A Madison psychiatrist will pay the State of Tennessee more than $325,000 for allegedly overbilling TennCare patients for visits, Tennessee Attorney General Bob Cooper announced today.
Named in the agreement is psychiatrist A.K.M. Fakhruddin who is alleged to have overbilled patients for psychotherapy visits. Such practices are illegal under the Tennessee Medicaid False Claims Act. The settlement, which included substantial penalties, represents nearly three times the amount Fakhruddin is alleged to have taken from the program.
An investigation by the TennCare Provider Fraud Task Force revealed that from May 2007 to December 2010, Dr. Fakhruddin billed for extensive 45-50 minute psychotherapy visits when in most cases he was performing brief medication management services with minimal psychotherapy.
"In a few instances, he billed for more than fifteen hours in a day when the actual time spent with patients was a fraction of that amount," Attorney General Cooper said. "The Task Force takes very seriously the misuse of taxpayer dollars and will continue to work diligently to end such practices. "
The fraud concerned billings for over 150 patients. The Task Force includes the Attorney General's Office, TennCare, the Tennessee Bureau of Investigation's Medicaid Fraud Control Unit and the Office of Inspector General. It is charged with pursuing fraud by any TennCare provider. General Cooper noted, "The Task Force concentrates on every aspect of Medicaid Fraud, which includes not only physicians and drug companies but also mental health services."
Inspector General Deborah Faulkner stated, "The State of Tennessee is aggressively investigating TennCare fraud and abuse from every angle by working in unison to achieve the overarching goal of protecting taxpayer resources. The cooperation between our Offices is an example of a successful collaboration to stop TennCare fraud."
Dr. Fakhruddin, who intends to retire and sell his practice, has denied any wrongdoing. There were no allegations of patient harm.