Posts Tagged ‘Dr. Judith Robinson’

$18 Million Settlement: IU Health/HealthNet Whistleblower Case

Dr. Judy Robinson with Tyler & Koger families.

Dr. Judy Robinson with Tyler & Koger families.

A whistleblower suit filed by Dr. Judith Robinson under the False Claims Act has led to an $18 million settlement with two of Indiana’s largest health care providers.  Indiana University Health and HealthNet have agreed to pay $18 million to the federal government and State of Indiana to resolve illegal kickback and false billing claims.  Dr. Robinson, a client of James Hoyer, P.A., filed the whistleblower lawsuit in 2013.

In June, Dr. Robinson met with moms and children harmed during childbirth at IU’s Methodist Hospital. Click here to watch the story by WTHR’s 13 Investigates Reporter Sandra Chapman.

The Whistleblower

Dr. JudithRobinsonPicDr. Judith Robinson is a prominent Indianapolis Ob/Gyn and former employee of both IU Health and HealthNet, a Federally Qualified Health Center (FQHC), which primarily provides services to low income populations.  Her goal was to expose what she believed was substandard care being provided to pregnant women and babies on Medicaid.  This settlement is an important step toward protecting those women and babies.

“I’m grateful this case has shined a light on the care that was provided to low income pregnant women and their babies. I’m hopeful the changes caused by this settlement will help to ensure our community’s most vulnerable patients get the care they need and deserve,” Dr. Robinson said.

Dr. Robinson is represented by Attorney Jillian Estes, a partner at the James Hoyer law firm.

“Dr. Robinson made a real difference because of her courage to come forward,” said Attorney Estes. “Pregnant women and babies in Indianapolis are safer today because of her decision to become a whistleblower.”

The Settlement

The settlement covers three areas, including:

  • Inappropriate billing when Certified Nurse Midwives (CNMs), instead of doctors, cared for high risk pregnant women, in violation of Indiana Medicaid rules;
  • Kickback claims, regarding various financial schemes between IU Health and HealthNet, which improperly induced referrals; and
  • False claims for “wrap around” payments, which are payments made to FQHCs to supplement their care to the poor.

In addition to the $18 million dollars being paid for the settlement, HealthNet has agreed to a Corporate Integrity Agreement with the federal government related to the kickback allegations, which requires HealthNet to restructure and maintain complete independence from IU Health.  HealthNet also signed a separate, side agreement with the State of Indiana, which requires HealthNet to bill only for care to high-risk pregnant women provided by a physician or under a physician’s direction.

“It’s important to note that as part of the settlement, HealthNet has been forced to change its conduct in how it operates and how its CNMs care for high-risk pregnant women,” Attorney Estes said. “We hope these agreements, along with regular monitoring, will ensure that patients will be protected for years to come.”

Certified Nurse Midwife Claims

The suit, filed under the federal and Indiana False Claim Acts, alleged that IU Health and HealthNet violated Indiana Medicaid rules to save money by using CNMs, instead of doctors,  to care for medically high-risk pregnant women.

“Patient care has to come first, not money,” Dr. Robinson said.  “Midwives can provide excellent care to low-risk patients, but when it comes to high-risk pregnancies, the danger for complications requires a doctor’s attention. It’s important to me that these moms and babies get the care they need to keep them safe.”

In Dr. Robinson’s unique position as both Director of Women’s Services for HealthNet and Medical Director of Ob/Gyn Services at Methodist Hospital/IU Health, she became aware of CNM care she believed was putting patients at risk.  Dr. Robinson documented 3 instances of babies suffering permanent neurological damage and 17 “near misses” in just 6 months as a result of care to high-risk patients by CNMs. When her efforts to change the system fell on deaf ears, Dr. Robinson was ostracized and ultimately fired.  She then learned that the billing for CNM care of high-risk patients violated Indiana Medicaid rules and felt compelled to bring her information forward to the government.

Kickback Claims

Anti-kickback laws are essential to discouraging physicians from accepting financial incentives for referring patients, which can lead to unnecessary medical services and increased overall healthcare costs. This whistleblower suit alleged that IU Health paid illegal kickbacks to HealthNet to induce a steady stream of referrals to Methodist Hospital from its FQHC clinics. A variety of financial schemes were at the center of the kickback allegations, including:

  • IU Health providing an ever-increasing line of credit to HealthNet, which ballooned to nearly $14 million, with no strict requirement for payback;
  • IU Health giving HealthNet a sweetheart deal for rent, charging just $1 a year; and
  • IU Health paying to open and subsidize operation of a high-risk maternity clinic for HealthNet, with the understanding that critically ill newborns would be sent to IU’s Methodist Hospital Neonatal Intensive Care Unit, and not to other area NICU’s, as a scheme to make more money for IU Health off of sick babies.

“These hidden financial arrangements and sweetheart deals were not only illegal and costly to Indiana taxpayers, but also inappropriately restricted patient choice on where to get care,” said Attorney Estes. “Now, patients can be referred to the hospital that can best provide care, not just the hospital with financial connections to the clinic.”

Ultrasound Claims

The $18 million settlement also resolves claims from 2005 to 2010 that HealthNet inappropriately received extra payments provided to FQHC’s for physicians to read ultrasounds.  To get the so-called “wrap-around” payments, doctors were required to meet face-to-face with patients, which they did not do.  Additional wrap-around payments for claims made from 2011 to 2015 were also settled, but are still being calculated.  The value of these claims is estimated at $1.4 million.

