(CN) - A Texas doctor claims in court that a physicians network fired him for blowing the whistle on a doctor whom he believes improperly claimed a Medicare bonus.
Edward Leins, of Lubbock, sued UMC Physician Network Services and CEO Paul Acreman in Lubbock County Court.
Leins claims that a coworker at Kingspark Heath Center, Patrick Hanford D.O., examined patients who had no appointments and no need for new prescriptions.
Hanford is not a party to the complaint.
"Leins observed the front desk personnel receive a phone call with instructions from Hanford to contact Medicare-aged grandparents of sick grandchildren that were brought to the clinic and request that the grandparents come in to the clinic to be seen by Hanford," the complaint states. "Leins observed Hanford arrive at the clinic wearing his white coat, but without clocking in, as is customary when arriving to see patients."
Leins claims that after Hanford conducted a brief exam of a sick patient's grandmother in June 2011, he filled out an electronic record of the exam and sent a duplicate for medication for which she already had a prescription.
Leins says that he learned in February that Medicare offered a $28,000 bonus to doctors who implemented an acceptable level of electronic health records.
"Leins further discovered that Hanford had attested that he had met the Medicare guidelines to receive the bonus," the complaint states.
"At this time, Leins believed that Hanford's actions of examining patients that had no appointments and no need for new prescriptions was improper."
Leins says he reported the conduct to Acreman and chief operating officer Glen Frick, who thanked and congratulated him for "doing the right thing," the complaint states.
He says he provided copies of the patient records he made from the June 2011 incident and filed a complaint with the Texas Medical Board on March 9 this year.
Leins says that one month later, he was abruptly suspended and reprimanded for allegedly violating the Health Insurance Portability and Accountability Act and False Claims Act.
"Leins was not only reprimanded for reporting Hanford's behavior, but also for failing to report the behavior earlier," the complaint states. "Leins was further instructed to attend HIPAA training locally provided by UMC PNS and a LIVE CRE course on ethics and professionalism at his own expense."
Leins claims that after he filed a grievance against the suspension, he was informed by the Texas Tech University Health Science Center that his contract was being terminated. He believes the school did not conduct a separate investigation, but acted solely on information provided by UMC PNS.
"Leins expressed his opposition to the allegations, his concern that the review process was improperly administered, biased or unfair, his concern that the actions were retaliatory, his belief the actions were in violation of UMC PNS employment policies, and his request for access to any policies, procedures, or ethics codes," the complaint states.
Leins claims that he has since learned that the defendant violated several of its own policies, that the peer review committee should have been comprised of unbiased physicians and that he should have been provided written notice of the review process, among other things.
Leins seeks actual and punitive damages for violations of the Texas Whistleblower Act, breach of contract and tortious interference. He is represented by H. Grady Terrill with Craig Terrill of Lubbock.Follow @davejourno
Read the Top 8
Sign up for the Top 8, a roundup of the day's top stories delivered directly to your inbox Monday through Friday.