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Former Hospital Employee Sues Southwest Health System for Alleged Billing Fraud, Retaliation

Austin Cope

A former employee of Southwest Health System is suing the corporation after allegedly being fired for pointing out fraudulent billing practices.

Robyn Bragg, former Health Information Manager for Southwest Memorial Hospital, filed a civil complaint against the company in U.S. District Court on April 3rd. In the suit, Bragg alleges the hospital knowingly used improper medical and billing procedures for IV infusions and critical care. She claims the hospital inaccurately documented those procedures when submitting Medicare and Medicaid reimbursements. The practices amounted to Medicare fraud, the suit alleges, and the hospital "engaged in an institutional scheme to maximize reimbursement from Medicare and Medicaid...at the expense of the United States Government.”

 

Bragg states she repeatedly tried to point out the improper practices, but the Hospital’s upper management worked against her. She claims she was eventually fired in retaliation for her whistleblowing-- in violation of Federal law. The lawsuit requests payment for damages and asks the Hospital to reinstate Bragg at her former position.

 

Southwest Health System Spokesperson Haley Leonard Saunders told KSJD the company received notification about the suit on Tuesday. She was unable to comment on details of the case, but said it was “completely unrelated” to the April 6th terminationof three of the corporation’s top executives.

 

The case has been assigned to a federal judge in Denver. Scheduling is expected to begin in May.

 

Update 4/12/18, 3:30pm: The headline has been updated to specify "alleged" billing fraud and retaliation.

 

Update 4/13/18, 7:15am: SHS Spokesperson Haley Leonard Saunders' name has been corrected.

Austin Cope is a former Morning Edition host for KSJD and now produces work on a freelance basis for the station. He grew up in Cortez and hosted a show on KSJD when he was 10 years old. After graduating from Montezuma-Cortez High School in 2010, he lived in Belgium, Ohio, Spain, northern Wyoming, and Himachal Pradesh, India before returning to the Cortez area. He has a degree in Politics from Oberlin College in Ohio.
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