A doctor from Michigan is seeking whistleblower protection from the hospital where he worked after attempting to report the allegedly fraudulent actions of his supervisor.

Whistleblower protection under state and federal law helps prevent actions like wrongful termination or hostile work environment, which can be used to intimidate or prevent a whistleblower from reporting fraud.

Plaintiff Ali J. says in a lawsuit he needs whistleblower protection from TeamHealth Inc. and coworker Dr. Mahum Zamlut, who sometimes acted as the claimant’s supervisor.

According to the qui tam lawsuit, Ali had started working at TeamHealth’s hospitals throughout Detroit in August 2016. During the course of his employment, Ali says he was required to order consults by other medical professionals in different specialists for his patients. Not long after he was hired, Dr. Zamlut allegedly told Dr. Ali that he was issuing consults for physicians employed by IPC Healthcare or physicians who were on good terms with the healthcare company.

At the time Dr. Zamlut had this conversation, Ali says he had been been issuing consults for physicians that he believed would issue the best patient care. Ali says he also refused to send patients to nursing homes, which often utilized doctors from TeamHealth.

In response to Ali’s refusal to comply, Dr. Zamlut had allegedly issued him unfavorable shifts, told other physicians not to work with him, and even took him off the work schedule. Ali says he had spoken with supervisor and hospital administrators regarding this alleged hostile work environment, and asked for Dr. Zamlut to be replaced. However, Ali says he was instead discharged and forced to file legal action for whistleblower protection soon after.

Overview of Healthcare Fraud Allegations

According to Healthcare CMS rules and regulations, consults must only be ordered if medically necessary. Ali alleged in his whistleblower lawsuit that there were not in many medically necessary consults ordered. While Dr. Ali says he did order consults if medically necessary, he alleges that the number of consults he ordered would go directly into his billings for services rendered to patients he treated.

According to the qui tam lawsuit, Ali’s employment compensation was based his billings for services rendered to his patients, which means that higher billings for patients equated to more compensation for him. It is important to note that Dr. Zamlut’s employment compensation was also based on his patient billings, as well as the amount of billings physicians who worked under also submitted.

With this in mind, Dr. Zamlut allegedly ordered Ali to regularly order consults for cases that were not medically necessary. In addition, Dr. Zamlut allegedly ordered Ali to admit patients to nursing homes that utilized physicians employed by TeamHealth regardless if the patient needed this course of care or not.

Dr. Zamlut also reportedly had a high number of Medicare billings, which made it impossible for him to keep track of the patients he saw and treatments he administered when issuing these bills.

Each of these allegations could be classified as healthcare fraud — one of the most significant forms of fraud the federal government faces. Whistleblowers are one of the most important tools in preventing fraud against the federal government, and can receive up to 30 percent of any award or settlement recovered.

Under the False Claims Act (FCA), whistleblower protection can also be granted to help protect individuals who report healthcare fraud from wrongful termination and other acts of retaliation.

This Whistleblower Lawsuit is Case No. 2:18-cv-13709-DML-DRG, in the U.S. District Court of Eastern Michigan, Southern Division.