Wednesday, June 27, 2007

Belleville psychiatrist billed government for 40-hour day

For those keeping track, there are only 24 hours in a day, but this freak billed for 40. As seen here

Belleville psychiatrist Ajit Trikha seemed to be able to pack a lot into one day.

On 76 days from 2001 to 2004, Trikha billed Medicare and Medicaid for more than 24 hours per day for patients' individual therapy, according to a federal agent's court affidavit.

Twice, Trikha said he packed 40 hours' worth of appointments into one day.

In court on Tuesday, Trikha admitted the truth — that he and his company, TRX Health Systems, had submitted fraudulent billings to Medicare and Medicaid between 2000 and 2005. He agreed to pay back $1.85 million.

Trikha pleaded guilty in U.S. District Court in East St. Louis to two counts of health care fraud. Under federal sentencing guidelines, he could face 30 to 37 months in prison and a fine of $6,000 to $60,000, the plea agreement says.

He also agreed to forfeit proceeds from the scam, which may include property in Belleville and Town and Country, documents show.

TRX pleaded guilty of mail fraud and agreed to pay a $1,000 fine, $10,911 restitution and spend five years on probation. Trikha is listed as president, secretary and treasurer of TRX, which was started in 2000.

Asked where the money from the fraud went, Trikha's lawyer, John Stobbs, said, "Dr. Trikha was scammed." He would not elaborate.

In the plea agreement, Trikha agreed to help prosecutors investigate other criminal conduct, both in Illinois and elsewhere.

Court documents show that Trikha acknowledged billing for a 45- to 50-minute session when he spent little or no time with the patient, billing for sessions when no patient was present and billing for group therapy when he had "far exceeded" the recommended 12 patients per session.

He also admitted billing for services provided when he was actually out of the country.

Trikha's plea agreement is not specific about the individual false billings, but an affidavit filed by Special Agent Kenneth Wells II of the inspector general's office of the U.S. Department of Health and Human Services is more specific.

Wells' affidavit, the basis of a search warrant for Trikha's offices in 2005, says investigators were first alerted by a Medicare contractor that analyzed billings and found Trikha billing for a certain type of group medical psychotherapy more often than any other doctor in Illinois. He also was at the top for several types of individual psychotherapy sessions, the affidavit says.

Trikha sent 683 claims to Medicare and Medicaid for services provided while he was on a trip to Amsterdam in 2003, and 492 claims when he went to Paris in 2004, the affidavit says.

The indictment cites Medicaid billings for 92 patients when he was in London in 2005.

On March 18, 2005, Trikha billed Medicare and Medicaid as if he had provided services to 83 patients, but investigators watching his office saw patients in the office for only about 2 1/2 hours, the affidavit says.

Later that year, it says, a woman complained that Trikha was billing for psychotherapy sessions for her mother even though she had Alzheimer's and was unable to communicate.

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