Medicine is a profession with high ethical standards. At the same time, there is much money to be made. Bad players find ways to siphon some of the nearly $600 billion we spend on Medicare each year. So, both the health care industry and its regulators constantly struggle with how to cope with the kickbacks, conflicts of interest and billing for unnecessary care.

Illustration by Nora Valdez

Last year, $2.5 billion of the $2.8 billion in Department of Justice False Claim Act recoveries involved the health care industry. In 2019, whistleblowers working with the DOJ included hospital administrators, sales representatives, home health care workers, physicians and patients.

Now, they may have more muscle. Maria Durant, a partner with the firm Hogan and Lovells, told a group of lawyers gathered in Boston last week there has been a a major shift in the way courts interpret the validity of medical opinion. She spoke at a conference on health care law held Thursday by the Boston Bar Association.  Continue Reading Can medical opinions be false claims? Now they can, as two whistleblower cases suggest a shift.

For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors.

To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians across the nation, the federal government charged in a lawsuit filed this spring.

In addition, Wheeling paid an obstetrician-gynecologist a salary as high as $1.3 million a year, so much that her department bled money, according to a related lawsuit by a whistleblowing executive. The hospital paid a cardiothoracic surgeon $770,000 and let him take 12 weeks off each year even though his cardiac team also routinely ran in the red, that lawsuit said.

Despite the losses from these stratospheric salaries and perks, the recruitment efforts had a golden lining for Wheeling, the government asserts. Specialists in fields like labor and delivery, pain management and cardiology reliably referred patients for tests, procedures and other services Wheeling offered, earning the hospital millions of dollars, the lawsuit said. Continue Reading Kaiser Health News: Hospitals Accused Of Paying Doctors Large Kickbacks In Quest For Patients

Whistleblower protection has changed dramatically in the past 15 years, says Stephen M. Kohn, chair of the National Whistleblower Center. Writing in the international publication “Ethical Boardroom,” Kohn spells out the changes and what they mean to those on governing boards and in the C-suite.

This is all radically different than the whistleblowing depicted in popular culture. It has nothing to do with employee grievances or the stealing of national security secrets. Done correctly, an employer never learns the identity of the whistleblower and thus, traditional employment relations cases become relics of a time when whistleblowers lacked safe, confidential and effective reporting mechanisms.

These changes need to be embraced, not opposed. The issue is no longer the whistleblower, but whether a company will tolerate criminal activity in order to profit. Turning a blind eye to corruption can have disastrous consequences…Trying to silence whistleblowers is the biggest mistake any corporate executive can make. Continue Reading Memo to C-suite: Don’t silence whistleblowers. Do consider becoming one.

Idaho’s tort law limiting damage awards in lawsuits does not apply to the state’s whistleblower law, according to a Tuesday ruling by the Idaho Supreme Court. The justices rejected a lower court’s decision to limit the amount of money awarded to a State Police detective who exposed a cover-up of another deputy’s dangerous actions.

In 2017, a jury awarded Detective Brandon Eller $30,000 in economic damages under the state’s Protections of Public Employees Act. The judge ruled that he was not entitled to non-economic damages under the whistleblower law, but he was awarded $1.5 million for a “negligent infliction of emotional distress” claim. The court reduced that to claim to $1,000,000 because Idaho Tort Claims Act caps damages at $500,000 for each incident.

Both sides appealed. From the ruling:

Continue Reading Idaho court overturns ruling limiting damages award to state police whistleblower

Nader in 2008

Scientific whistleblowers include drug reviewers, medical researchers, quality control monitors, and engineers. The recent emergence of Boeing whistleblowers demonstrates that we need more of the latter, says Ralph Nader. The legendary consumer advocate and founder of the consumer protection group Public Citizen writes in Scientific American that engineers are “often the first to notice waste, fraud and safety issues”

Compared to the technologically stagnant dark days in the auto industry of cruel suppression of technical dissent over safety and toxic emissions … today’s engineers are working in an improved environment for taking their conscience to work. Yet much more remains to be done to safeguard the ability of engineers to speak truth to the powers-that-be.

