Tolland psychiatrist to pay $400,000 for up-charging Medicaid

HARTFORD, Conn. (WTNH) – A psychiatrist from Tolland has agreed to pay more than $400,000 to settle a lawsuit claiming she boosted her charges to Connecticut’s Medicaid program.   The state accused Dr. Leela Pandoor of “upcoding” claims she submitted to the state Department of Social Services for her Medicaid patients over a three year period, from March of 2010 through September of 2013.

According to the State Attorney General’s office, “upcoding” is knowingly using a higher-paying code on the claim form to bill for a more expensive service, procedure or device than was actually used. The state says during that three-year period, Pandoor tacked on charges for group counseling or individual psychotherapy to patients who were simply given prescriptions.

Pandoor has agreed to pay $404,798 to Connecticut’s Medicaid program to resolve the civil False Claims Act lawsuit.  She has also agreed to restrict her participation in Medicaid services.

“This case demonstrates that enforcement of the False Claims Act continues to be a priority of my office,” said Attorney General Jepsen. “The Connecticut Office of the Attorney General and our law enforcement partners are committed to protecting the public and vigorously pursuing all those who knowingly submit false claims affecting the Medicaid program.” 



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