The lawsuit, filed Oct. 10, claims that from January 2022 to present, Adena Health System, Adena Medical Group and Adena Health Center knowingly submitted false claims for payment for transcatheter aortic valve replacements that did not meet the requirements of the National Coverage Determinations and were not reasonable or necessary, according to court documents.
The lawsuit also alleges that the system retaliated against a whistleblower, who served as vice president of quality and safety, who reported concerns around the program, NBC4 reported May 14. The whistleblower’s employment was terminated after they raised concerns, according to the report.
The suit seeks damages on behalf of the whistleblower, including back pay, front pay and compensatory damages, and seeks to recover three times the amount of money paid by the government for the allegedly false claims, plus civil penalties.
“Adena cannot comment on ongoing legal matters or on any of the specifics outlined in this initial complaint and its accuracy,” a system spokesperson told Becker’s. “However, we have protocols in place that ensure the privacy and protection of any employee that comes forward with any complaint. These issues are taken extremely seriously and investigated to ensure that appropriate actions are taken.”
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