Covid-Test Doc’s Woes Mount; UNH Bails

A Greenwich doctor who sparked controversy by cashing in on New Haven’s Covid-19 testing has seen his problems and fights broaden as new revelations emerge about his practice.

City officials originally hailed the doctor, Steven Murphy, as a public-spirited partner when the coronavirus pandemic hit this spring and he set up government-sanctioned ​“free” testing sites around town.

Then people started noticing inflated bills sent to insurers, of up to $2,000 for a single test —and in at least one case, a debt collector coming to a ​“free” patient’s door (or, at least, to his mailbox).

The city cut ties with Murphy following the Independent’s reporting this summer and fall about local patients waiting up to two weeks for their test results, having their insurance companies billed upwards of $2,000 for a single test, and, in one case, having a debt collector hound an Edgewood resident to pay a $314 charge stemming from a ​“free” test he received in Day Street Park.

But in the meantime Murphy struck deals with other government agencies throughout the New York metropolitan region — and similar complaints have emerged in Westchester and Fairfield Counties, documented in stories this past week in The New York Times and the Stamford Advocate.

Back here, the University of New Haven, meanwhile, has joined an ever-increasing number of partners to sever ties with Murphy’s controversial firm.

A spokesperson for Connecticut Attorney General William Tong said his office has launched an investigation into Murphy’s practices.

Another local client, the Tower One/Tower East senior complex, has decided to allow the doctor’s clinic to continue providing regular coronavirus tests.

And Murphy has swung back with a new federal lawsuit accusing an international health insurance company of withholding $4.6 million in Covid test-related payments he claims he is owed.

Those are just the latest twists and turns in the ongoing saga of Murphy Medical Associates, the doctors’ group run by internist Murphy.

Insurance company explanations of benefits and interviews with patients and their family members show that Murphy charges insurance companies over $200 for a 10-second nasal swab, up to $1,500 for the processing of a swab sample in a lab, and then another $450-plus for a brief follow up phone call with a patient.

All of these complaints seem to be accumulating into potentially larger trouble for Murphy than just severed public contracts.

“[W]e have received complaints and have an active, ongoing investigation,” Tong spokesperson Elizabeth Benton wrote in an email. She added that the ​“investigation has been ongoing for several months,” and declined to comment further.

The complaints, meanwhile, keep flowing in.

Parents of University of New Haven students who were tested by Murphy before returning to campus this fall have recently added their voices to the chorus of concerns about alleged overbilling and misrepresentation of services.

“This is why we are the way we are in the healthcare system,” said one UNH parent, Aimee Jusino.

Fellow UNH parent Chip Dyer agreed. ​“All this overbilling is how medical inflation happens.”

And former volunteers at the now-shuttered Day Street Park testing site told the Independent how they feel as if their free labor was exploited by Murphy to potentially juice his profits and grow his business.

“I was sort of getting the sense that he was making hand-over-first money” off of the work of volunteers, said former volunteer David McIntosh.

UNH Parents: Murphy ​“Not On The Up & Up”?

While most of the reporting on Murphy to date has focused on complaints from patients tested at government-sanctioned sites run by the Greenwich doc, Murphy has also partnered with private institutions like the West Haven-based University of New Haven and the local elderly residential facility, Tower One/Tower East.

UNH Assistant Vice President for Marketing & Public Relations Doug Whiting told the Independent by email Friday that Murphy Medical conducted roughly 3,500 tests for students, faculty and staff in a three-week period in August before the start of the fall semester.

“The University is aware of reports that examine the billing practices of Murphy Medical Associates,” he wrote. ​“The University has had no role in the billing of the COVID-19 tests that were administrated on campus by Murphy Medical Associates. The University does not condone any issues of upcoding.”

He said that Murphy Medical has not conducted any testing on campus since August. Throughout the fall semester, he said, UNH has used Yale New Haven Health to administer random asymptomatic Covid-19 testing, and that that arrangement will continue for the Spring 2021 semester. He also said that UNH did not pay Murphy any money as part of their testing agreement.

Even though Murphy is no longer testing UNH students, parents of those who have been tested have taken to a private UNH-run Facebook page to voice their disbelief of just how much money their insurance plans have been billed for what seemed like a 15-second nasal swab test and a 10-second follow up phone call completed weeks ago.

