quote:

Originally posted by Kevbo:
Another thing to think about is what you’re describing is likely insurance fraud, and if Medicare and Medicaid are involved it is likely a federal crime....

There are likely whistleblower protections out there if you would want to explore that route

Does the severance package contain a silence clause?

Because, if it was me, I would probably take th severance and then report what I had seen...

And there is a significant financial reward for the whistle-blower if the claim is substantiated. An office manager in the office of a oncology group in FL that was ordering unnecessary tests received a $1.1M payment from the Feds.

IANAL. I would consider consulting one, then likely taking the money and landing on my feet elsewhere.

Since you mentioned "fraud," google "healthcare fraud qui tam attorney" and consider that whistleblowers in THAT sense are treated very, very well when there are recoveries.

I had a similar experience with the health care "industry". Dip into your savings and buy parkas for you and your family and come to MQT. We have just built a new hospital. I dont know first hand how good hospital management is, but the community needs you.

quote:

Originally posted by sns3guppy:
Jim,

Take the severance and find a better employer. Life's too short to be stuck working for assholes, particularly dishonest ones. I don't take a job I'm not willing to walk away from, and I have.

The temptation will be strong to put your feelings in a resignation letter. It's best not to.

You might talk to an attorney privately about a whistleblower claim.

+1

Revenge is a dish best served cold.

What are you still doing there? Take the money and run.

Sorry for your turmoil.
Hope you learned something and will handle it differently next time.
Maybe it's good for both you and your employer to part ways.
Good luck.

I had a buddy call with this conundrum once. I said only he could make the decision, but if it ever happened to me, I'd make them terminate me. Maintain all of my rights, get unemployment, and start job hunting. Most big employers aren't going to reveal anything other than that you worked there and most savvy background investigators will get the truth anyway.

I hope there are as many ARNP jobs where you are as there are here.

No...you cannot be legally bound contractually to NOT report a crime. It just gets a little more complicated in the initial he said, she said. Whistleblower statutes almost always provide immunity to the whistleblower from any civil liability from violation of a contract. For example, a lot of places make you sign disclosure agreements, hut they can’t enforce them and try to stop someone from reporting and revealing a crime

It can be hard on whistleblowers....that’s why the feds pay so much for them

Medicare fraud is a big deal. A big, big deal. My wife and I spend a shit load of time making sure everything is coded and billed properly.

quote:

Originally posted by irreverent:

quote:

Originally posted by Kevbo:
Another thing to think about is what you’re describing is likely insurance fraud, and if Medicare and Medicaid are involved it is likely a federal crime....

There are likely whistleblower protections out there if you would want to explore that route

Does the severance package contain a silence clause?

Because, if it was me, I would probably take th severance and then report what I had seen...



(No one gets away with that stuff forever. I’m a lawyer that owns a medical practice and worked once upon a time as part of a private profiling team that consulted for law enforcement. It’s been an interesting life. Anyway, when it goes south, they will look at former employees to be witnesses. If what you’re seeing really is rampant fraud it’s just something to consider)

Can a silence clause be enforced if what he reports was fraudulent? I’m curious, and pretty naive about legal issues- like OP, I just believe what’s right is right, and that the telling the truth shouldn’t be punished.

I agree, move on and don’t badmouth your current to your future employer. It just leaves a bad taste. As others said, once you’ve stabilized your position, take a closer look at the infractions you witnessed and determine if they are reportable. At that point, I’d follow my conscience.

I also hate to bring this up, but if you’re an NP, are you sure they haven’t billed you improperly?

There is a Medicare fraud hotline. 1-800-MEDICARE

If it was just a bad job I’d be on board with the take the severance, find somewhere better and good riddance to bad people

But your statements about witnessing what is likely a federal crime changes that scenario for me

quote:

Originally posted by SevenPlusOne:
Revenge is a dish best served cold.

This is correct.
"Take the severance pay and run" and "Report The crime"...all good advice and please do exactly that.
But wait a few months after you've landed a new position and then nail their smelly hides to a wall. Every detail you can substantiate. If nothing else for your own peace of mind and for us poor saps who are paying elevated premiums because of these idiots.
I wish you and your family the best.

You have to take care of your own interests first. However, in my humble opinion you have an obligation to the long suffering taxpayers (and your children and grandchildren who are being saddled with this enormous debt we are running up) to report any Medicare or Medicaid fraud that you may be aware of. This is the link to the Medicare OIG website. I recommend the website rather than calling 1-800-Medicare. (Trust me. You want to go straight to OIG. Not implying anything. It's just better to go straight to the OIG.) The 800 number is the general Medicare number. The website has the phone number directly to OIG. It also gives you several different ways to make your report. What you describe (billing for services never performed) is classic Medicare fraud. https://oig.hhs.gov/fraud/report-fraud/index.asp

Take the money, lock down a new job, then make some discreet mentions to parties that might be interested in investigating the fraud.

Pick and choose your battles carefully. Take the severance package with an agreement that they only verify wages and time period worked. Do not allow them to answer the question "Would you rehire?" Have them state that is is company policy not to answer that question or any derivatives of it.

And you probably know this already but be careful if and what you post on social media about your previous employer. I know of a couple people that have posted in anger and has come back to bite them in the future. I go by the motto "If you can't say anything nice don't say it at all". Remember they probably have deeper pockets than you.

There will be some that do not agree with my approach but remember you have to provide for you and your family, no sense in creating more roadblocks to your future.

I vote bail, lawyer up, and sue under a whistle blower law. Get a large severance and negotiate a mutual non disclosure.

As a PA I can tell you with PA’s and NP’s in such demand taking the severance and getting a new job will be no problem. I resigned from a horrible job about 18 years ago and had a new job in under 24 hours. If you are a skilled competent NP the same should go for you

take the severance and find a place you'll be happy working. life is too short for any of the other options

quote:

Originally posted by shovelhead:
There will be some that do not agree with my approach but remember you have to provide for you and your family, no sense in creating more roadblocks to your future.

This is the only correct answer. I can’t understand why anyone would suggest the OP become a whistleblower. He should be concerned with his career and family. Ohio is an at-will state. Take the money and run. If anyone is concerned with Medicare/Medicaid fraud they should apply to a federal law enforcement agency. If someone thinks becoming a whistleblowing martyr is some noble righteous calling you’ve been watching too many movies.

quote:

Take the severance package and run.

Yes, swallow your pride and run.

If anyone is concerned with Medicare/Medicaid fraud they should apply to a federal law enforcement agency. If someone thinks becoming a whistleblowing martyr is some noble righteous calling you’ve been watching too many movies.--------------------------------------------[/QUOTE]

Have to disagree. Law enforcement can't be everywhere. The ONLY way to become aware of a crime like Medicare fraud is to have someone report it. It's not like there is a dead body that someone will find. Do the right thing. Report it. If you want to, wait a few months. OIG will accept confidential reports. If you have concerns, call the OIG hotline. Ask to speak to the duty agent. Explain what your concerns are about reporting the fraud. They will give you your options. Additionally, you are not really acting as a whistleblower who will have to fight it out from the inside and take all the abuse. You're already gone, out the door. What can they do to you - nothing. HHS OIG 1-800-447-8477