Watonga resident and psychiatrist Dr. Richard Zielinski has agreed to pay $173,143 to the State of Oklahoma to settle a lawsuit alleging he knowingly submitted false claims to the Oklahoma Medicaid program, SoonerCare.
As operator of Richard Zielinski MD, PLLC, Zielinski allegedly upcoded claims for evaluating and managing patients and submitted them to Sooner-Care for payment between Jan. 1, 2019, and June 30, 2021.
The Watonga Republican reached out to Dr. Zielinski and spoke later to his attorney. Zielinski’s license indicates a Watonga residential address, but his practice appears to be in Yukon.
The attorney, Dan Shadid, pointed out the case was dismissed without cannot be refiled. He also noted there was no finding of wrongdoing on the part of the medical practice, and the settlement was a way for both parties to avoid the time and expense of a trial. He underlined the fact that the claims resolved by settlement were only allegations and there has been no determination of liability.
“As expressly stated in the Attorney General’s press release, all of the Attorney General’s claims were “allegations” and there was never a determination of fact or liability,” Shadid wrote via email.
“Dr. Zielinski denies that he ever deliberately up-coded claims for medical bills submitted to SoonerCare. As stated in the settlement agreement, Dr. Zielinski made no admission of wrongdoing. In fact, the settlement agreement specifically provided that the ‘Agreement is not an admission of liability by Defendants,’ nor was it ‘a concession by the State of Oklahoma that its claims in the Civil Action are not well founded.’” he continued.
“Rather, Dr. Zielinski and the State, jointly, chose to enter into the settlement so as ‘to avoid the delay, uncertainty, inconvenience and expense of protracted litigation.’” For decades, Dr. Zielinski has provided good and necessary psychiatric care for his patients and will continue to provide such care for his many patients in the future.”
The settlement also clears up allegations that Zielinski forced his employees to fabricate records supporting the false claims after the Oklahoma Health Care Authority notified him they intended to audit patient records. The authority referred the matter to Attorney General Gentner Drummond’s Medicaid Fraud Control Unit for investigation.
“I appreciate the thorough investigation completed by my team to recover funds that were taken from the State and, as a result, the taxpayers of Oklahoma,” Drummond said. “I take very seriously all allegations of false claims law.”
Assistant Attorney General Jamie Bloyd, Agent Rachel Hayward and Nurse Analyst Laurie Hudson handled the investigation and resolution.