A federally qualified health center in Havre is battling lawsuits filed by former employees. Two people who worked at Bullhook Community Health Center have sued the center within the last two years.
In August 2018, a former pharmacy manager filed a lawsuit alleging Bullhook wrongfully fired her months earlier. Bullhook claimed that the former employee, Tami Miller, stole intellectual property and broke nondisclosure and confidentiality agreements. Bullhook officials allege she also disrupted pharmacy business when she allegedly reported the facility to the federal Drug Enforcement Agency (DEA) after being fired.
More than a year after the lawsuit was filed, on Nov. 18, 2019, a mediator filed court paperwork saying the parties reached a settlement. Miller had sued for unspecified damages to be proven at trial.
Today, the case remains open, with no further details about the pending settlement. But Bullhook’s attorney, Roberta Berkhof, told The Havre Herald on Thursday that all parties involved in the lawsuit are bound by confidentiality provisions in the settlement.
Just 12 days before Miller and Bullhook announced their settlement, another former employee filed a lawsuit. On Nov. 6, Kelly Kohler, who worked as a front desk manager from August 2016 to Sept. 2019, filed a complaint in District Court in Havre against the facility for wrongful discharge. Kohler claims the official reason she was fired — scheduling errors — was a ruse for the real reason: She had blown the whistle on the health center’s “fraudulent accounting and billing practices.”
Bullhook denies Kohler’s accusation. Berkhof, the facility’s attorney, said the lawsuit “lacks a factual basis” and should be thrown out.” She added:
“… most of the allegations in the complaint are mere legal conclusions unsupported by plain, straightforward allegations of fact. (Kohler) makes vague allegations about the circumstances surrounding her termination and casts liability to the entire Bullhook organization without any specific facts or concrete allegations to which Bullhook could formulate a response.”
If the lawsuit is not dismissed, Berkhof asked the judge to order Kohler to refile the lawsuit with “concise and unambiguous factual allegations.”
The Havre Herald checked for complaints about questionable Bullhook billing practices with multiple oversight agencies, including the Department of Health and Human Services, the Department of Justice’s Medicaid Fraud Unit, and the Centers for Medicaid and Medicare.
In response, spokespersons for the Department of Health and Human Services and the Department of Justice’s Medicaid Fraud Unit said there are no complaints about Bullhook related to fraudulent billing practices. Also, a spokesman for the Centers for Medicaid and Medicare said the agency does not comment on the complaints it receives because they contain private patient health information and/or financial information. Kohler confirmed during a phone call on Thursday that she only reported her complaint in-house.
On Jan. 16, Kohler filed a response to Bullhook’s request for dismissal or a more detailed complaint.
“Bullhook Community Health Center knows full well the basis for the claim,” she said in the court filing. She referred to the attached 32-page grievance she filed with her former employer as evidence.
In the grievance, which is included in court filings, Kohler detailed her basis for Bullhook’s unethical business practices: “In June and July 2019, I brought to (CEO Kyndra Hall’s) attention our facility has a major problem,” wrote Kohler.
The issue, Kohler said, stemmed from a policy dealing with patients who were late to their appointments. Center policy allowed patients to arrive five minutes late for 20-to-30-minute visits, and 10 minutes late for 40-to-60-minute visits, a practice that “created very uncomfortable situations for my staff,” said Kohler. Her reason: “Often a patient would be filling out paperwork as they were checked in at the 6 or 7 minutes mark,” she said, adding that then the professional staff would notify the front desk that the patient was late and had to be rescheduled.
Kohler said she started tracking the patients who were being turned away and comparing that information to providers’ schedules at the times. In some cases, she found the provider had no other appointments for hours and therefore had time to see the patient despite the tardiness. She said she reported the discrepancy to the CEO.
“I was concerned because we take grant monies to see underprivileged patients and that it was troubling we were turning them away even when a doctor had time to see them,” she said, according to the grievance.
After reporting to the CEO, Kohler said people in the professional department gave her the cold shoulder: “I think they felt threatened because I had pointed out they were getting paid from grant monies and not really working at providing the care we should.”
Kohler clarified during a phone call why she believes Bulhook committed unethical billing practices. When the center’s providers — whose salaries are heavily supported by taxpayer money thanks to millions in federal grants to the health center — sent patients home despite having room on their schedule to see them, they were essentially being paid for services they weren’t providing. Bullhook receives federal funds to see patients and turning them away when there is time to see them even though they were late is unethical, Kohler explained.
Bullhook Community Health Center opened in 2005 as Bullhook Clinic, part of the Hill County Health Department, after receiving a federal grant to help fund its operation. The federally qualified health center provided dental, physical, and behavioral health care services to about 4,500 patients in 2018, a reduction from the nearly 5,000 it served in 2016.
Nearly half the patients– 47% in 2018– are below the 100% poverty line. Over half– 57%– rely on Medicaid or Medicare, according to Health Resources & Services Administration .