False Claims Act

The federal False Claims Act provides for private citizens to file suit on behalf of taxpayers when they become aware of fraud against the government.  Whistleblowers receive a portion of the funds returned as a reward for exposing the fraud.

“The False Claims Act is an important tool for the government to fight fraud with the help of whistleblowers,” said Attorney Estes. “It’s very easy for a private citizen who sees wrongs to look the other way, but Dr. Robinson didn’t do that. She did the right thing, and with her help, millions of dollars will be returned to the taxpayers.”

The settlement was reached through a joint effort between Dr. Robinson, her attorneys, and attorneys from the United States Department of Justice and State of Indiana.  Dr. Robinson and her counsel are particularly grateful to Assistant U.S. Attorney Jonathon Bont for his efforts throughout the case in helping to attain a successful resolution.


Whistleblower Case Exposes Harm to Babies and Moms

13 WTHR Indianapolis

The case of a baby who suffered permanent neurological damage during birth was exposed in a whistleblower case filed by James Hoyer client Dr. Judith Robinson.  WTHR, the NBC affiliate in Indianapolis, profiled the story of little Denise and her mom, Nancy Koger. The Koger’s case was one of three permanently injured babies and 17 “near misses” in a six month period documented by Dr. Robinson when she worked at IU Health and Methodist Hospital.  Dr. Robinson blew the whistle on the health network for allowing midwives to care for low-income, high risk, pregnancy patients, in violation of state Medicaid rules by filing a whistleblower case.

Investigative Reporter Sandra Chapman took viewers into the delivery room to witness alarming moments during baby Denise’s birth and revealed that her mom required an emergency C-section, after a mid-wife missed key warning signs two days earlier and sent her home. As a result, Denise suffered brain damage.  The toddler is now in a wheelchair, unable to talk and must be fed through a tube.  Nancy Koger is in the process of filing suit against IU Health and Methodist Hospital.

WTHR Report- PART 2: Mom Claims Botched Delivery & Missing Medical Records13 WTHR Indianapolis

In this second report, WTHR Investigative Reporter Sandra Chapman looks at the case of Dorothy Riggle and her daughter Crystal, who is now 10-years old. Crystal suffered brain damage and permanent injury to her arm and eye after a traumatic birth, at Methodist Hospital. Her mom says a midwife refused to call a doctor when she came to the emergency in labor, despite telling her that she had a high risk pregnancy. Adding insult to injury, the hospital told them it lost the medical records of Crystal’s birth, so their efforts to take legal action have been compromised.


Family Reacts to Whistleblower Suit against IU Health


Dr. Judith Robinson

The NBC affiliate in Indianapolis continued its coverage of a whistleblower case filed by James Hoyer law firm client Dr. Judith Robinson.  In a powerful report, WTHR TV Investigative Reporter Sandra Chapman interviewed the mother of a maternity patient who died during childbirth at Methodist Hospital in Indianapolis.

Dr. Robinson is a well-respected Obstetrician/Gynecologist who’s practiced in Indianapolis for 30 years. She chose to come forward as a whistleblower and put her career on the line after witnessing multiple violations of Medicaid rules, which she believes put pregnant women and their babies at risk.

Both WTHR and the Indianapolis Star told the story of Dr. Robinson’s whistleblower case in earlier reports.

Watch the video below to see WTHR’s latest story: “Mom dies during childbirth; Family reacts to $100M suit against IU Health.”

13 WTHR Indianapolis


Whistleblower Doctor Stands Up against Indiana’s Largest Hospital System: Says Care Compromised for Low Income Pregnant Women

Dr. Judith Robinson Picture

Dr. Judith Robinson

James Hoyer law firm client Dr. Judith Robinson is a well-respected Obstetrician/Gynecologist who’s practiced in Indianapolis for 30 years. She chose to come forward as a whistleblower and put her career on the line after witnessing a violation of Medicaid rules, which she believes put pregnant women and their babies at risk. The Indianapolis Star reported on Dr. Robinson’s recently unsealed False Claims Act case in a front page story in today’s paper.

Dr. Robinson was in a unique position to realize pregnant women on Medicaid who had high risk complications were being cared for by midwives, instead of doctors, in violation of Medicaid rules.  Dr. Robinson was both Medical Director of Ob/Gyn Services at Methodist Hospital, a  safety net Indiana University Hospital and Director of Women’s Services at HealthNet, which provides health care to the medically under served.

She repeatedly tried to get the hospital administration to address the need to have doctors treat high risk patients and not midwives. She documented 17 cases which resulted in emergencies, three of which resulted in permanent neurological damage to the babies and one maternal death.

Despite these serious issues, her efforts to correct the situation were rebuffed by the hospital administration multiple times and she was ultimately fired.  Dr. Robinson presented evidence in her whistleblower suit to show the hospital chose to use midwives, instead of doctors, to save money.  She refused to stay silent and is speaking out in the hopes that this practice will be stopped.

WTHR TV in Indianapolis profiled Dr. Robinson’s case as the lead story on its 6pm newscast.  Play the video below to watch.

Dr. Robinson now practices at another hospital in Indianapolis. Click here to read more about her courageous stand against Indiana’s largest hospital system.

Dr. Robinson is represented by James Hoyer attorneys Jillian Estes and Chris Casper, as well as, co-counsel Robert Saint of Indianapolis and Christopher Jayson and Phil Farthing of Tampa.