Vanessa Roberts Avery, United States Attorney for the District of Connecticut, David Sundberg, Special Agent in Charge of the New Haven Division of the Federal Bureau of Investigation, and Philip Coyne, Special Agent in Charge of the US Department of Health and Human Services, the office said. of the Inspector General ANANTHAKUMAR THILAINATHAN, Ph.D., 44, of Stratford, waived his right to be arraigned and pleaded guilty today in federal court in Hartford to health care fraud and bribery offenses.
According to court documents and statements made in court, Thillainathan is a physician and the owner and president of MDCareNow LLC, a medical practice with offices in Stratford and Milford. MDCareNow is a participating provider enrolled as both an internal medicine group and a behavioral health clinician group in the Connecticut Medicaid program. Between approximately June 2019 and May 2022, Thillainathan submitted or caused to be submitted to Connecticut Medicaid approximately $839,724 in fraudulent claims for psychotherapy services that he knew patients were not receiving from his employees. Thilainathan knew that the billable Current Procedural Terminology (CPT) codes for psychotherapy, 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 that his staff conducted 60-minute psychotherapy sessions, when in fact his staff had only very brief conversations with patients, only leaving voicemails at patients or had no contact with patients at all.
In his guilty plea, Thillainathan also admitted that, in violation of his Connecticut Medicaid Program Provider Agreement (CTMAP), he paid a third-party company to “recruit patients” for each Connecticut Medicaid patient. which the company hired and provided transportation to MDCareNow for medical services. Thillainathan paid the patient recruitment company approximately $100 per patient for an initial MDCareNow visit and approximately $40 per patient for each subsequent visit. Between approximately November 2019 and May 2021, Thillainathan paid the recruitment company to recruit approximately 1,018 Connecticut Medicaid patients, and Connecticut Medicaid reimbursed MDCareNow a total of approximately $1,071,328 for services provided to these patients.
Thillainathan pleaded guilty to one count of health care fraud and one count of kickbacks involving federal health care programs, felonies that carry a maximum prison term of 10 years on each count. He is scheduled to be sentenced by U.S. District Judge Stephen R. Underhill in Bridgeport on January 26, 2023. As part of his plea, Thilainathan agreed to pay $1,674,880 in restitution.
Thilainathan, a Sri Lankan citizen and legal permanent resident of the United States, has been released on $100,000 bail pending sentencing.
This case is being investigated by the Federal Bureau of Investigation and the US Department of Health and Human Services, Office of the Inspector General (HHS-OIG), the Medicaid Fraud Control Unit of the Connecticut Attorney General’s Office, the Connecticut Attorney General’s Office, and the of Connecticut Social Services.
The matter is being prosecuted by Assistant United States Attorneys Heather L. Cherry and Elena L. Coronado.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.