Psychiatrist suspended for overbilling the state of California

From the Orange County Register.

A psychiatrist who once worked for the Orange County Health Care Agency has been suspended from practice for one year by the California Medical Board over false billing practices.

Dr. John Rajaratnam was found to have billed state Medi-Cal for examining patients on days when he had not seen them, according to legal documents. In one case, the state says he billed 21 hours for one day. In another, he billed 52 minutes for a 5-minute visit, the documents show.

Rajaratnam's suspension went into effect last month. Additionally, he was placed on probation for five years and ordered to take ethics and medical record keeping courses. If he violates probation, he could lose his medical license.

His Irvine attorney Bradley Garber said Rajaratnam never defrauded Medi-Cal, the public insurance program for low-income families.

"He knows he did the work. He gave his life and all of his efforts in providing care to his patients," Garber said Thursday. "Unfortunately sometimes you can't prove it in a 'he said, she said' situation where no one takes detailed records of signing in and signing out."

In the last fiscal year, 135 California doctors were disciplined for medical negligence and nine were disciplined for committing fraud. Penalties vary.

For instance, Richard Moy, a Lake Forest podiatrist, received a 30-day suspension last year in the settlement of a case where he was accused of fondling a patient's breasts.

Medical Board spokeswoman Candis Cohen described a one-year suspension as "a significant sanction."

The state documents summarized testimony that described Rajaratnam as well-liked and caring but noted that a suspension was warranted because of his lack of remorse.

"Respondent has not accepted any responsibility for his misconduct. … He has admitted to only one mistake, related to his allegedly 'collapsing' services rendered over two dates into one progress note," the papers read.

Garber said Rajaratnam, 54, suffered a debilitating stroke last month shortly before the suspension took effect. He said his client often worked on administrative paperwork late at night after carrying a heavy patient load and commuting to four different satellite offices.

"He never profited from anything about this purported medical fraud claim," Garber said. "He was never paid a dollar more than he earned in a 40-hour workweek, yet he worked himself to the bone."

Rajaratnam worked at the Health Care Agency from 1994 until he was terminated in 2004 for falsification of medical and timekeeping records, according to Medical Board documents. The records also say the county received an anonymous complaint about his billing practices that led to an audit revealing discrepancies between his medical charts and billing.

In one case, the county reimbursed Medi-Cal $2,340.76 for treatment of a minor who was not present on dates listed by Rajaratnam, the state documents say.

The matter is not the first to involve improper billing practices at the Health Care Agency.

In December, the county paid $7 million to the federal government to settle allegations that false bills were submitted to Medicare for mental health and drug addiction services from 1990 to 1999.

The health care agency admitted no wrongdoing in the matter, which centered on improperly billed Medicare for psychiatric evaluations that were not performed by appropriate medical staff. The county also engaged in a billing practice known as "upcoding," where brief office visits were described as lengthier, intensive office visits in order to receive higher compensation.