Continue Reading Ralph Nader says we need more engineering whistleblowers. Think Boeing

The Whistleblowers series returns to CBS tonight, Friday, with its true crime, network news take on “people who put everything on the line to stop illegal and often dangerous wrongdoing when major corporations or individuals rip off the government and U.S. taxpayers.”

The season premiere tells the story of police corruption and Shannon Spalding, an undercover Chicago police officer who worked to expose it.

From the CBS announcement: “Additional cases that will be examined this season include a medical system where midwives are in charge of high-risk pregnancies; kickbacks at a crematorium; a scam allegedly involving counterfeit healthcare hardware being used in back surgery, which may have defrauded Medicare; and, for the first time on national television, two whistleblowers discuss how they brought suspicions of massive fraud by members of a polygamous cult to the FBI.”

In the Chicago case, officers were “shaking down” drug dealers and residents of a public housing complex, according to the Chicago Tribune. Spalding and her partner went to their supervisors and worked with FBI. They also filed lawsuit in 2012, “alleging that their supervisors told them to ‘disregard’ the wrongdoing and blackballed them.”

The Intercept news site ran a lengthy series on the Chicago case in 2016, where Spaulding described the force’s retaliation campaign. It included punitive reassignments and on-the-job harassment.

When Spalding and Echeverria were on the verge of breaking the case open, the investigation was sabotaged by a high-ranking official who outed them as “rats.” Other CPD brass ordered officers under their command to retaliate against Spalding and Echeverria for violating the code of silence. Reprisals were especially harsh against Spalding, leaving her financially devastated, suffering from post-traumatic stress disorder, and stripped of the job she loves.

The lawsuit was settled in 2016 for $2 million. Two officers received short jail terms.

A 2016 post on the Poynter Institute journalism education website about the series criticizes the Chicago press for its poor coverage of the police department.  It also offers this conclusion about the case.

Settlement aside, the tale does not really have a happy ending. The dirtiest cop got a light sentence on a smaller charge. Echeverria is very isolated within the department in the fugitive apprehension unit. Spalding essentially has lost a job she loved and was broken emotionally and financially (until the settlement, which includes stiff legal fees).

 

Two weeks after a whistleblower filed an updated federal complaint accusing the network of promoting terrorism, Facebook continues to deal with pressure about questionable content. The details of the complaint to the Securities and Exchange Commission were outlined in an Associated Press story.

https://www.facebook.com/pages/%D9%87%D9%8A%D8%A6%D8%A9-%D8%AA%D8%AD%D8%B1%D9%8A%D8%B1-%D8%A7%D9%84%D8%B4%D8%A7%D9%85/237269353391307?timeline_context_item_type=intro_caAt issue in the complaint: the network’s failure to limit content designed to promote groups like ISIS and to interfere with elections. The complaint, filed with the support of the National Whistleblower Center, offers evidence that Facebook is auto-generating videos and pages for terrorist groups. It describes Facebook’s efforts to stamp out terror content as “weak and ineffectual.”

  • On Thursday, Facebook issued a “Community Stanfards Enforcement Report” that concluded “terrorist propaganda” accounted for .03 percent of aof the site’s views. The network finds 99.8 percent of all terrorist material before being alerted by users.

Facebook’s has said that much of its antiterrorism efforts rely on artificial intelligence (AI). Several Facebook executives painted a less positive picture of the company’s content moderation effort.

  • On Monday,The Verge website quoted Facebook’s top artificial intelligence (AI) scientist saying the company is “years away from being able to fully shoulder the burden of moderation, particularly when it comes to screening live video.”
  • On Friday, in a New York Times profile, Mike Schroepfer, Facebook’s chief technology officer, admitted that AI was not going to solve the problem completely.

In two of the interviews, he started with an optimistic message that A.I. could be the solution, before becoming emotional. At one point, he said coming to work had sometimes become a struggle. Each time, he choked up when discussing the scale of the issues that Facebook was confronting and his responsibilities in changing them. “It’s never going to go to zero,” he said of the problematic posts.

