Observing a co-worker's reckless behavior is one thing; it becomes more stressful for an employee who observes reckless or fraudulent behavior by someone in authority over them. Federal and state laws prohibit employers from retaliating against employees who report practices by employers that threaten public health and safety or violate the law. Other laws prohibit retaliation against employees who file complaints about their working conditions, including unsafe working conditions.
Although the laws vary from state to state, anti-retaliation laws generally prohibit adverse actions such as termination, layoff, demotion, suspension, denial of benefits, reduction in pay, and discipline when adverse action is taken in retaliation for employees' reports of unsafe or unlawful practices.
Whistleblower policy
A whistleblower policy is an integral part of a healthcare organization's Code of Conduct.
Intent: The whistleblower policy intends to encourage staff (and volunteers) to come forward and report credible information on illegal practices or violations of organizational policies without fear of retaliation. (Fear of retaliation is essential to consider if an employee is reporting a supervisor or manager.)
Healthcare organizations are encouraged to include their whistleblower policy in the employee handbook.
Mechanism: This policy should be written in such a way that it encourages internal reporting. The policy must emphasize that reporting is confidential and anonymous. There should be a procedure for reporting (e.g., a hotline number to call). Finally, the policy must guarantee that an employee will not be a victim of retaliation for reporting misconduct.
If the issue is not addressed through the internal reporting mechanism, the whistleblower may need to report the concern anonymously to the institution's accrediting agency. The situation then must be addressed if patient, employee, or environmental safety is at risk.
What should be reported under a whistleblower policy:
Suspected misconduct should be reported under a whistleblower policy. Types of misconduct include:
- Financial improprieties
- Failing to follow institutional policies
- Misuse of the organization's resources
- Failure to comply with legal requirements
- Breaches of ethical conduct
Examples:
- A laboratory was fined millions of dollars for a massive kickback scandal as well as for Medicare fraud.11
- Unbundling of laboratory test panels in order to bill tests separately, even though they were performed simultaneously in a panel. Reimbursement for the higher individual test fees is not allowed in these cases.12
What should not be reported under a whistleblower policy:Personal grievances and complaints should not be reported using the whistleblower reporting mechanism. Human resources departments have separate reporting mechanisms for these issues.
