Wrongdoers Who Drive You Crazy

Wrongdoers Who Drive You Crazy

People who can say things that are obviously untrue but get away with it drive me crazy.  I am not alone.  Paul Krugman goes bonkers sometimes, too.  In the field of science, there are tricks to fight false statements presented as true.  But in the whistleblowing business, brazen lies by our adversaries are especially infuriating.

Some of that lying describes us.  Hoping to justify their retaliation, organizations say we performed poorly, we were insubordinate, we broke rules, we did not get along with others, and on and on.  Mostly lies.  Even when companies are caught doing wrong, they dissemble.

When JP Morgan agreed to pay $13 billion in settlement of claims from its fraudulent sale of mortgaged-back securities, it admitted no wrong.  CEO Jamie Dimon just said they were pleased the dispute was concluded.  The folks at Better Markets thought the deal stank.  They sued the Department of Justice, but their suit was dismissed.

Wells Fargo opened 3.5 million unauthorized accounts, fired whistleblowers right and left, paid $185 million in fines, but never admitted doing wrong.  Except for saying some employees didn’t live up to its values.  It drives me crazy.  One U.S. House subcommittee said the Consumer Financial Protection Bureau fine could have been $10 billion, not just $100 million.  Crazy-making because we’re powerless to make it right.

In November 2007 Dr. Darren Sewell began working as a senior manager at Freedom Health and Optimum Healthcare (co-owned by a third firm, they operate as basically one company).  By fall 2008, he was aware they were fraudulently overbilling Medicare.  A year later he had filed his False Claim Act complaint, and he started cooperating with government investigators into the crimes.  In 2012, the government’s questions alerted Freedom’s and Optimum’s management that they had a serious problem and Sewell was the cause.  They stripped him of responsibilities, put him on leave, forced his resignation, and then defamed him.

This year, Freedom Health agreed to pay $31.7 million settling the claims.  They didn’t admit guilt.  They settled only to avoid the time and cost of more litigation, they said.  The Department of Justice (DoJ) demanded Freedom Health sign Corporate Integrity Agreement to force better behavior.  But the company pitches compliance as its way of improving the healthcare system. 

Sewell died in 2014.  His estate could receive something like $5 million from the settlement.  The reward doesn’t make the situation feel any saner.

Another case: Dr. Viran Roger Holden was hired as an oncologist by a Catholic-affiliated clinic in Springfield, Missouri, in 2005.  After some name changes it became known as Mercy Clinic Springfield Communities.  He learned that two doctors at the Clinic were providing unnecessary treatments and charging Medicare for them.  He complained internally about the two in 2011. 

One of the two offending doctors was put on a performance improvement plan, but the behavior continued.  In May 2012, Holden discussed the possible Medicare and Medicaid fraud with the Mercy Clinic general counsel.  As a result, he was demoted from Chair of Medical Oncology.  He began cooperating with State and Federal investigators in late 2013.

After he testified in favor of another wrongfully terminated Mercy Clinic employee, he was fired in May 2015.  The supposed cause was his past personal relationships with two Mercy Clinic employees and a narcotics prescription he wrote.

Mercy Clinic and Mercy Hospital settled Holden’s False Claims Act lawsuit with the payment of $34 million – paltry against their $1.5 billion in revenue.  Like Freedom Health, Mercy admitted no wrongdoing in its settlement agreement.  Mercy’s regional president said, “We take this situation very seriously. We made a regulatory mistake and we are working hard to make it right.”  It was just a technical problem.  Like Freedom Health, it signed a Corporate Integrity Agreement with the DoJ, but Mercy keeps its out of sight.

Holden won $5.4 million from the Mercy settlement, taking some sting from the incident.  But a few days before the DoJ’s announcement, Holden settled with the Missouri State Board.  He admitted Mercy’s allegations against him; his disciplinary action is public knowledge. 

There's no comfort for Holden in news that the former Mercy employee he testified on behalf of was awarded $1.5 million and a former Mercy nurse was awarded $751,000 in her wrongful termination lawsuit.  Mercy’s depiction of its holy service guided by nuns in habits drives me crazy.

Then there is HomeFirst Services, which fired me for whistleblowing.  HomeFirst had taken government money it didn’t deserve.  It overbilled the U.S. Department of Housing and Urban Development (HUD) by $1.2 million in 2003-2006.  It used for general purposes $138,000 the City of San Jose had advanced for a specific housing program.  And it overbilled the County of Santa Clara $140,000 for two housing programs.  My telling the County about the last problem started the ball rolling toward my termination.

I disclosed the County overbilling in July 2013.  Until I left a year later, HomeFirst tried unsuccessfully to get the County to forgive the liability or repurpose it for another program.  Then the County wanted to confirm the amount.  By March 2015, both sides had agreed on the amount due, but HomeFirst, being nearly insolvent, could not afford to repay it.

A year later, HomeFirst’s CEO, who had been on board in March 2015, asked for documentation supporting the amount “we were told we owed the County.”  In 2016 the company sent the County long analyses in hopes of whittling down the amount.  By mid-2017, the CEO called the overbilled amount “back debt that HF supposedly owed” the County.  She proposed reallocating it to the company’s other expenses.

The back-and-forth drives me crazy.  It’s the simplest of things: if you overbill by accident, you repay the excess. 

It bugs me HomeFirst got the City of San Jose to retroactively charge the advance to different programs.  And it is trying to get HUD to do the same with the $1.2 million overbilling.  I’m disheartened governments can’t be trusted either.

It drives me crazy that the State of California has had my whistleblower complaint for three years without making a determination.  It will be even worse if it does not decide in my favor.