Robert Baker alleged in a qui tam whistleblower lawsuit that Community Health System (CHS) was engaged in a scheme to improperly increase Medicaid payments to its three hospitals in New Mexico. CHS paid a total of $75 million in 2015 to settle the whistleblower lawsuit, which Phillips & Cohen LLP brought on Baker’s behalf. Below are excerpts from a two-part story published in Health System Specialist, detailing the fraud Baker uncovered and his experiences as a whistleblower.
Healthcare Whistleblowers: Inside Their Hearts and Minds
“Don’t ever say ‘fraud’ in my office again!”
That was the response Robert Baker recalls receiving when he notified supervisors that payments made by three Community Health Systems-owned hospitals to New Mexico county governments were not kosher.
According to Baker, the biggest concern among CHS management was that the counties would keep the donations and never send them to the state level and draw the federal dollars. But his concerns about the legality of this arrangement led to a manager screaming at him, red in the face, spittle flying from his mouth, questioning his basic accounting skills.
That set something off in Baker, who had been bullied during his childhood in a rough-and-tumble Baltimore neighborhood.
“If you let people walk on you, other people will join in,” Baker says. The manager who had been red in the face had begun instructing Baker to memorialize the donation process in a way that would make him [Baker] personally responsible.
Read what happens as told in the entire Health System Specialist story: Part 1: “Healthcare Whistleblowers: Inside Their Hearts and Minds.” Part 2: “Healthcare Whistleblowers Risk Careers to Keep Patients Safe.”