The story talks about a Facebook meeting where images of broccoli and marijuana were shows side by side

The problem was that the marijuana-versus-broccoli exercise was not just a sign of progress, but also of the limits that Facebook was hitting. Mr. Schroepfer’s team has built A.I systems that the company now uses to identify and remove pot images, nudity and terrorist-related content. But the systems are not catching all of those pictures, as there is always unexpected content, which means millions of nude, marijuana-related and terrorist-related posts continue reaching the eyes of Facebook users.

Everyone uses the Internet of Things to do things better faster easier cheaper and that includes in the unfortunate cases where people are strategizing real-world harm and that is something that as tech companies we have to face.

In her academic research into the process of radicalization, Saltman saw the growing  role of the internet.

While we can’t blame the Internet entirely as this violence and terrorism predates the internet, we can see that there is a catalyst role.

  • In the meantime, The Washington Post reports that the U.S. declined to endorse an international effort designed to curb extremism online. White House officials said free-speech concerns prevented them from joining the campaign, which emerged in response to live-streams of shootings at two New Zealand mosques.
  • And, the auto-generated Facebook page identified in the AP report and whistleblower complaint remains online. As of this morning, more than 4,400 users like the page for the Syrian terrorist group Hay’at Tahrir Al Sham.

Take Action! Urge the SEC to investigate and hold Facebook accountable! 

Resources

By Maya Efrati

After nearly a year of research and review, the U.S. Government Accountability Office (“GAO”) has released a report outlining best practices for how Congressional staff should appropriately handle information from whistleblowers. Titled “Key Practices for Congress to Consider When Receiving and Referring Information,” the report focuses on what happens when federal whistleblowers reach out to their representatives in Congress, whether in the House or Senate, for help. The GAO produced the report on the request of the House of Representatives’ Committee on Appropriations, Subcommittee on the Legislative Branch.

One of the ways that Congress is able to fulfill its mandate for oversight of the federal government is through receiving and acting on whistleblower information. The GAO report notes that, “[w]hile data is not available on the number of whistleblower disclosures across Congress, a staff member at one congressional office said the office can receive hundreds of whistleblower disclosures every year.” Yet too often, those whistleblowers are retaliated against for bravely speaking up about waste, fraud, and abuse. Compounding the problem, the GAO report demonstrated some existing deficiencies in the process for whistleblowers to disclose their information.

Maya Efrati head shot
Maya Efrati

Crucially, the GAO noted the importance of maintaining the confidentiality of whistleblowers who come forward with information to Congress. Key practices highlighted in the report include that Congress should “Develop… [p]rotocols to keep disclosures secure and protected, while appropriately limiting access to information on a need-to-know basis.”

This includes not only handling of sensitive or classified information provided by the whistleblower, but also  the whistleblower’s own personally identifiable information, which is any details that could allow someone to trace that person’s identity. Whistleblowers often risk their careers and more when speaking up about what they know; no whistleblower should be placed in an even more precarious situation because Congress lacks appropriate processes and guidelines to help them.

Continue Reading GAO report on key whistleblower practices for Congress released

From ProPublica,  an independent, nonprofit investigative newsroom.

By Isaac Arnsdorf

President Donald Trump often touts a law he signed to speed up firings at the Department of Veterans Affairs. He and other Republicans see the law as a model for weakening civil service protections across the federal government.

The administration’s case for the new law centered on Brian Hawkins. Hawkins was the director of the VA hospital in Washington when an internal investigation discovered safety risks for patients. The VA tried to fire Hawkins but got held up on appeal. Then-Secretary David Shulkin said Hawkins showed why “we need new accountability legislation and we need that now.” Once Congress passed the legislation, the VA used it to go after Hawkins a second time.

Now, almost two years later, the VA’s case against Hawkins has fallen apart. On Tuesday, the government said it would give Hawkins his job back rather than defend the statute in court.

While the administration tried to make Hawkins into a symbol of why it needed the legislation, court records tell a different story: of Trump appointees so eager to score political points that they ran roughshod over legal protections for civil servants.

