Stratford Doctor to Pay $700K for Alleged Nursing Home Scheme

Updated 3:15 p.m.

The office of Dr. James P. Ralabate has issued a statement in response to the fraudulent billing allegations that resulted in the $700,000 civil settlement with the government.

The statement says, contrary to what the government alleged, Ralabate "never billed for services that were not provided."

And:"It was only when he later learned that the excellent level of care he provides to all his patients was found in a later audit to be beyond what Medicare pays for that he chose to settle the case -- rather than take time away from his patients and pay legal bills for a trial."

Click here to read the full statement.

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A Stratford doctor has agreed to pay $700,000 to resolve allegations that he and his business engaged in fraudulent billing at several nursing homes in the state.

Dr. James P. Ralabate, a physician, and his company, Primary Care Associates, located at 2890 Main St., Stratford, entered into the civil settlement with the government on Thursday.

"The allegations against Ralabate involved fraudulent billing to Medicare occurring over a five-year period for medical services provided at various nursing homes in Connecticut," states a release from the United States Attorney for the District of Connecticut.

It continues, "The government alleges that Ralabate billed Medicare for high-level physician services when the services of a physician were not medically necessary. The medical records did not provide documentation necessary to meet the detailed history, examination or medical decision-making requirements necessary to justify the high level of physician care. At times, there was no medical record documenting Ralabate's visit.

"The government further alleges that Ralabate billed Medicare for services he supposedly provided to patients in nursing homes when the patients were, in fact, not present in the nursing homes. Instead, the patients had been transferred to local hospitals for treatment. Yet Ralabate billed government health care programs as if he had provided medical services in the nursing homes.

"To resolve their liability under the False Claims Act, Ralabate and his professional corporation will pay $700,000 in order to reimburse the Medicare programs for conduct occurring between January 1, 2006 and August 31, 2011."

U.S. Attorney David B. Fein said his office is committed to tracking down doctors and other health care providers who submit fraudulent claims to federal health care programs:

"Health care providers that overcharge Medicare drain critical funds from the Medicare program and increase health care costs...Providers who submit false claims to the government face serious monetary and administrative sanctions."

By entering into the settlement agreement, Ralabate and his company does not admit liability, according to the release.