Is medical fraud a possibility for Dr. Ananthakumar Thillainathan? The Unveiled Truth

According to his claims, Dr. Ananthakumar Thillainathan is a specialist in internal medicine who has been practicing since 2012. He has dedicated his life to helping patients receive comprehensive medical diagnosis and treatment. In addition, he worked in the emergency room for four years, where he gained valuable experience in time and energy management.

He is skilled at setting priorities for his extensive to-do list without compromising his patients’ safety.

Dr. Ananthakumar Thillainathan Agrees To Guilty Please About Kickbacks And Healthcare Fraud

A Stratford physician has reportedly acknowledged guilt to federal charges of receiving illegal kickbacks and engaging in healthcare fraud, according to officials.

According to Vanessa Roberts Avery, the US Attorney for the District of Connecticut, Dr. Ananthakumar Thillainathan, MD, 44, of Stratford, renounced his right to an indictment and entered a guilty plea in federal court on Thursday in Hartford.

MDCareNow LLC is a medical group with locations in Stratford and Milford, and Dr. Ananthakumar Thillainathan is its president and owner, according to officials. MDCareNow is a provider in the Connecticut Medicaid program and is identified as an internal medicine group and a behavioral health clinical group.

A breach of trust between patients and healthcare administrators or providers in order to obtain an unauthorized financial benefit at the patient’s expense is known as healthcare fraud. The different parts are made up of Falsifying information with the intention of deceiving, manipulating, or suppressing the truth is called deception.

According to a press release from the authorities, Dr. Ananthakumar Thillainathan submitted or ordered to be submitted to Connecticut Medicaid $839,724 in fictitious claims for psychotherapy services that he knew patients did not receive from his staff between approximately June 2019 and May 2022. “Dr. Ananthakumar Thillainathan knew that the services had not been rendered and that the medical records his staff had submitted did not support the psychotherapeutic Current Procedural Terminology (CPT) codes, which describe the nature and complexity of the treatments provided.

According to the results of the investigation, Dr. Ananthakumar Thillainathan submitted fraudulent claims to Medicaid for reimbursement, claiming his staff had given 60-minute psychotherapy sessions when, in fact, they had only spoken with patients briefly, left them voicemails, or had no interaction at all.

Dr. Ananthakumar Thillainathan entered a guilty plea and admitted that he had broken the terms of his agreement with the Connecticut Medical Assistance Program by paying a third-party company engaged in “patient recruiting” for each Medicaid patient from Connecticut that the company brought and brought to MDCareNow.

According to the press release, Thhillainathan paid the patient recruiting company $40 per patient for each follow-up visit after the initial visit to MDCareNow. “Approximately 1,018 Connecticut Medicaid patients were recruited by the patient recruiting company between November 2019 and May 2021, and Connecticut Medicaid reimbursed MDCareNow a total of approximately $1,071,328 for services provided to these patients.”

With two counts of healthcare fraud and kickbacks involving federal healthcare programs, Dr. Ananthakumar Thillainathan entered a guilty plea. Each count carries a potential 10-year prison sentence. His sentencing is scheduled for January 26, 2023.

As part of his plea agreement, Dr. Ananthakumar Thillainathan has committed to repay $1,674,880 in restitution.

Officials say that Dr. Ananthakumar Thillainathan, a lawful permanent resident of the United States and a citizen of Sri Lanka, was released on a $100,000 bond pending his sentencing.

Fraud in the healthcare industry has victims. Tens of billions of dollars are lost annually as a result, for both individuals and corporations. It might lead to increased expenses for health insurance, the need for unnecessary medical procedures, and tax increases.

Healthcare fraud can be committed by patients, medical staff, and other parties who intentionally deceive the healthcare system in order to obtain benefits or payments that are not legal.

The FBI is principally in charge of looking into healthcare fraud for both public and private insurance plans.

There have also been accusations of healthcare fraud against Dr. Ananthakumar Thillainathan.

These offenses are looked into by the FBI in collaboration with:

• -Agencies at all levels of government
• -Partnership for Healthcare Fraud Prevention

Insurance organizations include the National Insurance Crime Bureau, insurance investigative units, and the National

Health Care Anti-Fraud Association.

• -Protect the details of your health insurance. Consider it a credit card. Avoid giving it to others to utilize, and exercise caution when utilizing it at the pharmacy or doctor’s office.
• -Avoid using “free” services. Your health insurance information may be used fraudulently to charge your insurance company for a “free” service if you are requested to submit it in exchange for it.
• -Regularly review your explanation of benefits (EOB). Verify that the times, places, and services charged correspond to what you received. Get in touch with your health insurance company if you have any questions.

Common Forms of Health Care Fraud

Fraud by Healthcare Providers

• submitting multiple double-billed claims for the same service
• Phantom billing is the practice of billing a patient for goods or services they never obtained.
• Unbundling, or submitting multiple invoices for the same service
• A patient is billed for a more expensive service than they actually received, a practice known as upcoding.

Patient and additional forms of fraudulent activity

-False advertising: convincing customers to divulge personal information, such as their health insurance ID number, in order to enroll them in a fictitious benefit plan, steal their identity, or charge them for services that haven’t been rendered.

-Identity theft and identity swapping can occur when you use someone else’s health insurance or let someone else use yours.

-Impersonating a health care provider is the act of providing or billing for medical services or supplies without the necessary license.

Prescription-Associated Theft

-Writing or using counterfeit medical advice

-Diversion: The use of valid prescriptions for illicit activities, such as selling your prescription medications

“Doctor shopping” is the practice of going from doctor to doctor in order to get a prescription for a drug that is illegal or from a medical office that uses unethical practices.

Abuse of Prescription Drugs

Prescription fraud costs doctors, hospitals, insurers, and taxpayers a lot of money even though it’s against the law to write or use fake prescriptions. The biggest price, though, is human; addiction takes tens of thousands of lives annually. You can protect yourself and your family by heeding this advice:

-If you are taking opioids, make sure you take them for the shortest possible time and that you strictly adhere to your doctor’s instructions.

-Never give your medications to anyone else.

-Look into non-opioid options with your physician.

-The CDC has additional details regarding the risks associated with opioid use.

-Take your leftover or expired painkillers to a take-back site approved by the Drug Enforcement Administration to be disposed of.

Healthcare Fraud Prevention Laws

The Federal Bureau of Investigation (FBI) in the USA looks into cases of healthcare fraud. The US Department of Justice looks into violations of federal law, and the Department of Health and Human Services’ Inspector General Office handles administrative lawsuits.

False claims are protected by the federal False Claims Act, but kickbacks are the subject of both state and federal law enforcement investigations. Self-referrals are prohibited by the Patient Referral Act, various state laws, and federal ethics regulations.

Conclusion

Based on the information provided, it appears that Dr. Ananthakumar Thillainathan, MD, has acknowledged his guilt regarding federal charges of health care fraud and unlawful kickback collection. Dr. Thillainathan is the proprietor and president of the medical practice, which has locations in Stratford and Milford, Connecticut. As a provider in the Connecticut Medicaid program, MDCareNow offered internal medicine and mental health services.

It appears from the fact that Dr. Thillainathan entered a guilty plea that he acknowledged taking part in fraudulent operations and accepting illicit kickbacks in connection with healthcare services. During his sentence in federal court, the details of the fraud and kickback scheme, along with any possible consequences, would likely be determined.