More former EKY mental health clinic workers allege federal billing fraud
Two more former employees of a Kentucky mental health system headquartered in Prestonsburg say the company committed federal billing fraud and retaliated against them when they refused to participate.
Kendra Allen, the former Mountain Comprehensive Care Center revenue cycle manager, and Jennifer Salisbury, the outpatient mental health provider’s quality improvement director, both filed lawsuits against their former employer this month.
The two women claim they were coerced into falsifying Medicare and Medicaid bills and medical records and ignore patient protection safeguards to generate more revenue for the company. They join three other ex-employees who have filed workplace harassment lawsuits against the nonprofit healthcare provider and its underlying tax-exempt support corporation since January.
Allen, an 18-year veteran at MCCC, claims she was told to lie on billing records about where federally-qualified health services took place and who provided them. She says she was also instructed not to engage with U.S. Centers for Medicare and Medicaid Services for inquiries about billing changes.
By contrast, Salisbury, who worked at MCCC for six years, says two specific incidents led to her firing. In one, she claims to have implemented enhanced protocols after a patient was given medication intended for someone else that drew retaliation from her supervisors.
Later, she claims MCCC CEO Promod Bishnoi lashed out at her when she drafted a corrective manual to correct deficiencies identified in a Medicaid audit. She claims she was subjected to workplace retaliation she says she believes was intended to force her resignation. When she failed to resign, she was fired in August, according to documents she filed in court.
Bishnoi’s alleged role at the center of an effort to commit federal healthcare billing fraud is a common theme across all five complaints filed against MCCC so far. Several former employees have accused him of personally directing fraudulent billing practices.
The company has denied these claims in court. It has not responded to Herald-Leader requests for comment.
MCCC operates 50 outpatient clinics across Kentucky, plus therapeutic foster care facilities, addiction service centers, nearly 20 primary-care clinics and several homeless shelters and transitional living facilities, according to its website. The company provides counseling and juvenile intervention services in several Eastern Kentucky school districts.
The company is also a publicly-funded community mental health center charged with providing services for Kentuckians struggling with mental health, developmental, intellectual disabilities or substance abuse through the Kentucky Cabinet for Health and Family Services. It receives a “significant portion” of its revenue from state and federal reimbursements, including Medicare and Medicaid, according to one lawsuit.
It is a separate company unaffiliated with Whitesburg-based Mountain Comprehensive Health Corp., which operates medical clinics across Eastern Kentucky and Southwestern Virginia.
