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Connecticut physician ordered to pay $4.2M in claims fraud settlement

Sidana and DOCS have been ordered to pay $4,267,950.21, and will be required to enter an Integrity Agreement.
Credit: sergign - stock.adobe.com

HARTFORD, Conn. — A Connecticut-based physician and a slew of his businesses have been ordered to pay $4.2 million in damages for false claims for payment to Medicare and state Medicaid program for improper billing and unnecessary services.

The state and federal settlement focuses on Jasdeep Sidana, a pulmonologist, and his businesses under the DOCS name - including DOCS Medical Group, Lung DOCS of CT - as well as Epic Family Physicians and Continuum Medical Group.

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Sidana and DOCS have been ordered to pay $4,267,950.21, and Sidana will be required to enter an Integrity Agreement that contains compliance requirements and annual claim reviews.

There are over 20 facilities under Sidana's ownership that offer primary care, urgent care, allergy testing and treatment, and COVID testing.

Between 2014 and 2019, submitted claims showed services provided by Sidana on days he was out of the country and were instead performed by lower-level providers, who usually get a lower reimbursement rate from Medicare and Medicaid for those services, according to officials.

There were also claims for "medically unnecessary annual re-testing" for allergies in patients, as well as claims for "unnecessary" immunotherapy services.

When it came to administering COVID tests, the government claimed DOCS and Sidana improperly billed Medicare and state Medicaid for those tests as what would be considered "evaluation and management" office visits.

“Dr. Sidana and his wide network of urgent care centers engaged in a long-running scheme to overbill the state and federal government for medically unnecessary treatment, as well as for treatment he and his team never provided. In addition to a $4.2 million penalty, Dr. Sidana and his clinic’s billing will be subject to ongoing oversight and scrutiny to ensure these unacceptable practices never occur again,” said Attorney General William Tong.

The state encourages anyone who suspects healthcare fraud to report it by calling 1-800-HHS-TIPS or the Health Care Task Force at (203) 777-6311.

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