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December 16, 2022

Physician, medical practice to pay $4.2M to settle false claims allegations

PHOTO | Pixabay.com
By Michelle Tuccitto Sullo

An area physician and urgent care practice have reached a $4.2 million civil settlement agreement with the state and federal governments to resolve allegations of improper medical billing.

Dr. Jasdeep Sidana and his practice, which includes Docs Medical Group Inc., Docs Urgent Care LLP, Lung Docs of CT P.C., Epic Family Physicians LLP and Continuum Medical Group LLC, will pay just over $4,267,950, according to an announcement.

Sidana is based in East Haven, according to the Secretary of the State’s office. Sidana specializes in pulmonology and is the owner and CEO of a medical practice with more than 20 facilities throughout Connecticut. The practice offers primary and urgent care services, allergy testing and treatment, and COVID-19 testing.

Sidana and the medical practices allegedly submitted claims for payment to Medicare and the Connecticut Medicaid program for medically unnecessary allergy services, unsupervised allergy services, and services improperly billed as though provided by Sidana, the U.S. Attorney’s office said.  

The settlement agreement also resolves allegations that they improperly billed for some office visits associated with COVID-19 tests.

U.S. Attorney for Connecticut Vanessa Roberts Avery said, “Depriving Medicare and Medicaid programs of federal funds that have been set aside for the care and treatment of beneficiaries is disgraceful.”

“Providers who participate in government programs must only bill for medically necessary services, and must accurately bill for the services provided,” Avery added.

According to the government, Sidana and his businesses for years submitted claims for services that were not medically necessary, were not properly supervised by a physician, and were allegedly performed by Sidana when he was out of the country.

Phillip Coyne, special agent in charge for the U.S. Department of Health and Human Services, Office of the Inspector General, said healthcare providers are expected to closely follow Medicare rules and bill properly.

“When that obligation is violated, government health care programs – and American taxpayers – pay the price,” Coyne said.

Sidana and his business have also entered into a three-year Integrity Agreement with Coyne’s office to ensure future compliance.

State Attorney General William Tong, whose office was also involved in the case, called it a “long-running scheme to overbill the state and federal government for medically unnecessary treatment, as well as for treatment (Sidana) and his team never provided.”

Sidana and his business’ billing will be “subject to ongoing oversight and scrutiny to ensure these unacceptable practices never occur again,” Tong added.

Contact Michelle Tuccitto Sullo at msullo@newhavenbiz.com.

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