DHS Whistleblower Says Agency Improperly Billed Medicare

Updated: 12/04/2013 7:45 AM
Created: 12/03/2013 10:28 PM
By: Jay Kolls

Ngozi Akubukie says she uncovered improper Medicare billing at the Minnesota Department of Human Services (DHS) and then was fired.

Akubukie was an attorney at DHS for 10 years. She tells 5 EYEWITNESS NEWS that in 2007 she found improper Medicare billing at the Brainerd Neurorehabilitation Hospital in Brainerd.

She says she reported it to her bosses and told her they would investigate the matter. Akubukie says she realized the practice was continuing in 2010 and when she brought the issue up again, she says, "I became a target and was fired for insubordination."

In 2007 alone, Akubukie says the wrongful Medicare reimbursements totaled $2 million.

Akubukie filed a wrongful termination lawsuit in 2011 and says she has reached a "tentative settlement with DHS." Now, she is speaking out about the case for the first time publicly.

Akubukie says the Brainerd hospital, which is run by DHS, illegally billed the federal government for some patients who did not meet criteria for psychiatric care. She says they were brain trauma patients who received cognitive rehabilitation "but did not qualify for psychiatric care, and Brainerd still billed the government for Medicare reimbursements under psychiatric care guidelines."

A DHS letter obtained by 5 EYEWITNESS NEWS sheds a similar light on the subject. The 2011 internal memo from an auditor to a compliance officer says some of the Brainerd patients "did not meet Medicare criteria" and that DHS reimbursed the Medicare payments for "August 2010 through October 2010." The memo goes on to say there was no intent of Medicare fraud and the case was closed. The memo does not say why the reimbursements were limited to that four-month time frame.

Akubukie says DHS knew all along they were improperly billing Medicare and more than just the four months, in 2010, should have been reimbursed to the Feds.

DHS declined an interview because the case is still in litigation with a settlement negotiations underway.

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