The state has initiated a False Claims Act lawsuit alleging that a Norwalk-based family practitioner engaged in a pervasive and illegal scheme to defraud Connecticut’s Medicaid program by submitting false claims for services never provided, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said in a statement.
The state alleges that, from November 2013 until at least October 2016, Dr. Ramil Mansourov and his company, Ramil Mansourov LLC, billed Connecticut’s Medicaid program – the Connecticut Medical Assistance Program (CMAP) – for millions of dollars in services that were never provided to his Medicaid patients and further defrauded the program by falsifying his income information in order to obtain Medicaid benefits for himself and his two children.
“The audacity of the alleged fraudulent conduct in this case is astounding,” Jepsen said in a statement. “In one case, this provider billed Medicaid for at least 500 visits to a particular patient that never happened, receiving $80,000 in taxpayer dollars for services never rendered, and at the same time, sought to receive Medicaid benefits himself. This sort of egregious fraud will not be tolerated, and we will hold accountable those who seek to engage in this sort of conduct.”
Mansourov has been charged by federal criminal complaint with federal money laundering charges related to the allegations of healthcare fraud and is currently being sought by law enforcement.
Mansourov, a resident of Darien, is a licensed physician who operated a walk-in medical practice in Norwalk known as the Family Health Urgent Care Center Inc. Through his billing company, Ramil Mansourov LLC, Mansourov submitted claims to CMAP for services purportedly provided to Medicaid patients by both himself and other providers at the Family Health Urgent Care Center. All but a small fraction of these claims were for services purportedly provided by Mansourov.
The state alleges that Mansourov fabricated thousands of claims for services he purported to have provided but, in fact, never rendered. He claimed to have provided services not only at the Family Health Urgent Care Center, but also at patient residences and long-term care facilities in the state. During the relevant time period, the DSS reimbursed the defendants a total of at least $5.2 million for CMAP claims.
On many of the dates when services were purportedly rendered, the state alleges that Mansourov was actually working at various urgent care centers in Kentucky or was vacationing in Florida or out of the country. On other dates of service, the Medicaid recipients were in-patients admitted at acute care hospitals and, therefore, could not have been seen by Mansourov at his office, their residences or in long-term care facilities, the state alleges. In some instances, Mansourov billed Medicaid for hundreds of visits with particular Medicaid beneficiaries that simply did not happen, the state alleges, and the doctor provided falsified medical records to DSS auditors and investigators in an attempt to conceal the fraudulent activity.
