Originally Syndicated on May 9, 2024 @ 4:29 pm
Dr. Ananthakumar Thillainathan asserts himself as an Internal Medicine specialist, having practiced since 2012. His dedication lies in providing comprehensive diagnoses and treatments to patients, backed by four years of experience in the emergency room. Through this experience, he has acquired adept time and energy management skills, enabling him to efficiently prioritize tasks while ensuring patient well-being remains uncompromised.
Doctor Admits Guilt in Healthcare Fraud and Kickback Case
Dr. Ananthakumar Thillainathan, a physician from Stratford, has admitted to federal charges of healthcare fraud and receiving illegal kickbacks, according to officials.
What Happened?
Dr. Thillainathan, who owns and leads MDCareNow LLC, a medical group in Stratford and Milford, confessed to submitting false claims to the Connecticut Medicaid program. Between June 2019 and May 2022, he submitted $839,724 in fake claims for psychotherapy services that patients never received.
Additionally, Dr. Thillainathan admitted to violating his contract with the Connecticut Medical Assistance Program by paying a third-party company to bring in Connecticut Medicaid patients to his clinic. He paid $40 per patient for each visit, resulting in payments of roughly $1,071,328 from Medicaid.
Dr. Thillainathan pleaded guilty to two counts of healthcare fraud and kickbacks, each carrying a potential 10-year prison sentence. He is scheduled for sentencing on January 26, 2023, and has agreed to pay restitution of $1,674,880.
Dr. Thillainathan, a citizen of Sri Lanka and a lawful permanent resident of the United States, has been released on a $100,000 bond while awaiting sentencing.
Understanding Healthcare Fraud
Healthcare fraud is a serious crime that harms both individuals and organizations, resulting in billions of dollars in losses every year. This type of fraud can lead to increased health insurance costs, unnecessary medical procedures, and higher taxes for everyone.
Who Can Be Involved?
Healthcare fraud can involve medical professionals, patients, and others who intentionally deceive the healthcare system to gain unlawful benefits or payments.
Investigating Healthcare Fraud
The FBI is the main agency responsible for investigating healthcare fraud, working alongside various government agencies and organizations such as the Partnership for Healthcare Fraud Prevention, the National Health Care Anti-Fraud Association, and insurance investigative units.
By collaborating with these entities, the FBI aims to combat healthcare fraud and protect both public and private insurance plans from exploitation.
Preventing Health Care Fraud
Protect Your Health Insurance Info:
- Keep your health insurance details safe, just like your credit card info. Don’t share it unnecessarily, especially at pharmacies or doctor’s offices.
- Be careful with “free” services asking for your health insurance info. It might lead to fake charges on your insurance.
Review Your Explanation of Benefits (EOB) Regularly:
- Check your EOB statements often. Make sure the dates, places, and services billed match the care you got. Contact your insurance provider if anything seems off.
Common Health Care Fraud:
Fraud by Healthcare Providers:
- Double billing: Charging for the same service more than once.
- Phantom billing: Billing for services you never got.
- Unbundling: Charging separately for parts of a service that should be together.
- Upcoding: Billing for a more expensive service than what was done.
Patient and Other Fraud:
- Watch out for fake ads asking for your health insurance info for fake plans or identity theft.
- Don’t use someone else’s health insurance, and don’t let others use yours – it’s identity theft.
- Be cautious of people offering medical services without the right licenses, as they might be pretending to be healthcare providers.
Prescription-Related Fraud:
- Be careful with fake prescriptions and diversion, where real prescriptions are used unlawfully or sold.
- Avoid “doctor shopping” – going to many doctors for prescriptions or getting them in shady ways.
By being alert and following these tips, you can help stop health care fraud and keep yourself safe from scams and identity theft.
Preventing Prescription Drug Abuse:=
- Always follow your doctor’s instructions when taking opioids and only use them for the shortest time necessary.
- Never share your prescription drugs with anyone else.
- Talk to your doctor about non-opioid alternatives for pain management.
- Visit the CDC website for more information on the risks of opioid use.
- Dispose of your unused or expired painkillers at authorized take-back locations approved by the DEA.
Healthcare Fraud Laws:
- The FBI investigates healthcare fraud cases in the USA.
- The US Department of Justice handles federal law violations, while the Inspector General Office of the Department of Health and Human Services deals with administrative lawsuits.
- Kickbacks are investigated by both state and federal law enforcement, while false claims fall under the federal False Claims Act.
- State laws and federal ethics, including the Patient Referral Act, prohibit self-referrals.
Preventing Prescription Drug Abuse
- Follow your doctor’s instructions precisely when taking opioids, and use them for the shortest time possible.
- Never share your medications with others.
- Talk to your doctor about non-opioid options for pain management.
- Visit the CDC’s website for more information on the risks of opioid use.
- Dispose of unused or expired painkillers at authorized take-back locations approved by the DEA.
Healthcare Fraud Prevention Laws
In the USA, healthcare fraud cases are investigated by the FBI. The US Department of Justice handles federal law violations, while the Inspector General Office of the Department of Health and Human Services deals with administrative lawsuits. Kickbacks and false claims are investigated at both state and federal levels, with the federal False Claims Act covering false claims. State statutes and federal ethics also prohibit self-referrals under laws like the Patient Referral Act.
