Halifax whistle-blower felt she had no choice

As a hospital compliance officer and physician services director, Elin Baklid-Kunz found evidence of Medicare billing abuses at Halifax Health, as did other officials there, she said in an interview. But hospital leaders did nothing to fix the problems after she and others reported them, she said.

One internal report at the Daytona Beach, Fla., hospital found 60% of patients in a sample of chest-pain patients had been admitted inappropriately. One neurosurgeon claimed to have provided a volume of patient care more than four times the national average. Two surgeons were receiving bonuses topping $1 million.

When she recommended strengthening the compliance department and returning the allegedly improper Medicare payments, she was told that would cost the hospital millions of dollars in revenue and was not going to happen, she said.

Baklid-Kunz, 48, said she couldn't stay silent after one of Halifax's staff attorneys, Audrey Pike, concluded that some of the payment arrangements violated the federal Stark law. “I thought I could go to jail if someone else blew the whistle,” she said, fearing she would be held to a higher standard because she has certification from the Health Care Compliance Association. “I honestly felt that I didn't have a choice.”

Then as now, Halifax officials deny any wrongdoing.

The False Claims Act allows private individuals to sue allegedly fraudulent contractors on the government's behalf. So she filed suit in 2009. The Justice Department joined her as a plaintiff in 2011.

A Norwegian citizen who is a permanent U.S. resident, Baklid-Kunz remains director of physician services at Halifax, where she's been employed for 20 years in various roles, including compliance and revenue collection.

Her life hasn't been the same since her suit became public. She has been featured in local newspapers. The hospital suggested she harbors a grudge against Halifax because her infant child died there, according to court papers.

She stands to receive at least 15% of the $85 million settlement-in-principle announced last week, and an even higher share of any award from a trial on related allegations in July. She doesn't know what she'll do after the case is over.

“I just hope I'll be able to work again,” she said. “I love this work. I would hate to have to go back to school and learn something new.”

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