A Connecticut psychiatrist and mental health clinic are set to pay more than $800,000 to resolve claims that they allegedly violated federal and state False Claims Acts regarding urine sample tests.
United States Attorney John Durham announced that psychiatrist Erum Shahab and Waire, LLC, which did business as Ellington Behavioral Health, have reached an agreement to pay $805,071 for submitting unsubstantiated claims to Medicare.
According to officials, Ellington Behavioral Health regularly conducted urine drug screenings of patients with substance use disorders at the practice. Urine drug screening tests use a single sample of a patient’s urine to test for multiple classes of drugs. Although the test screens a patient’s urine for multiple classes of drugs, Medicare considers it a single test that should be billed only once per patient encounter.
Shahab and his practice submitted claims to Medicare for multiple units of urine drug screening tests when they knew or should have known that only one unit of service could be billed per patient encounter. In doing so, Ellington Behavioral Health received hundreds of thousands of dollars that they were not eligible to receive.
Additionally, the government alleges that Shahab submitted claims to the Medicaid program for urine drug screening tests when the urine samples were either never actually tested at all or were tested weeks or months after the samples were collected from the Medicaid beneficiaries.
In an effort to resolve the allegations Shahab and Ellington Behavioral Health have agreed to pay the restitution, which covers claims submitted to the Medicare program from January 1, 2011 to September 30, 2013, and claims submitted to the Medicaid program from January 1, 2014 to June 30, 2014.
“Physicians and their medical practices must carefully code their claims, honestly bill for services, and ensure that taxpayers’ health care dollars are properly spent,” Durham said in a statement. “The U.S. Attorney’s Office and our federal and state investigative partners will hold to account all health care providers who submit false claims to federal health care programs.”
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