Health System Agrees to Restore Deleted Data in False Claims Act Lawsuit
In the case of United States of America et al. v. Bon Secours New York Health System, Inc., et al, a former compliance officer claims she was fired for trying to address healthcare fraud. These details are drawn from the lawsuit and other court documents.
The plaintiff, June Raffington, makes the following four primary allegations:
- Defendants forged doctors’ signatures on some patients’ plans of care that are required to support all invoices for service delivery. Other patients’ cases never had plans of care completed, but invoices were nevertheless submitted for services.
- Defendants improperly billed Medicaid for services that should have been billed to Medicare, in the case of patients who had health insurance through both federal programs.
- Defendants billed New York Medicaid for services without obtaining the necessary approvals from local county departments of social services.
- Defendants retaliated against the plaintiff by firing her for complaining about and attempting to correct these fraudulent practices.
Raffington filed a False Claims Act lawsuit against Bon Secours approximately one year after she was terminated. In May 2016, a U.S. District Court judge denied a motion by Bon Secours to dismiss the suit, saying Raffington had detailed the allegations in sufficient detail to proceed. In August 2016, the plaintiff requested electronically stored information (ESI) from the accounts of 27 witnesses from Bon Secours, which agreed to produce the emails and other data.
Three weeks before the initial discovery deadline, on Oct. 24, 2016, Bon Secours notified Raffington that email and other data from 14 of the 27 accounts had been destroyed. The company refused to provide information on whether the data existed on backup tapes. The plaintiff claims Bon Secours also failed to turn over a paid claims history, making it impossible for her to obtain an expert analysis that would support her claims.
On Dec. 21, 2016, a judge ordered Bon Secours to provide information about backup tapes and the paid claims history, and in February 2017, Bon Secours acknowledged that backup tapes exist. The company also stated that it destroyed data from the email accounts of Raffington and other key witnesses, but it said the data can be restored.
In the case of United States of America et al. v. Bon Secours New York Health System, Inc., et al, a former compliance officer claims she was fired for trying to address healthcare fraud. These details are drawn from the lawsuit and other court documents.
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