alleging he was terminated and then blacklisted in the medical community as punishment for reporting millions of dollars in fraudulent Medicare billings and improper financial relationships with local physicians.

According to The Oregonian, the Medicare fraud accusations made by Dr. Robert Dannenhoffer against Architrave are potentially “explosive” in a state that prides itself for its “progressive healthcare reform.” If is claims stand up in court, The Oregonian reports, it means “a major medical provider was prepared to look the other way as doctors enriched themselves at taxpayers’ expense.”

Dr. Dannenhoffer claims he was fired in February after he demanded that Architrave report improper payments it made to Umpqua Medial Group, an Architrave subsidiary, in violation of the Stark Law, and for submitting falsely inflated claims to Medicare for reimbursement.

The False Claims Act allows private individuals to sue on behalf of the U.S. government when armed with solid, original evidence of fraud committed against federal agencies and programs, while the Stark Law limits the financial relationships health care providers can have with physicians where Medicare and Medicaid patients are involved.

Dr. Dannenhoffer alleges Umpqua created a compensation structure that financially rewarded physicians for prescribing certain drugs and treatments for Medicare patients. The arrangement benefitted both Umpqua/Architrave and the physicians who provided referrals.

The former CEO also alleges that the retaliation didn’t stop with his termination but continued as he searched for employment elsewhere.

“Architrave and its members … have told members of the Roseburg medical community that they will have nothing to do with Dr. Dannenhoffer in retaliation for his unwillingness to go along with their fraudulent schemes,” the lawsuit claims.

According to The Oregonian, Dr. Dannenhoffer seeks reinstatement to his job as Architrave CEO, back pay, punitive damages, and attorney fees.

“He wants to have his reputation restored,” his lawyer told The Oregonian.

Source: The Oregonian