Darrow v. Integris Health, Inc.

2008 OK 1, 176 P.3d 1204, 27 I.E.R. Cas. (BNA) 219, 2008 Okla. LEXIS 2, 2008 WL 187389
CourtSupreme Court of Oklahoma
DecidedJanuary 15, 2008
Docket103,281
StatusPublished
Cited by89 cases

This text of 2008 OK 1 (Darrow v. Integris Health, Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Darrow v. Integris Health, Inc., 2008 OK 1, 176 P.3d 1204, 27 I.E.R. Cas. (BNA) 219, 2008 Okla. LEXIS 2, 2008 WL 187389 (Okla. 2008).

Opinion

OPALA, J.

¶ 1 The question presented is whether the Court of Civil Appeals (COCA) erred when it affirmed the trial judge’s decision that granted appellee’s (Integris Health, Inc.) motion to dismiss the action for failure to state a claim upon which relief can be granted? 2 We answer in the affirmative.

I.

THE ANATOMY OF LITIGATION

¶ 2 Chris Eugene Darrow (Darrow) brought suit against his former employer Integris Health, Inc. (Integris), 3 a home health-care agency, for wrongful termination based on the public-policy exception to the at-will employment rule. His petition states he worked for Integris for approximately eight (8) years before he was dismissed on or about 7 March 2005. According to Darrow, he originally worked as a home health aide, then did data entry and eventually progressed to the positions of administrative assistant and administrative coordinator. He described his duties as those of providing advanced secretarial and administrative support for various departments and auditing all billing activities associated with computer input for proper customer invoicing. This included billing for Medicare reimbursement. His job was to seek payment for services provided to patients covered by Medicare, Medicaid and insurance benefits. He had to verify the accuracy of patient information that was to be submitted to pay- or entities.

¶3 On or about 2 March 2005 Darrow received an e-mail from the clinical manager of Samaritan Home Based Care. 4 It notified him of the death of an Integris patient and three (3) family members as a result of a home fire. Because Darrow was aware that some of the equipment used in home health care posed an increased risk of fire, he responded to the e-mail.

¶ 4 That very day Darrow received conflicting information concerning the patient’s age. Because age discrepancies can delay billing, he attempted to verify the patient’s correct age by checking the source documents in the chart. In doing so, he noticed that the signature authorizing Integris’ services appeared to be that of a minor grandchild of the patient who also died in the fire. According to Darrow, media reports about the fire included information inconsistent with that contained in Integris’ documents. In addition to the age discrepancy, the news reports indicated the lack of smoke detectors and the use of non-breakaway security bars on windows at the patient’s residence. This differed from the admitting nurse’s initial *1208 evaluation of the home which noted “no discrepancies” on the patient’s initial intake form. 5

¶ 5 Darrow notified the company’s Quality Assurance Supervisor about these problems. She indicated she would talk with his supervisor when the latter returned to work later that week. Barrow’s employment was terminated approximately five days later for an alleged HIPAA (Health Insurance Portability and Accountability Act of 1996) violation in the course of his review of the deceased patient’s chart. 6

¶ 6 Darrow filed an amended petition 7 urging his dismissal was retaliatory, and asserted his right to relief in accordance with the public-policy exception to the at-will employment doctrine established in Burk v. K-Mart Corp. 8 Integris filed a motion to dismiss Barrow’s amended petition for failure to state a claim upon which relief can be granted. 9 The trial court sustained this motion. COCA affirmed the trial judge’s decision. It ruled the petition presented no set of facts which would entitle Darrow to relief because (1) he has not sufficiently identified an Oklahoma law that makes an alleged violation of the federal Medicare Act a breach of this state’s public policy and (2) his reports implicating patient safety dealt with loyalty to his employer which involved merely the latter’s private and proprietary interests that do not support a Burk claim.

II.

Standard of Review

¶ 7 In reviewing a nisi prius disposition by dismissal, this court examines the issues de novo. 10 Motions to dismiss are generally viewed with disfavor. 11 The purpose of a motion to dismiss is to test the law that governs the claim in litigation, not the underlying facts. 12 A motion to dismiss for failure to state a claim upon which relief may be granted will not be sustained unless it should appear without doubt that the plaintiff can prove no set of facts in support of the claim for relief. 13 When considering a defendant’s quest for dismissal, the court must take as true all of the challenged pleading’s allegations together with all reasonable inferences that may be drawn from them. 14 A plaintiff is required neither to identify a specific theory of recovery nor to set out the correct remedy or relief to which he may be *1209 entitled. 15 If relief is possible under any set of facts which can be established and is consistent with the allegations, a motion to dismiss should be denied. 16 A petition can generally be dismissed only for lack of any cognizable legal theory to support the claim or for insufficient facts under a cognizable legal theory. 17 This recapitulation of the standards that govern when a case is decided on a motion to dismiss guides our review in this case. 18

III.

A.

The Parties’ Certiorari Arguments

¶ 8 According to Darrow’s certiorari petition, his internal reports to personnel about Integris’ record discrepancies dealing with allegations of falsification of documents submitted to Medicare, possible Medicare fraud and concerns about patient safety are violations of public policy and hence are actionable in accordance with Burk 19 and its progeny. 20 Darrow bases his claims on (1) three federal statutes (the False Claims Act, 31 U.S.C. § 3730; the False Statements Act, 18 U.S.C. § 1001; as well as the criminal Medicare and Medicaid anti-fraud and abuse provision in 42 U.S.C. § 1320a-7

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Cite This Page — Counsel Stack

Bluebook (online)
2008 OK 1, 176 P.3d 1204, 27 I.E.R. Cas. (BNA) 219, 2008 Okla. LEXIS 2, 2008 WL 187389, Counsel Stack Legal Research, https://law.counselstack.com/opinion/darrow-v-integris-health-inc-okla-2008.