Legal Question in Employment Law in New York
Threatened Termination /Tampering With Medical Records
I work in a skilled nursing facility in New York. Recently, management admitted a patient one day short of a Medicare required three day hospital stay. When the admitting department noted the error, the employer discharged the patient back to the hospital and readmitted him the following day. All of the original admitting documents were destroyed, the medical record number was changed and Medicare is being billed for the patient's care. I was informed by management that if I spoke about it (the original admit date) to anyone, I would be terminated.
My employer does not know that my manager and I have copies of the original discharge slip from the hospital, the admitting documents from the SNF, preliminary nursing assessment, discharge papers releasing the patient back to the hospital and copies of the altered patient's log with the medical record number crossed out and a new one assigned.
We are upset about being involved in Medicare fraud as well as the threat of (wrongeful) termination, but don't know how to proceed. The employer has been generally making our lives miserable since then in a number of ways. Thanks for any feedback you can provide.
2 Answers from Attorneys
Re: Threatened Termination /Tampering With Medical Records
Please call me to discuss this matter privately.
Re: Threatened Termination /Tampering With Medical Records
Thank you for your inquiry. This response is for informational purposes only and should not be construed as legal advice.
You raise two issues - apparent medicare fraud and retaliation in the form of termination if the fraud is reported.
Most regulatory laws have built in protections against retaliation - whether discharge, demotion or the like - against those who report perceived violations of those laws. From what you describe, you must determine whether in fact this is fraud that should be reported, or whether as unseemly as the behavior is, whether it is a common everyday occurrence.
If in fact it is clearly inappropriate behavior and you wish to report it, start with the NY Attorney General's Office, specifically their medicare fraud unit or similar unit. They have attorneys on staff who can provide further advice, and you can speak with them about your fear of retaliation. If they cannot help you, they should be able to recommend who can.
I hope this had been of some help. Thank you again for your inquiry.
Related Questions & Answers
Looking for something else?
10,200 active attorneys ready to answer your legal questions today.
Featured Attorneys
Earn additional revenue and grow your business.
