EUGENE, OR – Dr. Robert Dannenhoffer filed a federal whistleblower complaint today that claims he was fired as CEO of Architrave Health LLC in Roseburg after he reported $10 million in illegal Medicare payments to Douglas County physicians.
“Dr. Dannenhoffer was fired because he did the right thing,” said Jennifer Middleton, an attorney with Johnson, Johnson & Schaller PC who represents Dannenhoffer. “He is the definition of a whistleblower.”
Dannenhoffer’s lawsuit, which was lodged in U.S. District Court in Eugene, seeks reinstatement as Architrave’s CEO, back pay, punitive damages and attorney’s fees. “He wants to resume the work he started at Architrave to improve health care delivery to low-income Douglas County residents,” Middleton said. “He wants his reputation restored.”
Dannenhoffer, who was involved in creating Architrave Health in 2013, was fired February 17, 2015, three weeks after he disclosed improper billings and kickbacks by the Umpqua Medical Group, a wholly owned Architrave subsidiary, to the Centers for Medicare & Medicaid Services.
The suit alleges his firing was in retaliation for Dannenhoffer’s actions after he uncovered fraudulent Medicare billings and resisted pressure to keep them hidden.
According to the complaint, the Architrave board of directors reluctantly authorized Dannenhoffer to self-disclose the Stark Law violations in late January 2015, then without notice fired him. When Dannenhoffer asked why he was being fired, “He was told it was because he failed to ‘cooperate and coordinate,’” the complaint says.
The federal Stark Law prohibits claims for designated health services when doctors profit directly from services or tests they prescribe. Its purpose is to reduce financial incentives for doctors to order unnecessary health services. Punishment for Stark Law violations can include full refunds of improper payments and civil penalties.
After he was fired, Dannenhoffer was blacklisted. In May 2015, Dannenhoffer was hired as interim CEO of Umpqua Community Health Center in Roseburg, but when he applied for the permanent CEO position, he was not hired. Dannenhoffer says a member of the Architrave board of directors applied pressure not to retain him. Architrave refers Oregon Health Plan patients to the federally qualified health center.
Dannenhoffer’s suit also says he was denied a spot on the Community Health Alliance board of directors after a Mercy Medical Center official threatened to withdraw from the Roseburg health care organization.
“As a result of defendants’ unlawful interference, Dr. Dannenhoffer lost employment and beneficial business opportunities, suffered and continues to suffer lost income and benefits, loss of future earning capacity, and harm to his reputation and professional standing,” according to the complaint. Dannenhoffer has continued his Roseburg-based pediatric practice and is the public health administrator and public health officer for Douglas County.
For interviews or more information: Contact Gary Conkling at 503.544.8997 or [email protected]
Background on Dr. Robert Dannenhoffer
Dr. Dannenhoffer, 59, is a board-certified pediatrician who has been in practice in Roseburg since 1989. He graduated in 1980 from Albany Medical School, one of the oldest medical schools in the United States, and did his residency at Massachusetts General Hospital. Dannenhoffer has played a role in Oregon’s health care reform, most recently in implementing a coordinated care organization in Douglas County. He is currently the executive director for the Douglas Public Health Network and the public health officer for Douglas County. He is a past president of the Oregon Medical Association and was named a Smoke Free Oregon hero in 2012. He is the recipient of the George Miller Patient Safety Award and Oregon Business Association Statesman of the year award. Dannenhoffer was the inaugural chair of the Oregon Metrics and Scoring committee and is the Co-chair of the Task Force on Resolution of Adverse Healthcare Incidents.
Background on Relevant Legal Issues
These are the two federal statutes referenced in the Dannenhoffer complaint.
Stark Law, 42 U.S.C. § 1395nn (in part):
(a) Prohibition of certain referrals
(1) In general Except as provided in subsection (b) of this section, if a physician
(or an immediate family member of such physician) has a financial relationship with an entity specified in paragraph (2), then –
(A) the physician may not make a referral to the entity for the furnishing of designated health services for which payment otherwise may be made under this subchapter, and (B) the entity may not present or cause to be presented a claim under this subchapter or bill to any individual, third party payor, or other entity for designated health services furnished pursuant to a referral prohibited under subparagraph (A).
(2) Financial relationship specified For purposes of this section, a financial relationship of a physician (or an immediate family member of such physician) with an entity specified in this paragraph is –
(A) except as provided in subsections (c) and (d) of this section, an ownership or investment interest in the entity, or
(B) except as provided in subsection (e) of this section, a compensation arrangement (as defined in subsection (h)(1) of this section) between the physician (or an immediate family member of such physician) and the entity. An ownership or investment interest described in subparagraph (A) may be through equity, debt, or other means and includes an interest in an entity that holds an ownership or investment interest in any entity providing the designated health service.
Anti-Kickback Act, 42 U.S.C. § 1320a-7b(b) (in part)
(b) Illegal remunerations
(1) Whoever knowingly and willfully solicits or receives any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind –
For interviews or more information: Contact Gary Conkling at 503.544.8997 or [email protected]
(A) in return for referring an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or
(B) in return for purchasing, leasing, ordering, or arranging for or recommending purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more than $25,000 or imprisoned for not more than five years, or both.
(2) Whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person –
(A) to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or
(B) to purchase, lease, order, or arrange for or recommend purchasing, leasing, or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program, shall be guilty of a felony and upon conviction thereof, shall be fined not more than $25,000 or imprisoned for not more than five years, or both.
