Ellington Doctor, Practice to Pay $800K in Fed, State Fines

ELLINGTON, CT — The owner of an Ellington mental health practice has agreed to pay more than $800,000 in fines for violating federal and state regulations, authorities said Monday.

United States Attorney John H. Durham and Connecticut Attorney General George Jepsen said that Dr. Erus Shahab, and Waire LLC, doing business as Ellington Behavioral Health, or EBH, have entered into a civil settlement agreement with the federal and state governments that dictates they pay $805,071 to resolve allegations that they violated the federal and state False Claims Acts.

Shahab, a psychiatrist, is the owner of EBH, a psychiatric medical practice located in Ellington, case records indicate.

As part of EBH’s treatment of patients with substance use disorders, the practice regularly conducted urine drug screening tests on urine samples collected from patients treated there, Durham said.

Medicare considers it a single test that should be billed only once per patient encounter, he said.

Shahab and EBH are accused of submitting claims to Medicare for multiple units of urine drug screening tests when they knew or should have known that only one unit of service could be billed per patient encounter, Durham said.

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, he added.

The government also 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, Durham said.

The $805,071 covers claims submitted to the Medicare program from Jan. 1, 2011 to Sept. 30, 2013, and claims submitted to the Medicaid program from Jan. 1, 2014 to June 30, 2014.

A complaint against SHAHAB and EBH was filed in the U.S. District Court in Connecticut under the qui tam, or whistleblower, provisions of the both the federal and state False Claims Acts.

The "relator," or whistleblower, Dr. David Simon, a former employee at EBH, will receive a share of the proceeds of the settlement in the amount of $99,113.

The whistleblower provisions of both the federal and state False Claims Acts provide that the whistleblower is entitled to receive a percentage of the proceeds of any judgment or settlement recovered by the government.

“Physicians and their medical practices must carefully code their claims, honestly bill for services, and ensure that taxpayers’ health care dollars are properly spent,” said U.S. Attorney Durham. “The U.S. Attorney’s Office and our federal and state investigative partners will hold to account all health care providers who submit false claims to federal health care programs.”

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