Missouri hospital allegedly fired coder for refusing to ignore improper billing

A medical coder sued Mosaic Life Care Medical Center in St. Joseph, Mo., May 25 for wrongful discharge, unlawful retaliation and age discrimination, according to the St. Louis Record.

The medical coder, Debra Conrad, alleges Mosaic Life Care fired her for disclosing the hospital's fraudulent billing practices.

In April 2017, hospital officials allegedly instructed Ms. Conrad to begin releasing charges for billing even if the claims were not supported by documentation.

"Plaintiff was instructed to push multiple charges through that may or may not be correct based on the current state of documentation, and such charges would consequently induce payment by Medicare and other third parties," states the complaint.

Ms. Conrad alleges she told her supervisors the hospital could potentially face significant fines under the False Claims Act if the claims were released. Ms. Conrad processed the charges, but she included notations stating her supervisors authorized the release of what she believed were fraudulent claims, according to the report.

In May 2017, Ms. Conrad was moved to a coding position in a different department, and someone 15 years younger replaced her. The hospital also took disciplinary actions, including a brief suspension, against Ms. Conrad because she opposed the fraudulent billing, according to the lawsuit.

After complaining about the disciplinary actions, Ms. Conrad had a meeting with human resources and coding department management. She was subsequently accused of violating HIPAA.

"Merely because plaintiff could see patient information while performing duties in the coding program (that she needed to access to perform her job), she was subject to discipline and suspension," according to the complaint.

Ms. Conrad was fired a short time after she was accused of violating HIPAA. She was a medical coder with Mosaic for 40 years before her termination, according to the report.

Ms. Conrad seeks more than $75,000 in compensatory damages, damages authorized by the False Claims Act, lost wages and benefits, attorneys' fees and reinstatement.

Mosaic did not immediately respond to Becker's request for comment.

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