Gronemeyer v. Crossroads Cmty. Hosp. (Summary)

FALSE CLAIMS ACT – RETALIATION

Gronemeyer v. Crossroads Cmty. Hosp., No. 3:10-cv-00571-WDS-DGW (S.D. Ill. Aug. 26, 2013)

The United States District Court for the Southern District of Illinois granted a hospital’s motion to dismiss a previously employed pathologist’s claim of retaliation in violation of the False Claims Act.

As a part of her employment, the pathologist served on the hospital’s Utilization Management Committee, Infection Control Committee, Medical Executive Committee, and Quality Improvement Committee.  Her responsibilities included reviewing records, approving transfusions, and conducting assessments of the medical necessity for transfusions.  While performing these duties, the pathologist allegedly discovered that the hospital was billing for unnecessary transfusions.  She claimed that the hospital terminated her in violation of the False Claims Act anti-retaliation provisions for reporting this to her superiors.

In ruling on the hospital’s motion to dismiss, the court found that the pathologist, as a “fraud-alert” employee, or one whose position involved investigating fraud, was held to a heightened notice standard.  Specifically, for the hospital to be on notice that the pathologist was engaged in protected conduct under the False Claims Act, the pathologist had to use words such as “illegal” or “unlawful” when reporting the allegations to her superiors.  This she did not do.  Accordingly, the court dismissed the pathologist’s retaliation claim.