“They couldn’t defend their actions in court,” Hawkins said in an interview. “The VA took away my rights, I had no say, my 25-year career was gone. It violated everything I tried to teach my family and tried to believe in myself: this country was founded on a Constitution, the Bill of Rights, equal opportunity for all.”

Hawkins argued that his firing was unconstitutional because the VA used a standard of proof that was too low. Since the government opted not to contest that claim, it could have repercussions for thousands of other VA employees who were fired under the accountability law, according to Jason Briefel, the executive director of the Senior Executives Association, which lobbies for high-ranking career officials.

“The passage of this law was a signature achievement for the president and many members of Congress,” said Briefel, who also works for the law firm that represented Hawkins. “If they were wrong and this was indeed unconstitutional, now they’re going to have to go figure out what to do with thousands of folks fired under this authority.”

VA spokesman Curt Cashour said the agency “has complete confidence” in the law but declined to comment on the Hawkins case. A White House spokesman didn’t respond to a request for comment.

House veterans committee chairman Mark Takano, a California Democrat, said he would hold hearings this summer to examine the VA’s implementation of the accountability law.

“This is another example of how VA has misconstrued and unfairly applied legislation once lauded as the Administration’s preferred method to root out corruption,” Takano said in a statement. “Instead of weeding out troubled leadership and incompetent supervisors, this law has been exploited and misused to target whistleblowers and employees.”

According to the government’s court filing, Hawkins will get back pay, but the VA could try to fire him again. The government now wants the judge to throw out Hawkins’ case as moot.

Many of the details in the litigation have been sealed for more than a year because the government considers the information protected by attorney-client privilege. But ProPublica uncovered the information from other documents and people involved.

Hawkins, 50, started working at the VA in 1992 cutting grass. He worked his way up through the ranks and in 2011 became director of the Washington hospital, overseeing a staff of 2,000 at the 200-bed facility three miles north of the Capitol. Under Hawkins’ charge, the hospital struggled with stocking medical supplies and filling leadership positions. In early 2017, Hawkins found out about problems in the logistics department and reported his concerns to the VA’s inspector general.

The inspector general’s office found dirty storage areas and supply shortages that were endangering patients. The inspector general’s report didn’t name Hawkins but suggested that even higher-ranking officials in the VA health system were aware the problems and had failed to fix them.

Shulkin was under pressure from Trump. As a candidate, Trump had campaigned on cracking down on errant VA employees, a rallying cry for conservative critics of the government-run health system. “You just need to start firing people,” Trump told Shulkin at a spring 2017 meeting with veterans groups, as reported in The Wall Street Journal. “Let them sue us. I don’t care if they sue us.”

The VA could have taken action against Hawkins based on the problems at the hospital he ran, but that would have required an investigation — and time. The Trump administration didn’t want to wait. Political appointees said they wanted to fire Hawkins “for any reason we can find,” according to a June 2017 email sent by Scott Foster, a senior official overseeing the staff responsible for investigating VA executives. According to the email, the staff investigators responded that there was “insufficient evidence.” (Foster declined to discuss personnel matters, citing privacy rules, but he agreed to tell his story.)

“We are setting ourselves up for slam-dunk due process fouls,” Foster said in the email, sent to his boss and the VA’s top lawyer. “We will lose this case on appeal, and in a very embarrassing way.”

The VA fired Hawkins anyway.

That same day, Foster was on a conference call where his boss, a political appointee named Peter O’Rourke, said he wanted 10 to 15 people who could be fired as soon as Trump signed the new accountability law, according to notes that Foster recorded later that month. Foster cautioned that the VA would still need to follow the legal process and act on evidence.

O’Rourke responded by moving to fire Foster. The stated reason, according to the written notice that O’Rourke gave to Foster, was that Foster had voiced concerns about the legality of how the agency was firing civil servants.

Foster knew that the law protected him from such explicit retaliation, but he wasn’t sure if that would matter.

