Stamford Doctor, Practices To Pay Over $860K To Settle Billing, COVID Fraud Allegations: CT Attorney General

STAMFORD, CT — A Stamford doctor and his businesses will pay $866,539 to the state and federal government to settle allegations of submitting inflated bills to government health insurance for medical services and COVID-19-related fraud from September 2019 through April 2022, according to an announcement Friday from Connecticut Attorney General William Tong.

The federal government will receive $583,310, and CT will get $289,310 from Dr. Steven Murphy and his businesses, Murphy Medical Associates, LLC and Diagnostic and Medical Specialist of Greenwich, LLC, located in Stamford.

As part of the settlement, Tong said Murphy and his practices agreed to be excluded from all federal health care programs and the Connecticut Medical Assistance Program for three years.

"Medical overbilling erodes public trust, wastes vital public resources, and is against the law," Tong said in a statement. "My office stands ready with our federal and state partners to take action against anyone who abuses the system."

The Connecticut Office of the Attorney General launched an investigation into Murphy's billing practices in May 2020.

An investigation found Murphy had an in-house lab that performed blood tests on patients who had possible exposure to COVID-19 or were showing COVID-19 symptoms, Tong said. The lab also performed blood tests on non-COVID patients, including patients who were having their annual physical exam.

According to Tong, Murphy and his practices used blood testing panels in their in-house lab, billing Medicare or Medicaid separately for each test rather than charging a single price per panel.

Some tests required reagents that Murphy and his practices had not purchased or did not have, preventing them from completing the panels, Tong said. The government claims Murphy and his practices billed Medicare and Medicaid for tests included in their standard panel that were never performed because they lacked the necessary reagents.

Congress passed a series of bills in response to the COVID-19 pandemic to fund testing and treatment for uninsured individuals through the Uninsured Program, Tong explained.

The program reimbursed eligible health care providers for COVID-19 testing, treatment and vaccine administration for uninsured individuals. HRSA was selected to oversee and manage the program.

The program defined an uninsured individual as someone who was "not enrolled" in government or private health insurance on the date of service. Before seeking reimbursement from the Uninsured Program, health care providers were required to attest to the government that they had confirmed the patients were uninsured.

Murphy and his practices received reimbursement through the Uninsured Program after attesting that patients were uninsured, despite having insurance cards and other documents indicating some patients had enrolled in government or private coverage, the government claimed, according to Tong.

Murphy and his practices also changed patients' insurance information in their electronic medical records system to "Covid19 HRSA Uninsured," then submitted claims and received reimbursement for those patients, Tong noted.

Anyone with knowledge of suspected fraud or abuse in the public health care system is asked to contact the Attorney General’s Government Fraud Section at 860-808-5040 or by email at ag.fraud@ct.gov; the Connecticut Medicaid Fraud Control Unit at 860-258-5986 or by email at conndcj@ct.gov; or the Connecticut Department of Social Services fraud reporting hotline at 1-800-842-2155, online at ct.gov/dss/reportingfraud, or by email to providerfraud.dss@ct.gov.