News: Coder claims she was fired after disclosing billing fraud, files lawsuit
Debra Conrad filed a lawsuit in the U.S. District Court for the Western District against Heartland Regional Medical Center, also known as Mosaic Life Care, alleging wrongful termination for raising concerns about fraudulent billing practices, Revenue Cycle Advisor reported.
Conrad alleges that hospital officials instructed her to report services that were not supported by documentation. Conrad processed the charges but included a statement in her entry that she did not believe the claims were supported by documentation or eligible for Medicare reimbursement and that her supervisors authorized the release of the charges even though Conrad believed they were fraudulent.
Shortly after the claims were submitted, Conrad was reassigned to a position in another department. She was replaced with someone who was 15 years younger, asked to create an individual development plan, and given a three-day suspension, the St. Louis Record reported.
Conrad notified the human resources department that she believed these disciplinary actions were taken because of age discrimination and her decision to disclose fraudulent billing practices, according to Revenue Cycle Advisor. She met with human resources and coding department management to discuss the allegations.
Following the meeting, Conrad was accused of violating HIPPA. She filed a complaint about this allegation and was fired shortly after.
Conrad had been employed as a medical coder with Mosaic Life Care for 40 years before her termination, the St. Louis Record said.
She seeks more than $75,000 in compensatory damages, as well as damages authorized under the False Claims Act, lost wages and benefits, attorneys' fees and reinstatement.
Editor’s note: This article originally appeared in Revenue Cycle Advisor. To read the St. Louis Record’s coverage of the story, click here. To read about a recent case in which a CDI specialist blew the whistle on fraudulent billing practices, click here.