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Branford clinic owner faces prison over alleged Medicaid fraud

On behalf of Heath Harte

Prosecutors say clinic owner did not have licensed psychiatrist on staff

The owner of a Branford outpatient clinic has been charged with Medicaid fraud in a scheme that allegedly defrauded the federal government of tens of thousands of dollars, according to the New Haven Register. The man is accused of claiming to have a licensed psychiatrist on his staff when no such psychiatrist existed. The case is the latest example of how state and federal authorities are clamping down on cases of health care fraud both in Connecticut and across the United States.

No psychiatrist on staff

Authorities say that the man claimed, in documents submitted to the Connecticut Department of Social Services in February 2010, that he had a licensed psychiatrist working at his outpatient clinic in Branford. The psychiatrist was also claimed to be the clinic’s medical director who provided oversight for the facility’s mental health services.

Prosecutors, however, say that no such psychiatrist was working at the clinic after January 1, 2010. Authorities allege that despite not having the licensed psychiatrist on staff, the clinic’s owner continued to submit claims to Medicaid entitling the clinic to larger reimbursements on the understanding that such a psychiatrist was working at the facility.

Lengthy prison sentence possible

According to the Branford Patch, the man and his clinic allegedly collected $57,000 in Medicaid reimbursements that required a licensed psychiatrist to be on staff at the facility. The fraudulent billing allegedly went on between January 2010 and February 2011. The man has now been charged with first-degree vendor fraud and insurance fraud by authorities and both charges each carry a prison sentence of up to five years. He has since been released on a non-surety bond and his case will be prosecuted by the state’s Medicaid Fraud Control Unit.

The case is an example of how both state and federal officials are trying to stamp out health care fraud. Prosecutors have been aggressively pursuing people suspected of Medicaid and Medicare fraud in recent years. The health care programs receive funding from both state and federal governments, and authorities are keen to recoup losses caused by alleged fraud, primarily through false billing practices.

Defending against accusations

In many instances of health care fraud, defendants are unaware that a crime may have been committed until they have actually been charged. By that point, prosecutors have likely already gathered evidence and prepared a case against them.

As a result, for anybody who is facing accusations of health care fraud it is vital to talk to a criminal defense attorney right away. An experienced attorney can help mount a defense against such charges and may be able to ensure that the defendant’s reputation and livelihood are not ruined by these potentially devastating accusations.

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