Plaintiff Says Chiropractic Practice Fired Her After She Reported ‘Suspicious’ Billing

On Tuesday in the District of Maine, a former employee of a chiropractic office filed a complaint under the False Claims Act (FCA) against the practice, alleging that she was terminated from her position in retaliation for reporting what she believed to be fraudulent billing.

According to the complaint, plaintiff Stephanie Wood began working at Waldoboro Chiropractic & Massage in October 2017 as an office manager and chiropractic assistant. Dr. Tillou was the owner of the practice (now retired, per the complaint), hiring another chiropractor, Matt Thomas, in January 2020.

Wood alleged that she “began to have concerns” about Tillou’s “suspicious” billing practices after Thomas was hired, claiming that Tillou told Thomas to add certain billing codes to every Medicare and private insurance claim submitted, regardless of the service. When Thomas objected and said “he would not charge for a service or procedure he did not provide,” Tillou allegedly said, “I don’t care, bill for it anyway,” the complaint claimed.

Even further, the complaint alleged, Tillou would add billing codes before submitting claims if Thomas refused to include them himself and would make changes to Thomas’ patients’ records to indicate that certain patients needed more treatment even if Thomas had written that they were on the mend. This alleged practice of changing notes on patients’ conditions caught the attention of a claims adjuster in February 2020, who spoke with Wood to inquire about why the notes had changed.

The complaint said that Wood and Thomas picked up on other hints of alleged false claims, and Thomas reported the pair’s concerns to the Maine Department of Professional and Financial Regulation, Office of Professional & Occupational Regulation in early June 2020. Thomas quit voluntarily “upon advice of counsel.” Subsequently, per a text message that purportedly said “Sorry it had to end this way,” Tillou terminated Wood. In the same text message, Tillou defended herself, saying she has never billed unnecessarily nor has she changed any of Thomas’ patient notes, according to the complaint.

In a letter from Tillou dated July 15, 2020, requested by Wood in order to have her reason for being terminated in writing, Tillou accused Wood of “financial misconduct.” Wood claimed that this reasoning was “false and pretextual,” her belief being that Tillou retaliated against her because she and Thomas reported allegedly fraudulent billing by the practice, which is protected activity under the FCA. According to the complaint, Wood had no history of poor job performance or conduct concerns before her termination.

Wood is requesting an injunction barring the defendant from continuing the alleged conduct and compensation, including punitive damages, backpay, and lost future earnings.

Maine Employee Rights Group represents Wood.