Health Care Whistleblowers: Dedicated to Ending Health Care Fraud

Health care whistleblowers are, in our humble opinion, pretty amazing people. They speak out against some of the nation’s biggest and most powerful companies, often taking their concern public after butting heads with company executives. Others see the same wrongs that whistleblowers spot and many are similarly upset, but whistleblowers take the critical next step — raising their concerns in a forum that can lead to change. Sadly, some people degrade whistleblowers, suggesting they are only looking for a payout. Simply stated, our California health care fraud attorney couldn’t disagree more.

From Whistleblower…
One whistleblower who demonstrates the commitment to right shared by most is Jacqueline Nash Bloink, whose story is shared by the Arizona Daily Star. Between 2010 and 2011, Bloink worked as a corporate responsibility coordinator for Carondelet Health Network, a healthcare provider in Southern Arizona. In that role, the certified medical reimbursement specialist noticed billing discrepancies in the files of Medicare, Medicaid, and the Federal Employees Health Benefit Program enrollees. Bloink filed a whistleblower suit pursuant to the False Claims Act (“the Act”) in 2011. The suit accused Carondelet of engaging in fraudulent billing practices, citing insufficient documentation to support inpatient rehab services allegedly performed at two network hospitals between April 2004 and December 2011. The U.S. Attorney’s Office helped investigate the case which settled in August for $35 million, the biggest payout to date for a federal False Claims Act case in Arizona.

Bloink earned close to $6 million for her role in the Carondelet case. The Act grants whistleblowers a percentage of any recovery, including a 15-25% payment in cases where the government intervenes. A representative for the U.S. Attorney’s Office in Arizona explains: “Whistleblowers – who at times have valuable, inside information – are an important part of the government’s efforts to detect and remedy fraud and abuse, and our office welcomes and appreciates their efforts.”

…To Educator
One of the best testaments to the true commitment of whistleblowers is what Bloink has done since earning the large payout. She is working to launch a campaign to prevent health care fraud. In a letter to her local community, she notes that most whistleblowers go underground after their “ordeal” ends but says “I intend to use my newly obtained silver hair to try and help our healthcare system by being open about fraud and discussing ways to prevent it.”

Taking her decades-long training in compliance matters, begun in the 1990s, Bloink is trying to train those in the health care industry to be fraud watchdogs. She suggests most providers don’t set out to defraud the government and are unaware that certain practices amount to fraud. Her goal is to have Tucson be a role model for a shift from a reactive model to a proactive approach educating medical students and others in the medical field about fraud, waste, and abuse. While Bloink is scheduled to speak to groups from the Association of Certified Fraud Examiners’ local and Los Angeles branches early next year, she has found little initial interest from the medical community.

…or Voter Information Source
Bloink is not the only former whistleblower who, rather than resting on a large award, remains focused on preventing and remedying health care fraud. Take John Shilling, who shared in a $100 million whistleblower award. Yahoo!News reports Shilling is now focused on politics, specifically informing voters about a big-name incumbent candidate’s role in the fraud (note: the candidate was never charged but was a founder of the company involved). Notably, Shilling counts himself as a member of the same party as the candidate he is speaking out against.

Protecting Whistleblowers, Recognizing Their Import
Patrick Burns, co-director of Taxpayers Against Fraud Education Fund, refers to whistleblowers as “force multipliers” and “guides to secret knowledge.” He suggests the complexity of the billing systems makes whistleblowers, who understand both the system and the individual companies, essential. Burns believes whistleblowers are good people doing the right thing, although he finds they can be a bit naïve in believing that companies share their positive motives.

Whistleblowers are impressive people, heroic in a way, but they have very real fears about the cost of doing good. Many are afraid to alienate their employer and possibly future employers as well. Attorney Greg Brod understands the fear. He also knows that the law provides protections against retaliation in addition to the financial award. Call to arrange a meeting with Attorney Brod, a Northern California whistleblower’s attorney dedicated to fighting fraud, recovering wrongfully diverted government funds, and protecting the people who make the fight possible.

(Image by Flicker user 401(K) 2013)