The whistleblower responsible for the record-setting Halifax Health Medical Center settlement spoke out about blowing the whistle on massive health care fraud. Elin Kunz was working in the hospital’s compliance department – a job she had held for 16 years – when she says she discovered some disturbing information that eventually led her to blow the whistle.
She discovered that the hospital was admitting patients without medical need and that physicians were getting kickbacks for performing surgeries or referring patients to the hospital. For example, she found that one neurosurgeon was doing procedures at four times the national average, and an outside firm that audits health care providers deemed nine out of ten back surgeries done by the surgeon as not being medically needed. In other reports, she discovered that internal hospital audits showed that 60 percent of sampled patients coming in with chest pain had been improperly admitted.
Like many whistleblowers, Ms. Kunz put her job and friendships on the line by speaking out. She reported the wrongdoing internally, but says that her concerns were ignored and that her superiors told her “loyalty should be with Halifax and not with the government.” That did not stop her. She says that she was motivated to keep going because she was “scared for patients” and that the hospital “knew [it] had broken the law” but “didn’t do anything about it.” She said she thought of her own parents and said, “I knew if it had been my mom or dad I would want to someone to investigate.”
So with the help of a whistleblower attorney, she brought her concerns to the government in the hopes that it would intervene and put a stop to the fraud. She was right – the government intervened and Halifax paid $120 million to settle the suit. As part of the settlement, the hospital agreed to allow the government to police the hospital to ensure that the misconduct is over for good.
After news of the settlement came out in March, Ms. Kunz, who at the time still worked at the hospital, said that her co-workers reacted either by embracing her and applauding her courage or by “shunning” her. She said that “people I used to interact with all the time won’t even acknowledge me in the hallway” because they were afraid that they would lose their jobs once the hospital tightened its belt and rooted out fraud.
Ms. Kunz received $20 million for her efforts in bringing the fraud to light. She said that it was not about the money, stating that “some of the headings will be that I won millions of dollars,” but “this is not about winning. It’s about doing the right thing.” And despite the large reward, she intends to continue doing the right thing by giving speeches and counseling hospitals on compliance issues to make sure that other hospitals do the right thing too.
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