Originally Syndicated on May 9, 2024 @ 6:14 am
Dr. Ananthakumar Thillainathan presents himself as an Internal Medicine specialist with a practice spanning since 2012. He is committed to providing patients with comprehensive diagnoses and treatments for their illnesses. With four years of experience in the emergency room, he has honed his skills in time and energy management. Dr. Thillainathan adeptly juggles his workload, ensuring that patient care remains his top priority without compromising their well-being.
Thillainathan Pleads Guilty to Healthcare Fraud and Kickbacks
Dr. Ananthakumar Thillainathan, a doctor from Stratford, has admitted to federal charges of healthcare fraud and receiving illegal kickbacks, according to officials.
Dr. Thillainathan, 44, who owns and heads MDCareNow LLC, a medical group in Stratford and Milford, entered a guilty plea in federal court in Hartford, renouncing his right to an indictment.
Between June 2019 and May 2022, Dr. Thillainathan submitted nearly $840,000 in fake claims to Connecticut Medicaid for psychotherapy services that patients didn’t receive. He admitted to knowingly submitting false claims and violating his contract by paying a third-party patient recruiting business for bringing Medicaid patients to his clinic.
For his crimes, Dr. Thillainathan faces a potential 10-year prison sentence for each count of healthcare fraud and kickbacks. He is set to be sentenced on January 26, 2023, and has agreed to pay restitution of $1.67 million.
Understanding Healthcare Fraud
Healthcare fraud is a serious crime that causes harm to both individuals and organizations every year. It involves deliberately deceiving the healthcare system for personal gain, leading to significant financial losses.
Who Can Commit Healthcare Fraud?
Anyone, including medical professionals and patients, who intentionally misleads the healthcare system for unlawful benefits or payments can be guilty of healthcare fraud.
Investigating Healthcare Fraud
The FBI is the main agency responsible for investigating healthcare fraud, working closely with various government agencies and organizations dedicated to fraud prevention in the healthcare sector. These include:
- Government agencies at all levels
- Partnership for Healthcare Fraud Prevention
- National Health Care Anti-Fraud Association
- National Insurance Crime Bureau
- Insurance investigative units
Preventing Health Care Fraud: Tips and Advice
Protect Your Health Insurance Information:
- Safeguard your health insurance details just like you would your credit card information. Avoid sharing it with others and be cautious when using it at pharmacies or doctor’s offices.
- Be wary of “free” services that require you to provide your health insurance information. This could lead to fraudulent charges on your insurance.
Regularly Review Your Explanation of Benefits (EOB):
- Take the time to review your Explanation of Benefits (EOB) statements regularly. Ensure that the dates, locations, and services billed match the care you received. Contact your health insurance provider if you have any concerns or questions.
Common Forms of Health Care Fraud
Fraud by Healthcare Providers:
- Double billing: Submitting multiple claims for the same service.
- Phantom billing: Charging patients for services or items they never received.
- Unbundling: Submitting separate invoices for components of a service that should be billed together.
- Upcoding: Billing for a more expensive service than what was provided.
Patient and Other Types of Criminal Fraud:
- Avoid falling for false advertising that requests your health insurance information for enrollment in fake benefit plans or identity theft.
- Refrain from using someone else’s health insurance or allowing others to use yours, as it constitutes identity theft.
- Be wary of individuals providing or billing for medical services without proper licensing, as it could be impersonating a healthcare provider.
Prescription-Related Fraud:
- Be cautious of fake prescriptions and diversion tactics, where legitimate prescriptions are used for unlawful purposes or sold.
- Avoid “doctor shopping,” which involves visiting multiple doctors for prescriptions or obtaining prescriptions through unethical means.
By staying vigilant and following these tips, you can help prevent health care fraud and protect yourself from potential 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.