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United States Attorney's Office District of Connecticut
Press Release

July 8, 2011

NEW MILFORD CLINICAL SOCIAL WORKER PAYS $210,000
TO SETTLE ALLEGATIONS UNDER THE FALSE CLAIMS ACT
Social Worker now excluded from all federal health care programs for five years

United States Attorney David B. Fein, Connecticut Attorney General George Jepsen and Chief State’s Attorney Kevin T. Kane today announced that JOSEPH UBAGHS, a licensed clinical social worker who resides in New Milford, has entered into a civil settlement with the federal and state governments in which he will pay $210,000 to resolve allegations that he violated the False Claims Act and common law.

The allegations against UBAGHS involve fraudulent billing to Medicaid for individual and group counseling services.  It is alleged that, on numerous occasions, UBAGHS billed Medicaid for 45 to 50 minutes of individual therapy services when, in fact, he provided less than 30 minutes of counseling services.  UBAGHS also billed Medicaid for individual psychotherapy services for separate family members when, in fact, he had provided one group therapy session to the family members at the same time.  Finally, it is alleged that UBAGHS billed Medicaid for counseling sessions that the patients had cancelled and not attended.

To resolve his liability under the False Claims Act, UBAGHS will pay $210,000 to reimburse the Medicaid programs for conduct occurring between January 1, 2006 and December 31, 2007.

Additionally, under the terms of the settlement agreement, UBAGHS is excluded from Medicare, Medicaid, and all other federal health care programs for a period of five years.  This exclusion has national effect and prohibits UBAGHS from receiving payment from any federal health care program during the exclusion period.  It also prohibits payment to any individual or entity, such as a hospital, that employs or contracts with UBAGHS, for any services furnished, ordered, or prescribed by UBAGHS.

“Licensed practitioners that participate in the Medicare and Medicaid programs must bill their services honestly, and the failure to do so increases the cost of health care for all of us,” stated U.S. Attorney Fein.  “The U.S. Attorney’s office is committed to vigorously pursuing health care providers who submit fraudulent claims to federal health care programs.  Providers who submit false claims to the government face serious monetary sanctions and exclusion from the Medicare and Medicaid programs.”

“Medicaid is an important program that provides basic healthcare for many of Connecticut's most needy residents,” stated Attorney General Jepsen.  “This settlement recovering $210,000 for taxpayers and excluding Mr. Ubaghs from state and federal healthcare programs for five years sends an important message – we will aggressively pursue and deal with health care providers who try to defraud or abuse Medicaid.  I thank the Connecticut Department of Social Services, the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney, the U.S. Attorney's Office and the U.S. Health and Human Services Office of Inspector General for their outstanding work and assistance on this matter.”

In addition to the civil settlement, the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney brought state criminal charges against UBAGHS, which were resolved this week when he was granted Accelerated Rehabilitation.

“The civil settlement is yet another example of what we can accomplish when government works together in a collaborative fashion between all agencies at all levels,” stated Chief State’s Attorney Kane.

This matter was investigated by the Office of Inspector General for the Department of Health and Human Services, the Medicaid Fraud Control Unit of the Connecticut Chief State’s Attorney’s Office and the Connecticut Department of Social Services.  The civil case was prosecuted by Assistant United States Attorney Anne F. Thidemann and Auditor Kevin A. Saunders of the United States Attorneys Office, and by Forensic Fraud Examiners Lawrence Marini and David Boucher and Assistant Attorney General Gregory K. O’Connell for the state Office of the Attorney General.

In entering into the civil settlement agreement, UBAGHS did not admit liability.

U.S. Attorney Fein encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at (203) 785-9270 or 1-800-HHS-TIPS.

 

CONTACT:

 

U.S. ATTORNEY'S OFFICE
Tom Carson
(203) 821-3722
thomas.carson@usdoj.gov

 

 

 

 

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