Fraud and abuse is a major concern in the healthcare industry. What would you do if you learned first hand that your boss was involved unethical reimbursement practices?

• Find a compromise. If there's a way to meet your boss' objective without sliver-ing over to the dark side, your job is to find that way. You'll keep your boss off your back and your conscience clear, and that's a win-win.
• Find another job. This is the least attractive option, I'll grant you, but if your values and the values of your boss/organization are seriously out of whack, a separation is inevitable. Whether your boss gets tired of hearing your "no" or you get tired of his (or her) sleazy ways, something, at some point, is gonna give.
• File a complaint. If things get really bad, you may want to have a chat with someone in HR (assuming you aren't the top person in HR). If there is no one else, and you have good reason to believe your boss's boss is fine with the status quo, you might want to consider filing a complaint outside the company (and consulting an attorney). Of course, a step this drastic can have major consequences, so make sure your ducks are in a row first. And that brings me to ...
• CYA. Let's say your boss remains firm in his opinion that creating a file after the fact to justify disciplinary action is morally upright. Okay. Document the entire conversation and then place your notes in a nice safe place, because it's not unheard of for HR folks to be held personally liable in lawsuits and that's what I'd call adding insult to injury in a case like this. Later, you'll want to have a heart to heart with yourself about whether you want to work in a place that has so little regard for your professional opinion and (perhaps) the law, but first things first.
• Start a revolution. Are you one of those rare HR folks with real power? Congratulations! Maybe you're in the perfect position to persuade other leaders within your organization that an Ethics Committee would be a great idea. Sometimes all employees need to do the right thing is their employer's permission.

When you routinely deal in rules, policies, and people (as HR pros do), ethical dilemmas are bound to occur, and everyone working in HR should expect them.

However, there's a big difference between facing an ethical dilemma and facing a boss who wants to resolve the dilemma in an unethical manner.

Whistleblower Protections

The clearest protections for employees reporting misconduct in the workplace are provided by 22 separate federal acts known collectively as "whistleblower protections." These protect an employee who reports a safety, health or environmental hazard or who reports racial or sexual discrimination and sexual assault as well as certain other violations with the federal government.

However, these protections are not absolute. To be protected, the employee must demonstrate a "good faith belief" that the employer has violated federal law. It is possible for an employer to argue in response to the filing that the employee has no reasonable grounds for the belief, or that the employee motivation was malicious.