Even with the Best Intentions, Whistleblowing is Grueling for All Concerned

Are whistleblowers bottom feeders who betray their employers to make a buck, or crusaders for the public good, responsible for bringing to light corporate or government malfeasance? Whichever your answer, the fact is that whistleblower lawsuits, to which urgent care operations are clearly not immune, take a massive toll on both the whistleblower/complainant and the defendant in the suit. The majority of cases involve healthcare, with Medicare fraud being an especially rich field (probably not surprising, given the program covers roughly 18% of the U.S. population). Such was the case detailed in a new article in The New Yorker, wherein a physician launched a whistleblower suit against the health insurance company that employed him, charging that the company unfairly cherrypicked healthy Medicare members while “lemon-dropping” those most likely to cost more. Years into the case, the company was found to have violated the False Claims Act and agreed to pay $31.7 million to settle the case with the government. By then the whistleblower, who went through a long period of unemployment and personal upheaval after his charges became public, had passed away in an unrelated accident; his percentage of the settlement went to his estate. The moral of the story is that there is no smooth road through a whistleblower case, for the accuser or the accused. The best way to avoid being the defendant in a case is to ensure that your urgent care center makes every effort to comply with both the letter and the spirit of relevant laws and regulations. JUCM will publish an article on how to protect your business from whistleblower lawsuits this spring. Look for it and see if any of the red flags identified apply to your operation—and take corrective action if they do.