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Connecticut’s Attorney General William Tong has announced a substantial settlement of $455,598.31 with Advanced Practice Registered Nurse Dayna L. Giordano and her Branford medical office over allegations of violations of the Connecticut False Claims Act.
The settlement resolves claims that Giordano’s negligent practices caused pharmacies to bill the state’s Medical Assistance Program for injectable specialty drugs that were never administered to patients, resulting in significant financial losses to Connecticut’s Medicaid program.
An extensive investigation revealed that between June 2019 and August 2023, Giordano, while operating her medical practice in Branford, prescribed monthly injections of long-acting, extended-release medications including Sublocade, Vivitrol, and Abilify Maintena. These medications were part of Medication Assisted Treatment programs for patients struggling with opioid or alcohol use disorders.
According to officials, specialty pharmacies delivered these injectable drugs directly to Giordano’s office for patient administration and subsequently billed the Connecticut Medicaid Program for reimbursement. However, investigators discovered that numerous doses were never actually administered to the intended patients.
While Giordano did not personally seek or receive payment for the medications, the investigation determined she knowingly failed to administer the drug injections due to improper medication tracking systems and inadequate record-keeping practices within her office. These shortcomings ultimately led to the pharmacies billing the Department of Social Services for unused medications.
“Dayna Giordano’s poor record-keeping wasted taxpayer dollars and unused medications. We will continue to work closely with our state and federal partners to aggressively protect the integrity of our public healthcare programs,” Attorney General Tong said in a statement.
The case highlights a growing concern within healthcare oversight agencies about waste and mismanagement in specialty medication programs, particularly those involved in treating substance use disorders. Specialty drugs like those prescribed by Giordano often cost thousands of dollars per dose, making proper administration and tracking essential to maintaining the financial sustainability of state Medicaid programs.
This settlement comes amid increased scrutiny of medication waste in public healthcare programs nationwide. According to recent industry reports, improper medication management costs public health programs billions annually, with injectable specialty medications representing a disproportionate share of these losses due to their high cost and specialized handling requirements.
The investigation into Giordano’s practice was a collaborative effort involving multiple agencies. The Attorney General acknowledged assistance from the Connecticut Department of Social Services, the Connecticut Medicaid Fraud Control Unit, the Connecticut Department of Consumer Protection Drug Control Division, the U.S. Department of Health and Human Services Office of Inspector General, and the U.S. Drug Enforcement Administration’s New Haven Tactical Diversion Squad.
The case was handled by Forensic Fraud Examiner Lisa Bailey, Investigator Peter Harrington, and Assistant Attorney General Karla Turekian, under the direction of Deputy Associate Attorney General Gregory O’Connell, who serves as Chief of the Government Fraud Section.
This settlement reinforces Connecticut’s commitment to protecting taxpayer dollars in healthcare programs and ensuring that medications intended for vulnerable populations actually reach those in need. It also serves as a warning to healthcare providers about the importance of maintaining proper inventory controls and accurate records, particularly when dealing with high-cost specialty medications.
For providers involved in substance use disorder treatment, the case underscores the need for robust systems to track medication inventory, especially as the opioid crisis continues to drive demand for medication-assisted treatment options throughout the Northeast.
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18 Comments
Medication assisted treatment is a critical component of addressing opioid and alcohol use disorders. Troubling to see allegations of improper billing related to these important therapies.
Yes, it’s unfortunate when fraud undermines access to evidence-based addiction treatments. Hopefully this case doesn’t discourage providers from offering these services going forward.
This looks like a complex case involving specialty medications and treatment programs. Curious to learn more about the specific breakdown of the $455,598.31 settlement amount.
Good point. Details on the calculation of damages and restitution would provide helpful context around the scale and nature of the alleged false claims.
Curious to see if there are any implications for the specialty pharmacies involved, or if the focus was solely on the medical provider’s actions.
Good question. The role of the pharmacies in billing the state program warrants examination, as they may have also been complicit or negligent in the alleged fraud.
This highlights the importance of oversight and auditing to prevent waste, fraud and abuse in government healthcare programs. Kudos to the Attorney General’s office for pursuing this case and recovering taxpayer funds.
Absolutely. Diligent investigation and enforcement are key to maintaining the integrity of Medicaid and ensuring limited resources are used appropriately to serve those in need.
Interesting case involving alleged false claims against the state’s Medicaid program. Curious to see if the investigation uncovered any systemic issues or just individual negligence in this nurse’s practice.
Agreed, these types of cases can reveal broader problems in how healthcare providers and pharmacies bill government programs. The settlement amount seems substantial, so it was likely a significant fraud.
The report mentions an ‘extensive investigation’ – it would be interesting to know more about the investigative methods and timeline that uncovered this fraud.
Yes, understanding the investigative process could offer insights into how these types of schemes are detected and the challenges in rooting them out.
The details around how the ‘numerous doses’ were allegedly never administered to patients are quite concerning. I hope the investigation uncovered the full scope of the misconduct.
Yes, the specifics of how the fraud was perpetrated will be important to understand, in order to identify systemic weaknesses and implement effective prevention measures.
This case underscores the need for robust compliance programs and internal controls at healthcare organizations to prevent these types of improper billing practices.
Absolutely. Strong oversight, auditing, and whistleblower protections are crucial to catch fraud early and mitigate the financial and reputational damage.
The scale of the alleged losses to Connecticut’s Medicaid program is quite concerning. Glad to see the state taking these types of violations seriously and pursuing recoveries.
Agreed, every dollar lost to fraud means less funding available for legitimate healthcare needs. Rigorous enforcement is important to deter this kind of misconduct.