Connecticut Psychiatry Practice Pays $310K For Employing OIG Excluded Provider

 Sarasota, FL (WorkersCompensation.com) – Healthcare providers and facilities have to abide by strict federal regulations when hiring clinical staff. Potential providers of all levels must go through not only licensing verification, but an extensive federal background check as well. In fact, healthcare providers are required to do a review of the HHS-OIG Exclusions list on a routine basis to check for matches of their employees. The OIG Exclusions list is a register of individuals and entities that are excluded from participating in federally funded healthcare programs due to a conviction of healthcare fraud, patient abuse or neglect, and illegal distribution of controlled substances. The Exclusions list is updated on a monthly basis, with around 60,000 individuals and vendors.  

In healthcare, Credentialing, and/or Personnel departments are often the groups that are charged with the responsibility of verification of the Exclusions list. While it’s not uncommon for these departments to be overwhelmed with detailed responsibilities that are hard to manage, it is still absolutely critical that checking the Exclusions list not fall through the cracks as penalties are extremely steep.  

Healthcare employers that participate in federal and state healthcare programs can be fined $10,000 for each they employ an excluded individual has ownership or controlled interest. Additionally, they can be fined $10,000 for each item or service provided during the same time period, and subject to three times the amount claimed for those items or services. Aside from those penalties, the healthcare employer can be denied reinstatement to federal healthcare programs resulting in substantial loss of income. 

In a recent case in Hamden, Connecticut, Geriatric & Adult Psychiatry, LLC and the owner Alan Siegal, MD experienced the pain of employing a healthcare provider that was listed on the Exclusions list.  

Eric Ressner was a Psychiatrist in south Florida in 2006 when he was convicted of conspiracy to commit healthcare fraud. According to the details in the case, from 2001 to 2005 Ressner allowed his name to be used to submit false prescriptions for Ketamine and other controlled substances that were not actually prescribed or given. Ressner’s medical license was suspended, and sentenced to 48 months.  

In 2016, Ressner was hired by Seigal as the clinical director, and serviced in that position until June of last year. During that time, the clinic continued to bill federally funded healthcare programs, using the reimbursement to pay Ressner’s salary which goes against the requirements of the OIG. 

As a result of employing Ressner, the practice has agreed to pay out $310K to resolve allegations of employing an individual that is excluded from federal programs.