May 15, 2018

Ellington doc owes $805K in whistleblower case

An Ellington psychiatrist and her practice must pay $805,071 to settle civil allegations raised by a whistleblower that they overcharged state and federal taxpayers for drug screenings, authorities say.

Dr. Erum Shahab and Waire LLC, doing business as Ellington Behavioral Health (EHB), agreed to settle the state and federal False Claims Acts violations, the state Attorney General's Office and the Connecticut U.S. Attorney's Office said.

According to investigators, Shahab owned EBH, a psychiatric medical practice that treated patients with substance use disorders. As part of patients' treatment, Shahab conducted urine drug screening tests on their urine samples.

Although the test screens a patient's urine for multiple classes of drugs, Medicare considers it a single test that should be billed only once per patient encounter, investigators said.

The government alleges that Shahab and EHB submitted claims to Medicare and Medicaid multiple urine drug screening tests from Jan. 1, 2011 to June 30, 2014, when they knew or should have known that only one unit of service could be billed per patient encounter. By coding their claims using multiple units instead of a single unit, Shahab and EBH received hundreds of thousands of dollars from the Medicare program that they were not entitled to receive, authorities said.

In addition, the government alleges that Shahab and EBH submitted claims to the Medicaid program for urine drug screening tests when the urine samples were either never actually tested at all or were tested weeks or months after the samples were collected from the Medicaid beneficiaries.

According to investigators, a former EBH staffer, Dr. David Simon, blew the whistle to authorities about the alleged misconduct. Under federal law, Simon is entitled to share in a percentage of the settlement proceeds, or in this case $99,113.

Shahab, Waire and Simon could not be immediately reached for comment.

It's not Shahab's first encounter with the authorities. She was fined $60,000 in 2014 for failing to properly document and maintain purchasing and dispensing records for the addiction-treatment drug Suboxone, Connecticut Health I-Team reported.

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