One UNM employee and another former employee were allegedly harassed and retaliated against for reporting instances of billing fraud in the Health Sciences Center Pain Management Clinic last year, reliable sources have told the Daily Lobo.
A nurse who began employment at the clinic in April 2001 noticed shortly thereafter that William L. Johnson, former director of the clinic, and Unit Clerk Evelyn Martinez were submitting bills for patients without actually providing services, the sources said, speaking on condition of anonymity.
Johnson and Martinez were also engaging in prescription drug fraud, the sources added.
The clinic nurse, also speaking on condition of anonymity, said she reported her concerns to the nursing supervisor, but nothing was ever done to stop the illegal activities. Furthermore, Martinez began to threaten and harass the nurse, she said, to keep her quiet.
"She [Martinez] slandered my name with several patients and even accused me of having an affair with a doctor," the nurse said. "It was downright dirty."
Martinez resigned from UNM in November 2002, in lieu of contemplated action arising from her role in the pain clinic matter, the sources said. Martinez could not be reached for comment.
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The clinic nurse also said the nursing supervisor threatened her and submitted negative performance evaluations "without ever having viewed my actual job performance."
Several health sciences doctors, including Eileen Yager, wrote letters on behalf of the nurse, rebutting the negative performance evaluations.
"One of the reasons she [the clinic nurse] asked me to write the letter was because she disagreed with some of the things in [the nursing supervisor's] evaluations," said Yager, who worked occasionally with the clinic nurse, in an April interview. "She also wanted something in her file in case she ever wanted to work in the field again. She was a very good nurse who was always very helpful."
Yager added that the clinic nurse was not the first person she knew of who was harassed for reporting misconduct at UNM.
"I know the University is sometimes very mean to whistleblowers," Yager said. "I had a friend who did that, who blew the whistle, and she got screwed."
The clinic nurse became frustrated when no action was taken to stop the illegal billing, so she went to Counseling and Referral Services to discuss employment issues with a counselor, the sources said.
The counselor, who wrote a letter supporting the clinic nurse, was also harassed, retaliated against and put on administrative leave, the sources said.
In April or May 2003, the sources said, the counselor and the University "resolved their differences," reinstating the counselor's employment status.
After reports of the alleged billing fraud reached University counsel and health sciences administrators in April 2002, UNM made a self report to the U.S. Justice Department detailing the fraud.
One year later, UNM agreed to pay more than $10,000 in penalties stemming from Johnson's activities.
The clinic nurse said federal investigators interviewed her regarding the fraud.
"The feds gave me the impression there was more to be uncovered than originally reported," she said. "They also brought in the DEA."
University counsel and health sciences public affairs officials have confirmed that a criminal investigation is still pending regarding the pain clinic matter.
Information concerning alleged inappropriate behavior by Johnson besides billing fraud: the number of patients' records reviewed after the billing fraud came to light; the number of patients' visits implicated in the billing fraud; potential notification of Johnson's activities to the New Mexico Board of Pharmacy; and the internal letter written by the counselor on behalf of the clinic nurse, according to written statements from University officials.
The officials said they have no knowledge of the nature of the criminal investigation.
The clinic nurse resigned from UNM in November 2002 as a result of the harassment, retaliation and lack of support from her superiors, she said.
"I just decided I'd had enough," the nurse said. "I stuck around long enough to see that the feds got involved. The saddest thing is that anesthesiology and pain management is one of the most needed services in medicine and now they get treated like [expletive deleted] at UNM. It was a year and a half of pure hell. That's why I stepped forward - people were being taken advantage of and it needed to stop."
The clinic nurse received no severance pay, she said. In a final interview with University counsel, Paul Roth, dean of the School of Medicine, and Steve McKernan, CEO of the Health Sciences Center, she said she was made some promises.
"University counsel was incredibly supportive," she said. "But Dr. Roth and McKernan shot me right down. They supported some of the higher-ups who knew about this [billing fraud] and did nothing about it."
Roth has refused interviews with the Daily Lobo regarding matters in the pain clinic since early March.
"To suffice me, they also said [the nursing supervisor] would be fired or penalized."
According to University employment records, the nursing supervisor is still employed by UNM.
In a written statement, University officials said issues of retaliation were "raised and handled in accordance with UNM policy. We do not discuss disciplinary action that may or may not have been taken against UNM employees."
