MOBILE, Alabama — A federal whistleblower case that led to one of the largest health care fraud settlements in recent memory for the Mobile area is not quite finished. While the core fraud claims against Infirmary Health and an affiliated physicians group were resolved last month, a separate piece of the lawsuit, a cardiologist’s claim that he was fired for raising concerns, is now headed toward a September trial in federal court.
A whistleblower’s long fight
Dr. Christian Heesch, a cardiologist who joined Diagnostic Physicians Group in 2003, filed the original lawsuit in 2011 under a federal law that allows private citizens to sue on behalf of the government when they believe fraud is occurring, then share in whatever the government eventually recovers. Heesch alleged that two clinics affiliated with Infirmary Health had arrangements to pay physicians bonuses tied to the volume of tests and procedures they referred, a practice that can run afoul of federal rules limiting financial incentives for referring Medicare and Medicaid patients.
A costly settlement
The federal government later took over prosecution of the case. Last month, Infirmary Health and the other defendants agreed to pay $24.5 million to resolve the allegations, one of the larger such settlements involving a South Alabama health system. Under the terms, Heesch is set to receive roughly $4.41 million for bringing the original claim forward.
Termination sparked a second claim
According to court filings, Heesch grew suspicious of the compensation arrangement and hired an outside accountant to look into it, but says he received only vague and conflicting answers from his employer. He claims that in June 2011 he formally requested to inspect company records, and that Diagnostic Physicians Group terminated his employment about a month later. Heesch contends the firing was direct retaliation for pursuing the whistleblower claim, while the practice has denied wrongdoing and asked the court to rule in its favor before trial.
Trial date set, questions remain
U.S. District Judge Kristi DuBose has scheduled the retaliation claim for trial in early September, though she has not yet ruled on the defense’s request to decide the matter without a trial. An attorney representing Heesch said the case was originally expected to take three to four weeks to try, but that estimate has shrunk considerably now that the larger fraud allegations are no longer part of the proceedings. Exactly how much shorter the trial will be remains unclear, and it is still possible the judge could dismiss the claim before it ever reaches a jury.
What Heesch is seeking
Beyond the fraud settlement payout, Heesch is asking for damages tied specifically to the retaliation claim, including double back pay with interest, lost pension and health benefits, and pay he says he would have earned through retirement age. He is also seeking compensation for emotional distress and damage to his professional reputation. Attorneys for Diagnostic Physicians Group have not publicly detailed their defense strategy beyond denying the allegations.