To date, Bullhook has received millions of dollars in grant money. From 2007 to 2019, Bullhook received over $22,252,962 in HRSA grants, according to HRSA.
Kohler is suing for unspecified damages for being wrongfully discharged.
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Settlement On The Horizon
While the Kohler lawsuit seems to be just getting started, another may be nearing conclusion.
Tami Miller, former pharmacy manager, hired Sept. 1, 2014 and fired July 30, 2018 — claimed she was fired as retaliation for reporting to the Human Rights Bureau that Bullhook discriminated against her based on her gender. Miller, who made about $170,000 a year, including benefits, claimed Bullhook passed on her for the CEO position because she is a woman.
Bullhook alleges that Miller was fired for stealing intellectual property from the facility and for breaching employee nondisclosure and confidentiality agreements. The facility says Miller “offloaded, without any encryption, Bullhook information to her personal email account,” according to court documents. The documents did not include further details about the alleged stolen property. The confidential provisions part of the pending settlement all but ensure those details will remain unknown.
Miller is the daughter of Cindy Smith, the former CEO who had been the main driving force behind the center since it opened. Smith resigned in February 2018 and moved out of state, where her husband worked at the time.
On Feb. 13, 2018, Miller applied for the CEO position left vacant by her mother. Nine days later she canceled her interview. Both parties reportedly agree on this point but court files do not elaborate on why she canceled.
“Despite not completing the entire interview process, Miller claimed gender bias,” Bullhook officials said.
Eventually, Bullhook’s board of directors hired Brian Hadlock in May, 2018. However, in October of that year, the board fired Hadlock for failing to fulfill “contractual obligations.” Current CEO Kyndra Hall, a former chief financial officer for the facility — and a woman– then stepped into the position.
The Herald confirmed with the Montana Department of Labor and Industry’s Human Rights Bureau that Miller did file a claim in which she accused the facility of gender discrimination. The bureau dismissed the claim because there was no “reasonable cause to believe discrimination occurred,” said Tim Little, a bureau case manager.
Bullhook officials indicate they believe Miller’s goal was to punish the facility. Bullhook alleges Miller threatened to get the DEA involved if it hired Hadlock.
Miller denies this allegation.
Whatever the case, four DEA agents showed up unannounced six weeks after Miller was fired. On Sept. 17, 2018, the DEA inspected the pharmacy, including mostly Miller’s work, according to Bullhook. The center described the inspection as a major interruption that consumed employee time and overtime pay.
Stacy Zinn, a DEA spokesperson based in Billings, said agents did indeed inspect Bullhook’s pharmacy that day, but found nothing unusual. The DEA’s job is to ensure that pharmacies follow regulations intended to keep strong drugs out of the hands of people who shouldn’t have them. One way the agency does this is through routine spot inspections, meaning it selects a region and sends a team to inspect the facilities in that region. In this instance, Zinn said the DEA inspected facilities in eight cities including Havre.
Zinn said the DEA found “nothing outrageous” at Bullhook.
The Herald asked Berkhof, Bullhook’s attorney, why it’s settling the case with Miller?
In response, Berkhof said she could not comment because the parties are bound by the confidentiality provisions of the settlement agreement. Hall, the facility’s CEO, when given an opportunity to comment, said the same thing.
Update: On Feb. 4, Tami Miller’s lawsuit against Bullhook was permanently dismissed and the case closed. No settlement details were made available in public documents.
Editor’s note: In Kohler’s grievance, she included a copy of a Herald investigative report published June 19, 2018: “Examining The Local Health Center: Internal Files Raise Concerns About Bullhook Community Health Center.” The 2018 Herald story, based on detailed internal audit files, reported that some Bullhook patients had to wait months, some a year, for the center to complete its chemical dependency assessments. Documents also show that one Bullhook provider had billed several evaluations before completing them and another provider falsified assessments by backdating their completion dates — bringing center practices into question.
Berkhof refers to The Herald report’s contents as“unfounded and malicious.” She points to the 2018 state audit, performed later that year, which emitted no billing concerns, as support for why The Herald report is “unfounded.”
The 2018 DPHHS audit of the Bullhook program, which The Herald obtained shortly after it was complete, did not reflect any billing concerns. The Herald, however, stands by the report, confident the extensive pile of internal audit documents that support it are true and legitimate.
While Berkhof called The Herald investigative report unfounded, whether intentionally or by chance she did not call it untrue. The internal audit documents, which have personal patient information marked out, were given to The Herald by a source (s) who wished to not have their name(s) revealed and who wanted to avoid any potential retaliation in blowing the whistle.
In the grievance, Bullhook’s attorney says the FBI is investigating the illegal release of the documents. An FBI spokesperson said she would not comment on whether it was investigating how the documents left the health center.
Email Paul Dragu at [email protected]
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