John A. Klassen, PA Minnesota Employment Law Attorney
612-217-4988 877-390-4527

Your rights if you report an employer for medical insurance fraud

Working in medicine can be a lucrative career. Unfortunately, some people aren't happy with the income their practice generates, which motivates them to take questionable or even illegal actions to increase their overall income. Insurance billing fraud, whether it involves private insurance companies or government programs like Medicaid and Medicare, is one way that medical offices can increase their income, even if it is illegal.

In medical offices, fraudulent billing practices can be a real concern. Doctors, business managers or billing specialists could intentionally enter inaccurate billing information. In some cases, practices unbundle services typically billed at one discounted rate to charge more. They may bill for a more expensive procedure than the one the doctor performed. Some doctors will bill for procedures they did not perform or even perform unnecessary procedures to bill insurance companies for them.

Whether you are a nurse, a physician's assistant or an office worker, you have a legal obligation to take action if your employer breaks the law. If you do not take action, you could wind up facing charges when your employer gets caught breaking the law.

You deserve protection under Minnesota whistleblower laws

Whether you bring the illegal practices to the attention of an executive in the corporate office or to a government regulatory agency, you have protections under both state and federal law. Specifically, Minnesota protects you from punishment for reporting any violation of the law, meaning that your employer cannot take vindictive action against you so long as you made the report in good faith.

In fact, you can report misconduct even if you believe it has not yet occurred but will soon occur in the near future. Whether you have documentation of illegal claims practices or have overheard a discussion with people planning to illegally bill private or government insurance in one manner or another, you have an obligation as a citizen to report the illegal activity.

If your employer retaliates against you, you have rights

Unfortunately, if you work at a small medical practice and are the only one not actively participating in a fraud scheme, it may not be that difficult for your co-workers or employer to figure out who alerted authorities to the potentially illegal activity at the company. That could mean that you wind up demoted, harassed at work or even fired from your job simply for doing what is right.

If your employer retaliates against you for acting as a whistleblower, you can likely take action against them under both whistleblower laws and wrongful termination laws. Documenting your concerns and the actions taken by your employer will strengthen your case and make it easier for you to prove wrongful termination or retaliation later.

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John A. Klassen, PA
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