Vanessa Roberts Avery, United States Lawyer for the District of Connecticut, David Sundberg, Particular Agent in Cost of the New Haven Division of the Federal Bureau of Investigation, and Phillip Coyne, Particular Agent in Cost for the U.S. Division of Well being and Human Providers, Workplace of Inspector Common, introduced that ANANTHAKUMAR THILLAINATHAN, MD, 44, of Stratford, waived his proper to be indicted and pleaded responsible at this time in Hartford federal court docket to well being care fraud and kickback offenses.
In response to court docket paperwork and statements made in court docket, Thillainathan is a medical physician and the proprietor and president of MDCareNow LLC, a medical observe with workplaces in Stratford and Milford. MDCareNow has been a collaborating supplier enrolled as each an inner medication group and as a behavioral well being clinician group within the Connecticut Medicaid program. Between roughly June 2019 and Might 2022, Thillainathan submitted or brought about to be submitted to Connecticut Medicaid roughly $839,724 in fraudulent claims for psychotherapy companies that he knew sufferers didn’t obtain from his staff. Thillainathan knew that the billed psychotherapy Present Procedural Terminology (CPT) codes, which establish the character and complexity of the companies offered, weren’t supported by medical data offered by his staff, and that the companies weren’t offered. The investigation revealed that Thillainathan submitted fraudulent claims to Medicaid for reimbursement that falsely represented his staff had rendered 60-minute psychotherapy classes when, in actual fact, his staff solely had very temporary conversations with sufferers, had solely left a voicemail for sufferers, or had no contact with sufferers in any respect.
In pleading responsible, Thillainathan additionally admitted that, in violation of his Connecticut Medical Help Program (CTMAP) supplier settlement, he paid a third-party “affected person recruiting” firm for every Connecticut Medicaid affected person the corporate recruited and supplied with transportation to MDCareNow for medical companies. Thillainathan paid the affected person recruiting firm roughly $100 per affected person for an preliminary go to to MDCareNow and roughly $40 per affected person for any subsequent go to. Between roughly November 2019 and Might 2021, Thillainathan paid the affected person recruiting firm for the recruitment of roughly 1,018 Connecticut Medicaid sufferers, and Connecticut Medicaid reimbursed MDCareNow a complete of roughly $1,071,328 for companies offered to those sufferers.
Thillainathan pleaded responsible to 1 rely of well being care fraud and one rely of kickbacks involving federal well being care packages, offenses that carry a most time period of imprisonment of 10 years on every rely. He’s scheduled to be sentenced by U.S. District Decide Stefan R Underhill in Bridgeport on January 26, 2023. As a part of his plea, Thillainathan has agreed to pay $1,674,880 in restitution.
Thillainathan, a citizen of Sri Lanka and a lawful everlasting resident of the U.S., is launched on a $100,000 bond pending sentencing.
This case is being investigated by the Federal Bureau of Investigation and the U.S. Division of Well being and Human Providers, Workplace of the Inspector Common (HHS-OIG), the Medicaid Fraud Management Unit of the Connecticut Chief State’s Lawyer’s Workplace, the Connecticut Lawyer Common’s Workplace and the Connecticut Division of Social Providers.
The matter is being prosecuted by Assistant U.S. Attorneys Heather L. Cherry and Elena L. Coronado.
Individuals who suspect well being care fraud are inspired to report it by calling 1-800-HHS-TIPS.