Most employee discrimination lawsuits involve an employer who uses discriminatory hiring practices to weed out potential hires. In certain circumstances, a hostile work environment is created by a company-wide culture of discrimination. There is another class of employment law altogether that relates not to protected people but to protected actions. These often involve a company retaliating against an employee for filing a complaint or blowing the whistle on an illegal or unethical practice.
Retaliation lawsuits come in many forms. Sometimes employees are fired because they file complaints against co-workers or managers. On rare occasions, employees are fired because they refuse to do something illegal or disclose illegal activity.
Such was the case for one Missouri medical coder who claims she was fired by her employer for disclosing fraudulent billing practices. The woman claims that the hospital instructed her to release charges for billing regardless of whether or not there was documentation to support the claim.
The woman advised the hospital that they were in violation of the False Claims Act. She processed the charges but noted that it was her supervisors who authorized the release and left a note in the file saying that she believed the claims to be fraudulent.
Shortly thereafter, the woman was moved to a coding position in a different department. Before that, however, she was briefly suspended and given a formal reprimand. Upset, she scheduled a meeting with her HR department and coding management. They accused her of violating HIPAA and fired her shortly afterward.
She is now suing the hospital for wrongful discharge.
Retaliation Protection Under the Law
Under both federal and Missouri law, an employer cannot harass, demote, or fire an employee for blowing the whistle on an employer who is expecting him or her to break the law. In Missouri, whistleblowers are protected when an employer is taking some action that is contrary to the public good or that violates public policy. Committing insurance fraud against publicly funded programs like Medicare or Medicaid would certainly qualify.
In a case such as this, the Attorney General’s office will usually come in to investigate fraud claims against Medicaid.
Medicaid Fraud and Whistleblowing
Although Missouri is considered an at-will state for employment, meaning employers can discharge an employee for any legal reason, there are certain exceptions available to whistleblowers. An employer cannot require an employee to knowingly violate the law. Nor can an employee be terminated for reporting the violation of the law to supervisors or a third party. In this case, the woman had made her apprehension concerning “phantom billing” known to her supervisors, while simultaneously disclaiming any wrongdoing in the file.
Now the hospital may face not one but two legal actions against it. One for wrongful termination based on retaliation, and another by the state seeking to recover fraudulent charges to publicly funded health insurance.
If you have been the victim of a retaliatory firing, contact HKM Employment Law of Kansas City and we can begin discussing your case.