Second Connecticut Medical Practice to Pay $192K For Employing Excluded Individual

Sarasota, FL (WorkersCompensation.com) – It would appear that the Connecticut Department Of Justice has employment of excluded individuals under their radar as a second case in less than month has been announced. 

At the first of this month, Geriatric & Adult Psychiatry, LLC and owner Alan Siegal, MD agreed to pay out over $310K to resolve allegations of employing Psychiatrist Eric Ressner. Ressner had been added to the OIG Exclusions list for having been convicted of healthcare fraud and related drug charges. Ressner had served the facility as the clinical director since 2016, and claims had been billed to federally funded healthcare programs during his tenure for which he received payment in salary.

In a press release on March 18^th, Windham Eye Care Practice and owners Dana Woods, MD and William Kaufold, MD agreed to settle for $192,699 to resolved allegations of employing an OIG excluded individual. Michael Vallone served as the practice administrator from February 2010 until May of last year, during which time the practice billed federally funded payers and used the reimbursement towards Vallone’s salary and benefits. According to the release, Vallone been convicted of healthcare fraud in New Jersey, but no further information was listed.

While both of these cases involve relatively small medical groups, another case earlier this year shows that even larger practices are not immune. According to a JD Supra case report, academic medical center Thomas Jefferson University Hospitals Inc. in Philadelphia agreed to a settlement of $19,958 in January of this year. In this particular case, the hospital employed an excluded individual from October 2018 to March 17, 2019 through a contract with a vendor. From March 18 to May 17, 2019 the former vender worker became a direct employee of the hospital

According to the report, the hospital found out about the excluded employee in July 2020 at which time they were accepted into the Self-Disclosure Protocol. While the hospital has not admitted liability, the OIG’s position is that the hospital should have known about the excluded employee prior to the March employment date.

In this particular case, the excluded employee was thrown out of the federal program in 2012 for 5 years for a related felony conviction. While there is a 5-year exclusion that would have ended before she was employed, in order to be reinstated offenders must re-apply.

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