Case details

Job eliminated after making fraud claim against employer: plaintiff

SUMMARY

$631200

Amount

Verdict-Plaintiff

Result type

Not present

Ruling
KEYWORDS
emotional distress, mental, psychological
FACTS
On Jan. 3, 2014, plaintiff Tansi Casillas, 51, a respiratory therapist for Central California Faculty Medical Group, learned that her position at University North Medical Specialty Center was eliminated. Prior to her termination, doctors allegedly left the responsibility to Casillas to have face-to-face evaluations with patients on continuous positive airway pressure, a treatment that keeps the airways open for people who have sleep apnea and other breathing problems. Patients and Medicare were then billed for a doctor’s visit, even though the patients were not seen by a doctor. As a result, Casillas allegedly refused to perform medical services outside the scope of her respiratory care license and continued to complain about the alleged fraud since April 2013. The faculty medical group’s compliance department eventually investigated Casillas’ claims and found that the medical group had “erroneously” over-billed Medicare, but determined that no fraud had occurred. As a result of the over-billing Central California Faculty Medical Group had to reimburse Medicare for the overcharges. Shortly thereafter, Casillas was informed that her position had been eliminated. Casillas sued her employer, Central California Faculty Medical Group Inc., which was doing business as University North Medical Specialty Center. She alleged that the medical group’s actions constituted whistleblower retaliation in violation of the Labor Code, gender and age discrimination, and wrongful termination. Casillas ultimately dismissed her gender and age discrimination claims prior to trial. Plaintiff’s counsel contended that after Casillas complained in April 2013, Central California Faculty Medical Group’s doctors, Lynn Keenan and Karl Van Gundy, took away all of Casillas’ job duties associated with the Sleep Department, falsely accused Casillas of violating the medical group’s conflict-of-interest policy, “investigated” Casillas for surfing the internet during work hours, and disciplined Casillas for violating HIPAA regulations when she took work home. Counsel also contended that Keenan and Van Gundy falsely accused Casillas of forgery and funneling referrals to a durable medical equipment company where her husband worked. Plaintiff’s counsel further contended that, ultimately, the medical group, through Keenan and Van Gundy, fabricated a story that Casillas’ job position was eliminated when, in fact, the medical group sought to hire respiratory therapists after Casillas was terminated. Thus, counsel argued that Casillas was actually terminated in retaliation for the fraud complaints she made since April 2013 and for refusing to perform medical services outside the scope of her respiratory care license. Defense counsel noted that the Medicare over-billings totaled an amount between $300 and $350. Defense counsel argued that Casillas was terminated for economic reasons that were aggravated by her “bad behavior in interacting with her coworkers.” Counsel contended that Casillas had used her job to unethically make referrals to a durable medical equipment company to benefit her husband, who was an employee there, and that Casillas became upset when the director for sleep medicine would not forge a doctor’s note for a Medicare audit of the equipment company. Defense counsel argued that only then Casillas claimed that she was a whistleblower., Casillas claimed that suffers from lost wages due to the periods of unemployment and securing lesser, hourly, per diem work. She also claimed that as a result of her treatment by Central California Faculty Medical Group’s staff, she suffers from emotional distress, including unexplained hair loss, fatigue, nausea, and other symptoms. She subsequently sought treatment for her conditions from her primary care doctor. Thus, Casillas sought recovery of $500,000 to $600,000 in emotional distress damages, $167,341 in past lost earnings, and $49,921 in future lost earnings.
COURT
Superior Court of Fresno County, Fresno, CA

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