“I was wondering if I was going to be caught up in a time in our country’s history when the people who ran the government did not necessarily feel compelled to follow the law,” Foster said.

O’Rourke, who later served as acting secretary and left the agency late last year, didn’t respond to phone messages.

Foster filed a complaint with the Office of Special Counsel, or OSC, an independent federal agency that investigates retaliation against whistleblowers. OSC blocked the VA from firing Foster.

OSC also received a complaint from Michael Culpepper, another senior official overseeing investigations of VA executives. Culpepper “witnessed VA leadership violate norms in seeking to terminate several senior level employees,” according to his lawyer, Mark Zaid. Culpepper became a whistleblower and suffered retaliation, Zaid said. Culpepper resigned in May 2017.

Based on the complaints from Foster and Culpepper, OSC moved to halt Hawkins’ removal. An administrative judge agreed to pause the firing for 45 days so that OSC could investigate further.

Shulkin seethed at the intervention. “No judge who has never run a hospital and never cared for our nation’s veterans will force me to put an employee back in a position when he allowed the facility to pose potential safety risks to our veterans,” he said in a press release.

Shulkin, who was forced out in March 2018, didn’t respond to a request for comment.

Rather than honor the 45-day pause, the VA said it would deploy the new accountability law that Trump had just signed. A Wall Street Journal editorial headlined “Can the VA Fire Anyone?” called the Hawkins case a critical test for the law’s powers. The order firing Hawkins was signed by Assistant Secretary for Congressional and Legislative Affairs Brooks Tucker, a political appointee who is outside the hospital system’s chain of command.

“The media circus that the secretary went on really made me feel less than human,” Hawkins said. “My children were laughed at and questioned by their friends. My neighbors stopped speaking to my family. It was a struggle to leave my home. I gained 30 pounds. I developed hypertension. I’ve been in counseling for stress and depression. I was unsure of how was going to provide for my family.”

Hawkins maintains that the Washington hospital had been on the upswing during his six-year tenure. When the inspector general’s office completed its review, it said Hawkins provided “ineffective leadership” but also faulted others above and below him. (A separate investigation found that Hawkins broke agency policy by sending sensitive information to a personal email account.)

Conditions at the hospital got worse after Hawkins left. The facility was designated “critical” last year and now ranks among the worst-performing hospitals in the entire VA system. The inventory problems still weren’t fixed — inspections found that some procedures had to be canceled because the hospital ran out of needed equipment.

“You’re using civil servants as political pawns to say, ‘OK, I fired them, therefore the problem is better,’ but a year or two years later, the logistics problem is still an issue,” Hawkins said. “It kills the efficiency of the organization, and then the ‘big bad VA doing bad things for veterans’ becomes a self-fulfilling prophecy.”

Cashour, the VA spokesman, said the Washington hospital is making “significant improvements” such as reducing wait times, hiring nurses and referring more patients to private providers. The latter was another Trump campaign promise.

Continue Reading ProPublica: Court hobbles VA firing spree that targeted whistleblowers

Danske Bank Whistleblower EU testimony
Danske Bank whistleblower Howard Wilkinson testifies during hearing at the EU Parliament Brussels, Belgium November 21, 2018.

The news program 60 Minutes had a piece on the Danske bank scandal and whistleblower Howard Wilkinson Sunday. He exposed Russian money laundering scheme at the bank’s Estonia branch that 60 Minutes said involves $230 billion.

The piece also features comments from Stephen M. Kohn,Wilkinson’s whistleblower attorney and the chair of the National Whistleblower Center. Both men say that the bank was failing to comply with law designed to prevent money laundering.

From the transcript:

Howard Wilkinson: Being named as a whistleblower in a case involving dirty Russian money. It’s not a good place to be.

Steve Kroft (of 60 Minutes) : You’re still concerned?

 Howard Wilkinson: You’ve gotta be, haven’t you? The very nature of the people who want to launder money probably means that they’re not the sort that you wanna go down the pub and have a pint with.

Continue Reading 60 Minutes: Danske whistleblower says bank ignored evidence of money laundering