Consumer Fraud

Connecticut Psychiatrist Settles Whistleblower Lawsuit Alleging Medicare Fraud

Pills Stethascope on Money 435x289 Connecticut Psychiatrist Settles Whistleblower Lawsuit Alleging Medicare FraudA Danbury, Conn., psychiatrist and his practice will pay the U.S. more than $36,000 to settle a lawsuit filed by whistleblowers under the federal False Claims Act.

According to Deirdre Daly, U.S. Attorney for the District of Connecticut, Dr. Anton Fry and his mental health practice CPC Associates Inc., submitted false claims to Medicare for psychiatric services that were not provided in compliance with government rules.

Dr. Fry and CPC will pay the government $36,704 allegations that they conducted psychiatric consultations with Medicare beneficiaries over the telephone instead of meeting them in the office and treating them in person, as Medicare reimbursement rules require.

Medicare permits certain types of “telehealth” services where the patient is in a rural area with a shortage of medical professionals. In cases where the physician is allowed to conduct consultations remotely, the provider must use an interactive audio and video communications system to talk with the patient in real-time. The government alleges that Dr. Fry and CPC did not engage with rural patients using such a system.

The False Claims Act complaint also alleges patients treated over the phone by Dr. Fry and CPC were not located in rural health professional shortage areas and thus should have been treated in person. Federal prosecutors said these practices occurred during the past six years.

CPC told the Danbury News Times that it denied any wrongdoing and telehealth services were intended “to accommodate patients, many of them elderly, who could not come to the office for their regular therapy sessions because of health related issues, inclement weather or moves from the Danbury area.”

The False Claims Act lawsuit was filed by Jodi Cohen, a former patient of Dr. Fry, and Medical Bill Consultants LLC. Thy will share a whistleblower award of $6,239.

Sources:
U.S. Department of Justice
Danbury News Times