North Hollywood Man Sues Ex-Employer Over Alleged False Audits

By City News Service

A former auditor of Medicare records at a major health care insurer is suing his former employer, alleging that he was fired for reporting to management that his boss ordered him to illegally change dates on those reports as well as falsify his personal expenses.

Sho Inouye of North Hollywood filed the lawsuit Friday in Los Angeles Superior Court against the WellPoint Companies of California and his ex- supervisor, Carlos Alaras.

His allegations include violations of the whistle-blowing law, wrongful termination, retaliation and intentional and negligent infliction of emotional distress. He seeks unspecified compensatory and restitution damages.

WellPoint spokesman Darrel Ng said the company does not comment on pending litigation.

According to the complaint, Inouye was hired as a temporary auditor for WellPoint in August 2010. He was then given a full-time job as a Medicare senior auditor in February 2011 and was fired in December of that year. His job was to draft and prepare audits for WellPoint's payment arrangement system, the suit states.

Within three weeks of being hired permanently, Inouye was told by Alaras to backdate several audit reports to show they were conducted in December 2010 rather than the true date of February 2011, according to the complaint. After complaining to Alaras about his alleged orders to backdate audits, Inouye was asked, "Do you have a problem with that?," the complaint states.

"What made this situation even worse is that ... Alaras' practice of backdating audits was not only tolerated by WellPoint, it was actually encouraged," the suit states.

Inouye realized that if he wanted to keep his job, he "better do what he was told," according to the suit.

Inouye also alleges that Alaras told him to prepare an expense report stating that he was traveling from his home to an assignment in Riverside even though the plaintiff was staying at his sister's residence near the Inland Empire city in order to avoid a long commute, the suit states.

"However, when plaintiff refused to submit such false expenses, Alaras asked, 'Who has the power to hire and fire you?,"' according to the suit.

Inouye reported Alaras' alleged demands to falsify his travel expenses and Medicare audit dating to officials in WellPoint's ethics and compliance and human resources department, the suit states. In response, Inouye was asked, "Do you really want to get your boss in trouble?," the suit states.

In December of 2011, Inouye received an email from a WellPoint financial auditor stating that he was going to withhold Medi-Cal audit results that the plaintiff prepared for the third quarter of 2011, the suit states. Inouye forwarded the email to the ethics and compliance department, according to the complaint.

"However, instead of thanking plaintiff for his honesty, integrity and protecting WellPoint from violating Medi-Cal regulations, WellPoint wrongfully terminated (Inouye)," the suit states.

Inouye maintains that in addition to blowing the whistle on the alleged illegal auditing and reporting practices, his diabetes also was "one of the motivating factors for his wrongful termination."

Alaras, knowing Inouye was diabetic and had high blood pressure, constantly asked "Are you going to have a heart attack?," when referring to the plaintiff's medical condition and the stress of his workload, the suit states.