$1.1 Million Judgment Entered Against Cleveland Psychiatrist On TennCare Fraud

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$1.1 Million Judgment Entered Against Cleveland Psychiatrist On

TennCare Fraud

posted March 20, 2008

A $1.1 million consent judgment has been entered against Cleveland

psychiatrist Gulshan Sultan, to resolve claims against her in a joint

lawsuit brought by the federal government and the state in January of

2007, U.S. Attorney Russ Dedrick said.

The claims were for alleged violations of the federal False Claims

Act and the Tennessee Medicaid False Claims Act during 2000 to 2005

which resulted in losses to the Medicare and TennCare programs of

$267,253 for more than 6,000 false claims.

The law provides for recovery of treble or triple damages as well as

civil penalties for each false claim.

The complaint alleged that Dr. Sultan submitted false billing to the

Medicare and the TennCare programs under two separate codes under her

name when services were not performed by her but rather by a nurse

without the requisite psychiatric training and licensing and also

submitted bills on over 200 separate days for face-to face, time-

based psychotherapy services when she did not perform the services

billed. The complaint also states that on a number of days Dr. Sultan

claimed to have performed time-based services well in excess of 24

hours.

Dr. Sultan agreed to the consent judgment to settle the claims

alleged in the lawsuit as well as separate administrative claims of

the Medicare program.

Dr. Sultan, previously charged with certain criminal violations

involving the false billing for psychiatric services performed by her

nurse, pled guilty in United States District Court and was sentenced

on July 7, 2006, to two years probation and ordered to pay

restitution of $3775 and a $5,000 fine for the federal criminal

conviction.

As a result of the criminal conviction, Dr. Sultan has been

excluded from participating in the Medicare and TennCare programs.

The joint investigation which led to both the criminal prosecution

and this civil consent judgment was initiated by the Tennessee Bureau

of Investigation Medicaid Fraud Control Unit (TBI) and subsequently

pursued by the U.S. Department of Health and Human Services - Office

of Inspector General (HHS-OIG), the United States Attorney's Office,

Eastern District of Tennessee, the Office of the Attorney General of

the State of Tennessee, and the TBI.

U.S. Attorney Dedrick noted:, " This consent judgment is an example of

how the coordinated efforts of this office, the State Attorney

General's office, HHS-OIG and TBI can effectively protect the

Medicare, Medicaid and TennCare Programs and the citizens of our

state. "

He specifically commended the dedicated efforts of HHS-OIG Special

Agent Tony Maffei and TBI Special Agent Kim Harmon for their roles in

the investigation as well as Assistant United States Attorney

Tonkin who was responsible for the oversight of the civil

investigation and litigation for the U. S. Attorney's Office and

Senior Counsel Coughlan with the State Attorney General's

Office for his role on behalf of the state.