A whistleblower can proceed with a lawsuit that alleges HealthNet and IU Health provided substandard care to low-income pregnant women and fraudulently billed for medical consultations, a federal judge decided, according to the Indy Star.
Judith Robinson, MD, is the whistleblower in the suit against the two Indianapolis-based health systems. HealthNet is an IU Health affiliate that serves low-income patients in inner-city clinics.
Dr. Robinson, who previously served as director of women's services at HealthNet and medical director of OB-GYN services at IU Health Methodist Hospital, brought the lawsuit after discovering patients with high-risk pregnancies were attended to by certified nurse midwives instead of physicians, some leading to dire consequences for the mothers and babies, according to the report.
According to her complaint, Dr. Robinson also described numerous instances in which HealthNet billed Medicaid for reimbursement as if the patients had been treated by physicians when they were treated by non-physician providers.
Dr. Robinson claimed she was fired from HealthNet in 2013 after raising questions about patient safety, according to the report.
U.S. District Judge Tanya Walton Pratt last week said Dr. Robinson's case against IU Health and HealthNet could continue. However, Judge Pratt granted the motion of a third defendant, local managed care insurer MDWise, to be dropped from the case. According to the report, Judge Pratt said Dr. Robinson "improperly lumped" together the insurer with the providers without personal knowledge to support claims against it.
Regarding the judge's decision, Dr. Robinson's attorney said, "[Dr. Robinson's] main motivation from the beginning has been the substandard care that she saw patients receiving, and patients not being treated by doctors when the law requires that high-risk pregnancies be treated by physicians. We were very pleased to see the court agrees with us."
IU Health and HealthNet both declined to comment, according to the report.