Consumer Fraud

Psychiatrist To Pay Connecticut $400,000 To Settle Medicaid Fraud Case

Pills Stethascope on Money 435x289 Psychiatrist To Pay Connecticut $400,000 To Settle Medicaid Fraud CaseA Connecticut psychiatrist and her husband have agreed to pay the state $400,000 to settle a False Claims Act lawsuit alleging they engaged in schemes designed to cheat Medicaid.

Dr. Ashwini Sabnis, a licensed psychiatrist enrolled as a provider in the Connecticut Medical Assistance Program (CMAP) and her husband Saurav “Sam” Mohanty, co-own a practice called Brighter Concept Inc. with offices in New Haven and Fairfield.

According to a complaint originally filed by Connecticut Attorney General George Jepsen, Dr. Sabnis and her husband illegally billed the state’s Medicaid program for services that they never actually provided.

Dr. Sabnis allegedly scheduled her Medicaid patients for 15 or 30 minute appointments. However, evidence developed during the investigation revealed that these appointments were often double, triple, and in several cases, quadruple booked.

Additionally, Dr. Sabnis “consistently used a reimbursement code which required her to see the patient for approximately 75 to 80 minutes when, in fact, she saw the patient for as little as 5-10 minutes,” an illegal practice known as “upcoding,” the Attorney General said.

The state also alleged that Dr. Sabnis and her husband tried to hide from state auditors databases containing information that showed their Medicaid claims to be false and that they attempted to alter patient records.

Under the terms of the settlement, Dr. Sabnis and Mr. Mohanty agreed to return payments totaling $400,000 to CMAP. Additionally, under a separate agreement with Connecticut Department of Social Services, Sabnis will be suspended and barred from billing the CMAP program for three years.

“The submission of false claims to federal and state health care programs is illegal,” said Attorney General Jepsen. “My office will continue to actively pursue and hold accountable those who attempt to take advantage of Medicaid and other taxpayer-funded healthcare programs.”

The settlement agreement was approved by a Hartford Superior Court Judge last week.

Source: Connecticut Attorney General George Jepsen