A compliance auditor who blew the whistle on alleged improper billing at Indianapolis-based Eskenazi Health claims she was fired for doing so, reports Indianapolis Business Journal.
The compliance auditor, Colette D. Jackson, filed a complaint Thursday in U.S. District Court in Indianapolis, accusing the hospital of improperly billing the federal government and Indiana for patients whose bills were already covered by research grants, according to the article.
Identification of the alleged improper billing dates back to June. At the time. Ms. Jackson said she found the problems after one of her research billing specialists notified her of the matter, according to the report. The problem involved "potentially hundreds" of Medicare or Medicaid patients over at least two years, reports Indianapolis Business Journal, citing the lawsuit.
According to the report, the complaint filed against Eskenazi and its parent, Health and Hospital Corporation of Marion County, claims the two entities retaliated against Ms. Jackson after she recommended a temporary suspension and a review of the research billing practices.
In July, Ms. Jackson forwarded the billing information along with her recommendation to her supervisor, Gina Thompson, Eskenazi's chief compliance officer. Ms. Thompson told Jackson to drop the investigation, the complaint said. On Sept. 15, Ms. Thompson terminated Ms. Jackson. The reason given for the termination, according to the complaint, was that Ms. Thompson had recently found inconsistencies in two separate versions of the resume in her personnel folder.
An Eskenazi spokesman told Indianapolis Business Journal it would be inappropriate to comment on a pending lawsuit.
Medicare and Medicaid regulations require medical providers treating patients who are also part of a grant-supported study to include a specific code in its billing so the agencies can determine whether the treatment was already paid by the grant, according to the report.
Ms. Jackson is asking to be reinstated, with back pay, damages and attorney fees.