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Clipped from: https://patch.com/connecticut/newhaven/533k-settlement-psychiatric-care-center-medicaid-fraud-case-ag
Crime & Safety
The deal “resolves allegations that New Haven-based psychiatrist Dr. Kishorchandra Gonsai over billed CT Medicaid for psychotherapy.”
Ellyn Santiago,
Patch Staff
Posted Tue, Nov 1, 2022 at 3:58 pm ET
CT AG William Tong announced a $532,830.33 Connecticut False Claims Act settlement with Psychiatric Care Consultants LLC and its owner, Dr. Kishorchandra Gonsai, resolving allegations that the New Haven-based psychiatrist over billed state Medicaid. (Shutterstock)
NEW HAVEN, CT — Connecticut Attorney General William Tong announced a $532,830.33 Connecticut False Claims Act settlement with Psychiatric Care Consultants LLC and its owner, Dr. Kishorchandra Gonsai, resolving allegations that the New Haven-based psychiatrist over billed the state’s Medicaid program for psychotherapy.
“Dr. Gonsai and PCC overbilled the state’s Medicaid program over a span of nearly five years for therapy services that were not provided at the level he claimed,” Tong said. “Our settlement forces Dr. Gonsai to return over half a million dollars to the state’s Medicaid program and sends a strong message that the Office of the Attorney General will not tolerate abuse of taxpayer dollars.”
Following a fraud referral from the Department of Social Services, an investigation by the Office of the Attorney General found that between June 1, 2017 and March 31, 2022 Psychiatric Care Consultants (PCC) repeatedly billed the Connecticut Medical Assistance Program (CMAP) for either 45-minute or 30-minute psychotherapy sessions that were not provided for the length of time claimed, Tong said.
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PCC billed the CMAP for 45-minute sessions when the amount of psychotherapy provided was 30 minutes or less and also billed the CMAP for 30-minute sessions when the amount of psychotherapy provided was 15 minutes or less, Tong said.
“This unfortunate example of overbilling by a psychiatric care provider is a clear reminder that strong anti-fraud measures are in place to protect the integrity of our public health coverage programs. I join Attorney General Tong in welcoming the return of nearly $533,000 from the False Claims Act settlement, and in commending the investigators and attorneys who were instrumental in this resolution,” state Department of Social Services Commissioner Deidre S. Gifford said.
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The Department of Social Services’ Office of Quality Assurance, Special Investigations Division, assisted in the case, Tong said.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Attorney General’s Government Program Fraud Section at 860-808-5040 or by email at ag.fraud@ct.gov; the Medicaid Fraud Control Unit at 860-258-5986 or by email at conndcj@ct.gov; or the Department of Social Services fraud reporting hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or by email to providerfraud.dss@ct.gov.
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