WASHINGTON (CN) – Casting himself as a whistleblower in a federal complaint, a doctor says he lost his job after reporting Medicare overbilling to the D.C. City Council.
Represented by the firm Katz, Marshall and Banks, Julian Craig notes that between 2015 and 2017 he was chief medical officer of the United Medical Center, with Veritas of Washington managing operations since 2016.
Craig, who won the Physician of the Year award twice during his brief tenure, says the management shift coincided with a noticeable shift in patient care and safety.
“Under Veritas’ direction, UMC eliminated positions that were critical for protecting patient health and safety, unilaterally attempted to reduce Dr. Craig’s pay and hours, and forced other hospital executives who objected to these practices into involuntary resignations,” the Feb. 15 complaint states, filed in the U.S. District Court for the District of Columbia.
The lawsuit alleges that Veritas pressured doctors to admit people who didn’t meet Medicaid and Medicaid laws, just so the hospital could gain more profit, violating federal and state laws.
Craig also describes one Veritas officer’s “checkered history of entering into lucrative management contracts with economically distressed hospitals, slashing key personnel and forcing the closure of departments.” Another, he says, put “the United Medical Center at serious federal regulatory and financial risk.”
On Feb. 23, 2017, according to the complaint, Craig learned from a letter from a Medicare beneficiary that “100% of the charts that were audited for short stays of less than two midnights did not meet criteria for inpatient admission, an indication that the hospital should not have billed Medicare for their admissions.”
Craig filed a complaint the following day to the hospital’s executive director of human resources, but he says neither UMC nor Veritas investigated or addressed Craig’s concerns about “inpatient admissions, fraudulent billing to Medicare and Medicaid, and other practices that he reasonably believed compromised patient health and safety, including actions to withhold resources from the hospital’s obstetrics department in a deliberate effort to force its closure, as a cost-cutting measure.”
On Nov. 3, 2017, Craig testified before the D.C. City Council about “the hospital’s improper admission practices, malfeasance affecting patient health and safety, and submission of fraudulent statements to Medicare and Medicaid at the direction of Veritas,” the complaint states.
Craig claims he was fired 15 days after he reported the alleged wrongdoings to the city council.
Craig seeks damages for violations of the False Claims Act, the District of Columbia Whistleblower Protection Act and other claims.
Veritas and UMC have not returned requests for comment.