Stratford doctor pleads guilty to $1.8m health care fraud

A DOCTOR in Stratford, Connecticut has pleaded guilty on Thursday (3) to health care fraud and kickback offenses, after making over $1.8m of fraudulent claims.

Ananthakumar Thillainathan, 44, of Stratford, was accused of submitting or causing to submit nearly $840,000 to Connecticut Medicaid between June 2019 and May 2022 in fraudulent claims for psychotherapy services that he knew patients did not receive from his employees.

MDCareNow, a medical practice owned by Thillainathan, with offices in Stratford and Milford, has been a participating provider enrolled as both an internal medicine group and as a behavioral health clinician group in the Connecticut Medicaid program.

According to court documents and statements made in court, Thillainathan knew that the billed psychotherapy Current Procedural Terminology (CPT) codes, which identify the nature and complexity of the services provided, were not supported by medical records provided by his employees, and that the services were not provided.

The investigation revealed that Thillainathan submitted fraudulent claims to Medicaid for reimbursement that falsely represented his employees had rendered 60-minute psychotherapy sessions when, in fact, his employees only had very brief conversations with patients, had only left a voicemail for patients, or had no contact with patients at all.

In pleading guilty, Thillainathan also admitted that, in violation of his Connecticut Medical Assistance Program (CTMAP) provider agreement, he paid a third-party ‘patient recruiting’ company for each Connecticut Medicaid patient the company recruited and provided with transportation to MDCareNow for medical services.

Thillainathan paid the patient recruiting company approximately $100 per patient for an initial visit to MDCareNow and approximately $40 per patient for any subsequent visit. Between November 2019 and May 2021, he paid the patient recruiting company for the recruitment of approximately 1,018 Connecticut Medicaid patients, and Connecticut Medicaid reimbursed MDCareNow a total of approximately $1.07m for services provided to these patients.