PRESTONSBURG, Ky. — A second former employee has now filed a lawsuit against Mountain Comprehensive Care, alleging she was subjected to a hostile work environment after she refused to submit fraudulent bills to Medicaid and Medicare.

Rachel Williams, a 14-year employee of Mountain Comp who was regional billing coordinator when she resigned in December, filed a lawsuit against the organization March 3.

Her complaint mirrors another filed by former Chief Financial Officer Rebeckah Hall against Mountain Comp and its subsidiary, Mountain Plus Services, in January. Both women claim their supervisors, including CEO Promod Bishnoi, instructed them to submit false billing codes to generate more revenue for the organization. Those allegations include:

• Billing for services provided at a federally-qualified health center, when services were provided at a different location.
• Refraining from engaging with Medicaid and Medicare for inquiries or clarification of charges identified by Bishnoi as billable.
• Billing for services under the credentials of a licensed provider when they were not rendered by a licensed provider.
• Not correcting billing codes after the Covid pandemic to reflect that services were provided as “audio only.”
• Changing billing locations despite being told by the Financial and Billing departments that the action violated state law.

Both women also claim that after they refused to submit false billing codes and reported their concerns, they were subjected to retaliation constituting a hostile work environment, and that their subsequent resignations from Mountain Comp amounted to constructive discharges. In legal terms, a constructive termination is a situation when an employee is forced to quit due to an employer creating intolerable working conditions.

Williams resigned from her position on Dec. 12, one week after Hall resigned from hers.

“Despite my commitment, I was placed in a situation where I was asked to engage in billing practices that were unethical and fraudulent,” William wrote in her resignation letter. “Because these requests went against my personal and professional morals, I refused to participate. I, along with two other staff members, wrote a letter to the Board of Directors, and expected this to be handled by them. I have still not heard anything about this, nor have I been contacted for any questioning about the information I had on the complaint. Following that refusal and letter being sent, I experienced clear retaliation that created significant strain in my work environment.”

Williams is seeking damages for emotional distress, lost wages, attorney’s fees, and punitive damages.
A lawsuit represents only one side of a dispute. Mountain Top News reached out to Mountain Comp asking for comment after each lawsuit was filed, but received no response.

However, the companies’ attorneys filed answers to Hall’s lawsuit on Tuesday. In them, Mountain Comp and Mountain Plus deny that Hall was retaliated against or forced out of her job after reporting alleged improper billing practices. The organizations say Hall voluntarily resigned from her position on Dec. 5 and deny that any unlawful or fraudulent activity occurred. The responses also deny that the organizations violated any laws or created a hostile work environment and state that any actions taken regarding Hall were legitimate business decisions made in good faith.

Mountain Comp and Mountain Plus further argue that Hall’s complaint fails to state a valid legal claim and ask the court to dismiss the lawsuit and award the company its legal costs.

Copies of Williams’ complaint and resignation letter, as well as the answers by Mountain Comp and Mountain Plus, follow:

Note: This story has been corrected to accurately reflect that Williams’ suit is against Mountain Comprehensive Care, whereas Hall’s suit is against both Mountain Comprehensive Care and Mountain Plus Services.