Doctor decertified by BWC after fraud uncovered
A Youngstown doctor has been decertified as a provider for the Ohio Bureau of Workers’ Compensation and has repaid more than $70,000 after pleading guilty to workers’ compensation fraud.
Surveillance video captured by an undercover agent from BWC’s Special Investigations Department posing as a patient in need of psychotherapy services showed Dr. Anil C. Nalluri providing inadequate care. He later billed BWC for services he never provided.
Nalluri was indicted in March and pleaded guilty to workers’ compensation fraud Dec. 13. He paid $71,669.62 in restitution and investigative costs. He was also voluntarily decertified as a BWC provider.
“This video shows Mr. Nalluri’s appalling lack of concern for his patient and a substandard level of care that is clear even to a layperson,” said BWC Administrator/CEO Steve Buehrer. “The care of his patients should have been Mr. Nalluri’s first concern but he instead chose to put his patients at risk in order to squeeze the most dollars out of BWC as possible.”
SID began investigating Nalluri in 2003 after receiving a complaint from an injured worker that he was providing only 10 minutes of psychotherapy services during what was supposed to be a 45 minute session. The injured worker confronted Nalluri about the lack of care and Nalluri informed the patient that he would receive payment from BWC regardless of the treatment provided. Nalluri later removed the injured worker from treatment at the office and failed to provide the patient his medical records when requested.
Agents conducted an undercover operation and observed several patients exiting the office very soon after arriving. An agent also posed as a patient, visiting Nalluri 12 times and capturing video supporting the allegation, including an appointment that lasted one minute. In another instance, BWC was billed for a 20 to 30 minute psychotherapy session that video showed lasted three and a half minutes and consisted primarily of discussions about the economy.
After the undercover operation concluded, investigators conducted interviews with Nalluri’s employees and patients. A number of patients reported the services they received were less than adequate and often lasted just enough time for Nalluri to write a prescription.
Additionally, an expert witness who reviewed the video and documentation reported sub-optimal treatment that did not meet the standard of care. The expert reported Nalluri falsified documents to obtain payment from BWC and failed to justify the prescriptions he wrote for the agent.