Doctor sues hospital, claims billing done for patients he never saw

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Hospitals prefer to be best known for providing quality patient care.

But lawsuits and former employees for a hospital in the scenic North Georgia mountains paint a separate picture. And it's not a pretty one.

Bills not paid.
Paychecks that bounced.
And claims from a former hospital top doctor that his physician identification number was used to bill for services he never provided and for patients he never saw.

There's no doubt the location is stunning. Perched high above the city of Clayton in North Georgia, the estimated $25 million Mountain Lakes Medical Center spared no expense when it opened for business in September 2017. An outdoor boardwalk with a view of Black Rock Mountain... a restaurant that would draw local artists to come eat and dream. And 24 patient rooms that look directly out at the serene landscape below.
Just don't include local attorney Michael Cummings as being so inspired.

"When I drive by it, I can kind of the hear the voices of all the people who complain to me all the time," he said.

Cummings has represented a Mountain Lakes Medical employee who says the hospital didn't pay what it owed... and two who say the hospital failed to pay their insurance premiums. He managed to settle the lawsuits after the hospital denied wrongdoing. But he says the complaints would continue.
Jennifer Dodd once worked as the hospital CEO's secretary. She says the money problems for employees started at the hospital's old location in Clayton.

"People would go to the doctor's office or go to the pharmacy to pick up their prescription," she remembered. "Insurance was declined. People would call me and say, hey, it was taken out of my check. I've been paying this."

Dodd says the hospital couldn't pay its own bills, either.

"There were tax bills that didn't get paid," she said. "They'd get behind on their water bills."

Nancy Ciochetti worked in the lab.

"The hospital was known for that," she agreed. "You better get your check to the bank before it bounces. Everybody knew that."

Clayton mayor Jordan Green backed up the former employees' accounts. He the told the FOX 5 I-Team the hospital's reputation for bouncing paychecks and falling behind on its city taxes and water bills started years ago. But that's not all.

According to lawsuits stretching back to 2013 at the hospital's old location, Mountain Lakes Medical Center once owed more than $90,000 for computers. Another $140,000 in back pay to a gastroenterology practice in Atlanta. Each time once lawyers got involved the case was settled and the bill ultimately paid.
But those money problems have continued in the new location. A lawsuit over failing to pay $18,000 for the flooring in the hospital restaurant. Enovate Medical also sued last year, claiming it wasn't paid the $40,000 for new medical equipment. Both debts were eventually satisfied. This week the city of Clayton said the hospital currently owes thousands of dollars for back taxes and overdue water bills.
Mountain Lakes Medical did not respond to repeated attempts for comment.

Plenty of rural hospitals in this country face financial stress. In fact, in the last decade seven Georgia rural hospitals closed their doors. But it's the latest legal complaint against Mountain Lakes Medical that's raising some disturbing concerns.

Dr. Butch Findley has practiced family medicine in Rabun County for 31 years. He was the Mountain Lakes Medical Center Chief of Service, representing the needs of doctors with administrators. He and the hospital parted ways last year.

But according to a complaint filed in March, shortly after he left former hospital employees came forward to say they were told to use Findley's national physician ID number -- or NPI -- to bill insurance for patients he never saw, procedures he never performed, sometimes "after he had already left Defendants' employment."

"It makes me angry," admitted Dr. Findley. "I've spent 31 years here. I love these people and they love me. And I don't want my reputation sullied."

Dr. Findley's complaint asked a judge to issue an emergency discovery order because he "believes... if he confronts Defendants or their attorney, Defendants will attempt to destroy, conceal or otherwise make it difficult for Plaintiff to obtain billing information from them."
In its response to the complaint, Mountain Lakes Medical denied the charges and asked the judge to dismiss the lawsuit. Dr. Findley has 30 days to respond. The judge did grant the emergency order, writing "under the circumstances the risk of loss, concealment or destruction of records in the possession of the Defendant may result in the civil or governmental prosecution of Plaintiff if he is not able to ascertain the extent of the uses of his Identification Number."

Even though neuropathy has made getting around a challenge, the 70-year-old Findley still practices medicine. But his days at Mountain Lakes Medical still weigh heavy.

"What if someone investigated and I was charged with Medicare or Medicaid fraud?" he asked. "That would be my legacy in this community."

He said suing his old employer was the only way to make sure the hospital stopped. We asked if there was any chance that any inaccurate billing could have been accidental.

"No," replied Dr. Findley emphatically. "This was deliberate."