The Office of the U.S. Attorney for the District of Connecticut and the U.S. Department of Health and Human Services”™ Office of the Inspector General have reached a $4.2 million settlement with Dr. Jasdeep Sidana and the companies operating under the DOCS Medical Group Inc. banner that resolves federal and state charges of fraudulent claims submissions and improper billing.
Sidana is a pulmonologist who is the owner and CEO of DOCS, a medical practice with more than 20 facilities throughout Connecticut. According to the charges, DOCS and Sidana started providing allergy testing and treatment services to their patients in 2014, but the government agencies alleged DOCS and Sidana submitted false claims to Medicare and Medicaid between October 2016 and September 2017 for immunotherapy services that were not medically necessary and not directly supervised by a physician. The allegations also involved claims to Medicare and Medicaid for medically unnecessary annual re-testing of allergy patients between January 2014 and November 2018.
The government also alleged DOCS and Sidana submitted claims for medical services performed by Sidana between January 2014 and January 2019 on dates of service when he was traveling internationally and did not perform or supervise the services. Instead, the services were actually performed by lower-level providers, who typically receive a lower reimbursement rate from Medicare and Medicaid for such services.
The government also contended DOCS and Sidana improperly billed Medicare and Connecticut Medicaid for certain evaluation and management services ”“ commonly referred to as office visits ”“ for Covid testing between April and December 2020.
As part of this settlement, DOCS and Sidana have entered into a three-year Integrity Agreement with the Department of Health and Human Services”™ Office of the Inspector General that is designed to ensure future compliance with the requirements of federal healthcare programs.
“Depriving Medicare and Medicaid programs of federal funds that have been set aside for the care and treatment of beneficiaries is disgraceful,” said U.S. Attorney Vanessa Roberts Avery.
“Medical services billed to Medicare and Medicaid must be provided based on each patient”™s individual medical needs. Providers who participate in government programs must only bill for medically necessary services and must accurately bill for the services provided. This office is committed to vigorously pursuing health care providers who submit false or fraudulent claims to federal health care programs.”
