GREENSBORO – Wake Forest University Baptist Medical Center (WFBMC) has agreed to pay the government $754,585 to resolve an overpayment resulting from improper documentation at the Wilkes Medical Center Skilled Nursing Unit (“Wilkes SNU”), announced U.S. Attorney Sandra J. Hairston in a Feb. 28 press release.
WFBMC acquired Wilkes Medical Center, including the Wilkes SNU, on July 1, 2017. The United States contends that between January 1, 2015 and September 30, 2019, the Wilkes Medical Center submitted or caused to be submitted claims to Medicare for physical and occupational therapy services provided to patients at the Wilkes SNU that were not supported by documentation.
The United States initiated its investigation when a whistleblower filed a lawsuit under the qui tam provisions of the False Claims Act, which allow private parties to bring suit on behalf of the government and to share in any recovery. WFBMC cooperated with the United States’ investigation and took remedial actions to address the issues discovered during the investigation.
“Medical facilities that submit claims to Medicare must ensure that those claims are supported by documentation and are medically necessary,” said Sandra J. Hairston, United States Attorney for the Middle District of North Carolina. “This office is dedicated to protecting federal health care programs and ensuring that the government does not pay for unsupported claims.”
This case was handled by the U.S. Attorney’s Office for the Middle District of North Carolina with assistance from Office of Inspector General of the United States Department of Health and Human Services.
The lawsuit is captioned United States ex rel. Cook v. Wake Forest Baptist Medical Center et al., No. 20-CV-386 (M.D.N.C.). The claims settled by this agreement are allegations only, and there has been no determination of liability. The Settlement Agreement is not an admission of liability or wrongdoing by WFBMC.
According to a a synopsis on the website Casetext:
MEMORANDUM OPINION AND ORDER
The plaintiff, Tonya Cook, filed this lawsuit against her employer, Wake Forest University Baptist Medical Center, for allegedly discriminating and retaliating against her in violation of federal law. Ms. Cook moves to dismiss her case with prejudice under Rule 41(a)(2) of the Federal Rules of Civil Procedure. The Medical Center moves to compel discovery and objects to dismissal unless Ms. Cook is ordered to disclose and return documents and recordings belonging to the Medical Center.
Given the unusual circumstances here, the Court will require Ms. Cook to make the materials belonging to the Medical Center available for its review and will condition the dismissal upon compliance. But the Court will not order Ms. Cook to return all copies of the documents or the recordings, as that is outside the scope of discovery and raises questions not appropriate for resolution in these proceedings in the current procedural posture.
In August 2020, the Medical Center served Ms. Cook with requests for production of documents. In Document Request Two, the only request at issue here, the Medical Center asked Ms. Cook to:
Produce any and all documents (including copies thereof) that are the property of the Defendant or that you have ever removed or directed to be removed from Defendant’s premises, including, but not limited to, copies of any schedules, calendars, or schedule notebooks.
Doc. 21-1 at 18. In her initial response on October 20, 2020, Ms. Cook stated that she was withholding responsive documents protected by the attorney-client privilege and work-product rule. Doc. 21-2 at 19-20.
After the Medical Center requested a privilege log, see Doc. 21-3 at 2, and identified other deficiencies, id. at 3-9, Ms. Cook supplemented her response in late November, maintaining her previous objections and asserting a third objection based on a federal regulation concerning disclosure of protected health information by whistleblowers. Doc. 21-6 at 11 (citing 45 C.F.R. § 164.502(j)(1)(ii)(B)). Ms. Cook also produced a privilege log with her supplemental responses; in that log, she claimed a privilege for “Audio Recordings, Video Recordings, and Other Documents of Defendant” in her possession and asserted that they were “not relevant to this action and can only be disclosed to those authorized by statute.” Doc. 21-5 at 2. These materials are the subject of the Medical Center’s pending motion. See, e.g., Doc. 27 at 7.
Immediately after receiving her supplemental responses and the privilege log, the Medical Center requested a phone conference to discuss their deficiencies, Doc. 21-7 at 4-5, as required by Local Rule 37.1. During that phone conference, counsel for Ms. Cook refused to produce the “Audio Recordings, Video Recordings, and Other Documents of Defendant,” despite the Medical Center’s assertion that the objections were improper. See id. at 2. Soon thereafter, Ms. Cook told the Medical Center that she planned to voluntarily dismiss her case. Doc. 21-8.
Ms. Cook filed her motion for voluntary dismissal under Rule 41 of the Federal Rules of Civil Procedure on December 10, 2020. Doc. 19. The parties continued to discuss whether Ms. Cook would voluntarily disclose the information at issue despite her motion for dismissal. See Doc. 26-1. But they were unable to agree, and the Medical Center filed this motion to compel disclosure and the return of its property on December 31, 2020. Doc. 21.