A former Emergency Department nurse alleges in a lawsuit that Lawrence Memorial Hospital committed fraud to improve Medicare payments. The hospital denies the claims.

A former employee of Lawrence Memorial Hospital has sued the hospital, alleging that it falsified records to increase Medicare and Medicaid payments.

An attorney for Megen Duffy, a former emergency room nurse at LMH, filed the “whistleblower” lawsuit in U.S. District Court in Kansas City, Kan.

The suit alleges that arrival times of patients with chest pains were falsified in the Emergency Department to appear to coincide exactly with the time of the automatically generated time produced by the EKG monitor. Changing this time, the complaint says, conceals any time the patient spent in the waiting room, at registration or in triage. The suit says the fraud started as early as 2007.

According to the complaint, hospital senior staff and supervisors told Emergency Department staff members that the purpose of going to such lengths to falsely document arrival times, and other times related to treatment, was “to maximize reimbursement from CMS (the Centers for Medicare and Medicaid Services).”

“When employees questioned the practice and balked at falsifying these records, they were told that if they did not want to follow the policy that there were other hospitals where they could go work,” the complaint states.

Duffy worked at LMH from August 2009 to October 2013 as an emergency department nurse. The lawsuit was filed through her attorney, Robert Collins, of Olathe.

Megen Duffy

Duffy was fired from LMH in October 2013 for the “fabricated reason” that she had sent a threatening text to another employee, according to the suit. Duffy claims she was fired because she objected to falsifying arrival times.

The Affordable Care Act established a program in which Medicare makes incentive payments to hospitals based on quality of care as measured by performance on several tracked metrics. Duffy’s complaint says that falsely documenting arrival time then meant other times and measures were falsely reported as a result, and that put patients at risk.

Collins said the case against the hospital is strong.

“As far as evidences, we have really strong witnesses, ER staff members, staff training materials and emails,” Collins said.

The lawsuit was filed originally in May 2014 but sealed while the U.S. Department of Justice reviewed the case to determine whether to participate in it. When the Justice Department declined to be involved, the case was unsealed in June 2015, and a summons was issued to the hospital on Wednesday.

Collins said that although the Justice Department did not join the case initially, it has reserved the right to intervene at any time.

The complaint does not specify an amount that is expected to be recovered. But Duffy could collect 25 to 30 percent of what is recovered for the government if the Justice Department is not involved.

Janice Early, vice president of marketing and communications for LMH, said the hospital was notifying its employees of the lawsuit on Monday.

Gene Meyer, president and CEO of the hospital, said in a statement that LMH had not yet been served with the lawsuit, which made it difficult to respond about the specific allegations.

“I can categorically deny that LMH has any policies or intention to defraud the government,” Meyer said in the statement. “We do have in place policies to comply with all federal regulations, and we do have in place systems to report fairly and honestly what we do to serve our patients.

“We take great pride in the integrity of our organization and strive to meet the highest standards in every area of operation, clinically and financially. I am confident our associates and physicians are committed to those standards which ensure quality and safe care for our patients.”