$1.1 Million Judgment Entered Against Cleveland Psychiatrist On TennCare Fraud

Thursday, 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 Elizabeth Tonkin who was responsible for the oversight of the civil investigation and litigation for the U. S. Attorney’s Office and Senior Counsel Peter Coughlan with the State Attorney General’s Office for his role on behalf of the state.

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