It's Getting Expensive

It's Getting Expensive As City, Whistleblowing Auditor Wrangle Over Retaliation Claims

By Robert Wilonsky Thu., Aug. 18 2011 at 9:55 AM

Of the myriad lawsuits involving the city, Doug Moore v. City of Dallas et al is among the most expensive -- and getting a little more pricey all the time. This case, for those not keeping score at home, has already cost the city $2.5 million, paid to the state and the feds in June over allegations that the Dallas Fire-Rescue and ambulance provider Southwest General Services of Dallas collected far more from Medicare and Medicaid than they should have by knowingly billing the government for "Advanced Life Support (ALS) level ambulance services for all 911 calls, regardless of whether the beneficiary's condition required that level of service."

It could have been worse: When the filed-in-'09 case came to light last summer, after it was unsealed in federal court, guesstimations were the city could owe close to $40 mil. When it settled with the feds and state earlier this summer, the city didn't admit to any wrongdoing or liability.

But the case is far from settled. On the other side are the docs filed in recent days as the City Attorney's Office and Moore -- who worked in the Fraud Waste and Abuse section of the City Auditor's Office and who blew the whistle on the overcharges to begin with -- wrestle over whether the city fired Moore for telling the feds about DFR and the ambulance provider's overcharges. Meanwhile, the city council will approve next week to spend even more money with Cathy E. Bennett & Associates, Inc., hired in April "for jury and trial consultant services." Initially the city agreed to spend $25,000 for Bennett's services; next week, the amount will increase to $100,000 out of the general fund. Because, far as the city's concerned ...

Twice this summer City Attorney Tom Perkins's office has filed a motion for summary judgment, including on July 29, insisting that in November 2009, City Auditor Craig Kinton and Perkins learned that "Moore had filed a False Claims Act lawsuit alleging that the City (DFR) was fraudulently billing Medicare and Medicaid by 'upcoding' and billing all ambulance transports at the ALS level." Moore claimed in his complaint that the city has received close to $26 million in Medicaid and Medicare overpayments.

His sealed suit didn't sit well with the city, which says it was in the middle of investigating the auditor's results when he filed the suit. As the city explained in a press release accompanying the June 2001 settlement, "Under the False Claims Act and Texas Medicaid Fraud Prevention Act, private individuals may bring actions alleging fraud on behalf of the U.S. and Texas and collect a share of any proceeds recovered by the suit. Mr. Moore can receive up to 30% of the recovery under the settlement."

According to the latest filing by the city, chief auditor Craig Kinton fired Moore on December 2, 2009, "because Moore violated his fiduciary responsibilities to the City and the City Auditor's Office" and was in "an adversarial relationship" with his employer. In other words, he now had a stake in the outcome of the audit's results.

That's now how Moore sees it. Far as he's concerned, the city axed him purely out of retaliation. Both parties make their cases below.

Here is the link if you want to look at the court documents:

http://blogs.dallasobserver.com/unfairpark/2011/08/its_getting_expensive_as_city.php  

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