Legal Question in Employment Law in California

Termination, Fraudulent Billings, & Unemployment Challenged
hires on as a medical biller/collector/coder for dr�s office. After 40 hr�s of training informs dr that scope of her responsibilities is more than the position she applied for. Also informs dr that if they were audited, they would be fined for fraudulent billing to Medicare and ins companies she discovered during her training. Dr is angered and says the ins companies rip him off. He fires her a few weeks later stating that she was not fast enough for their office. No verbal or written warnings given. Ground for wrongful termination suit?

applies for unemployment ins. and is being challenged by dr�s office. EDD of CA tells that dr�s office is claiming that her resume is false. can demonstrate that her resume is not false. If she were denied unemployment due to false statements by the dr�s office, would there be a case here?

She believes that she should report the fraudulent billing (and has the documentation to support all claims), but would this be waived off as sour grapes?

Asked on 9/27/03, 7:06 pm

2 Answers from Attorneys

Anthony Luti The Luti Law Firm

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Re: Termination, Fraudulent Billings, & Unemployment Challenged

Thank you for your inquiry. Donald is absolutely right. The civil false claims act is an anti-Medicare fraud weapon that enables the government to obtain sizable revenues through the imposition of treble damages and penalties of up to $10,000 per claim. Individuals such as yourself can bring a qui tam suit on behalf of the United States and -- if the United States intervenes, could result in you receiving a portion of the proceeds for being a whistleblower. Our firm has significant experience with qui tam actions. Please let us know if we can help.

With respect to the employment issues, based on the limited facts that you have provided here, there may also be claims for retaliation, potential Title VII violations and the like. Please feel free to contact our firm if you'd like to discuss the situation further.

Answered on 11/21/03, 2:14 pm

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