A Selma, Alabama, hospital has agreed to pay the U.S. government $1.45 million to settle a whistleblower lawsuit alleging it used underqualified residents to cover shifts in its emergency room. Two ER physicians and a hospital executive were also named as defendants and parties to the settlement.
U.S. Attorney Richard W. Moore, Southern District of Alabama, said that Dr. Samuel Clemmons sued Vaughan Regional Medical Center under the False Claims Act’s whistleblower provisions after his concerns about the hospital’s illegal use of residents in the ER went uncorrected.
Dr. Clemmons alleged residents who were not fully licensed were independently covering shifts in the hospital’s ER department.
A federal investigation of the whistleblower allegations found that from mid-2009 to March 31, 2012, Vaughan’s ER dept. recruited residents from the UAB-Selma Family Medicine Residency Program to independently treat patients in its ER.
The hospital paid the residents $50 per hour in cash, along with licensed ER physicians who were also paid an extra $50 per hour to co-sign the residents’ charts. Federal investigators said Vaughan Regional perpetuated this illegal moonlighting scheme by falsifying medical records and submitting false claims to Medicare as though the residents’ services were provided by licensed physicians.
Vaughan Regional Medical Center is part of LifePoint Health, a Brentwood, Tennessee-based hospital network with hospitals in 30 states. According to the DOJ, Dr. Clemmons also reported the illegal activity at Vaughan Regional to LifePoint, but no action was taken.
Emergency room physicians Dr. Sai S. Namburu and Dr. Phillip Alan Hicks, former Vaughan Chief of Staff and Director of Emergency Services, have also agreed to pay part of the settlement.
“Patients expect treatment by fully qualified medical professionals, and taxpayers should never be paying for health care provided fraudulently by an unlicensed physician – as alleged in this case,” said Derrick L. Jackson of the U.S. Department of Health and Human Services. “We will aggressively work with our law enforcement partners in pursuit of those who would defraud government health programs and the individuals they serve.”
Dr. Clemmons will receive a whistleblower award of $275,000 – about 19% of the total settlement – for bringing the case.
Whistleblowers are the key to exposing corporate wrongdoing and government fraud. A person who has first-hand knowledge of fraud or other wrongdoing may have a whistleblower case. Before you report suspected fraud or other wrongdoing – before you “blow the whistle” – it is important to make sure you have a valid claim and that you are prepared for what lies ahead. Beasley Allen has an experienced group of lawyers dedicated to handling whistleblower cases.
If you are aware of fraud being committed against the federal or state governments, you could be rewarded for reporting the fraud. If you have any questions about whether you qualify as a whistleblower, contact a lawyer at Beasley Allen for a free and confidential evaluation of your claim. Lawyers on our whistleblower litigation team are Archie Grubb, Larry Golston, Lance Gould, Paul Evans, Leslie Pescia, Leon Hampton, Tyner Helms and Lauren Miles.