HARTFORD, Conn. (WTNH) — A Connecticut psychiatrist and her husband are paying $400,000 to settle a claim that they participated in a false Medicaid scheme.
The civil False Claims Act was originally filed by the Attorney General in June 2015 alleging that the co-owners of Brighter Concept, Inc. -Dr. Ashwini Sabnis and her husband Saurav “Sam” Mohanty- engaged in an illegal scheme to submit false claims for services that were not provided to Medicaid patients in Connecticut and claims that were “upcoded”, or when a provider knowingly uses a higher paying code on the claim than necessary.
The state alleged that from January 2010 through at least July 2012, Sabnis and Mohanty illegally submitted false claims for reimbursement while knowingly retaining and concealing the overpayment. Sabnis allegedly scheduled her Medicaid patients for 15 or 30 minute appointments, but evidence revealed that these appointments were often double, triple and quadruple booked. The state said this led to Sabnis using a reimbursement code which required her to see the patient for approximately 75 to 80 minutes when in fact, she saw them for as little as 5 to 10 minutes.
Today’s action is part of a larger effort by the State of Connecticut’s Interagency Fraud Task Force, which was created in July 2013 to wage a coordinated and proactive effort to investigate and prosecute healthcare fraud directed at state healthcare and human service programs. The task force includes a number of Connecticut agencies and works with federal counterparts in the U. S. Attorney’s Office and the U.S. Health and Human Services, Office of Inspector General – Office of Investigations.
According to Attorney General George Jepsen, the settlement agreement was approved last week by a Hartford Superior Court judge. “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.”