Former CEO claims he was fired for calling out improper payments

Whistleblower says the system's board ignored $10 million in fraudulent Medicare payments
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A prominent physician and former CEO of an Oregon health system says he was fired by the governing board last year for suggesting the provider self-report $10 million in improper Medicare claims, according to The Oregonian.

Dr. Robert Dannenhoffer, who was once a prospective nominee to oversee the Oregon Health Authority, has filed a federal whistleblower lawsuit claiming he was fired as CEO of Architrave Health LLC for voicing concerns about overpayments. Dannenhoffer alleges Architrave maintained a compensation structure with Umpqua Medical Group that paid physicians who prescribed certain medications or performed certain procedures on Medicare patients, a violation of the False Claims Act (FCA) and Stark Law. Last year, the Office of Inspector General (OIG) released a fraud alert highlighting its renewed interest in physician compensation agreements that surpass fair market value.

After he was fired, Dannenhoffer says Architrave officials prevented him from obtaining employment at other providers within the Roseberg, Oregon area. Architrave officials declined to comment and it was not immediately clear whether the Centers for Medicare &Medicaid Services was investigating the physician's claims.

Although government FCA recoveries have dropped in 2015, statistics show that whistleblowers are still the main drivers of litigation. For that reason, legal experts have advised healthcare providers to focus on corporate compliance, and carefully review any internal reports of suspicious activity. Last year, the OIG released new recommendations calling on healthcare boards to take the lead on compliance initiatives

To learn more:
- read The Oregonian article

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