Aimee Jusino, a Plainville resident whose 18-year-old son goes to UNH, said that her son was tested on campus by Murphy Medical on Aug. 20. She recalled filling out a questionnaire in advance of his getting tested that asked if he wanted to receive a nasal swab test, an antibody test, or both. They went just for the nasal swab.

His coronavirus results ultimately came back negative, she said. But that’s not the only result she got.

She said her son received a multi-page PDF showing that he had also tested negative for a full panel of viruses and bacteria. She shared that document with the Independent. It shows that her son was tested by Murphy for adenovirus, four different coronaviruses, SARS-CoV‑2, metapneumovirus, influenzas A and B, four different parainfluenzas, as well as for the bacteria chlamydia pneuomoniae, mycoplasma pneumoniae, bordatella parainfluenza, and bordatella pertussis.

“After the swab was done and those multiple tests were performed that I and my son did not consent to, they billed my insurance company,” Cigna. Which she happens to work for.

The explanation of benefits showed three different claims: one submitted on Aug. 20 for $1,500, one submitted that same day for $268, and one submitted on Sept. 5 for $480.

“That’s when I contacted the fraud unit” at Cigna, Jusino recalled. She said that Cigna ended up denying two of the claims, but they still have the $1,500 claim pending.

“They are just so brazen in doing this,” she said about Murphy. ​“I work for the healthcare industry, and this is why we are where we are” with the high costs of healthcare and health insurance.

Fellow UNH parents Chip Dyer of West Suffield, Conn. and Patti Wilson-Fico of Cranford, New Jersey separately told the Independent that their families have had nearly the exact same experiences.

Dyer’s son got tested by Murphy on UNH’s campus on Aug. 16. He had a nasal swab and got his negative results the next day, Dyer said.

A few weeks later, he was floored by what he read in an explanation of benefits provided by his healthcare insurance provider, Cigna.

His insurer was also billed three times: once for $364, once for $1,500, and once for $480. The largest claim is still pending, he said, while another has been denied.

Dyer said he called Cigna on Oct. 9, and his insurance company encouraged him to file a complaint with the Connecticut attorney general.

“I’m not worried because I think Cigna is going to deny these anyway,” he said about the claims. ​“I’m not worried as far as me getting billed. But I’m pissed that they had the audacity to file three separate claims against my insurance company. I feel like they are trying to swindle money out of insurers.” He said he fears that this type of ​“overbilling” will ultimately result in medical inflation and higher premiums down the road.

“I wish they could have vetted the company that they chose,” Dyer said about UNH. ​“For whatever reason, they chose Murphy. To me, that was a bad choice.”

And Wilson-Fico told the Independent that her daughter drove up to UNH just for the day on Aug. 18 so that she could get tested before returning to campus later that month.

“It was literally just a Covid test,” she said. ​“It was outside. It took all of 15 seconds.”

Then, just like the others, she saw the explanation of benefits from her insurer, Cigna. One claim was for $480, one for $1,500, and one for $260.

She said she reached out to Murphy Medical by email, and got a prompt response with explanations of why those bills were so high.

She said a Murphy Medical customer service representative told her that the $480 was ​“for a medical professional performing the swab” and the $1,500 claim ​“was for processing the swab in their lab.” She said one of the $268 charges was for ​“the medical professional giving the results.”

“Personally, I kind of feel it’s not on the up and up,” she said about Murphy’s testing and billing practices.

Yet another UNH parent, Howard Adler, reached out to the Independent not because his daughter was tested by Murphy — she was ultimately tested by YNHH — but because of how concerned he was after reading all of his fellow parents’ complaints on the UNH family Facebook page.

Adler is a urologist who works in New York. As a medical professional himself, he said, these complaints jumped out to him as following a classic pattern of fraudulent billing.

“Overbilling is a very, very serious issues that we have to deal with,” he said. ​“It’s part of the reason why healthcare insurance is so high.”

He said it’s all well and good to say that no patient has to pay anything out of pocket after getting a test. But those costs ultimately catch up with the consumer, because healthcare costs go up and ​“there’s not an infinite pile of money some place.”

“There’s a possibility that this is not a top notch operation,” he said. ​“That they’re doing this just for the billing and the potential revenue of it.”

Murphy Volunteers: Feeling Used

Patients and their family members aren’t the only ones who have spoken up to the Independent about their concerns with Murphy Medical’s Covid-19 testing operations.

Two former volunteers at the now-closed Day Street Park walk-up testing site in Dwight also told this reporter about feeling used by the Greenwich doc.

Nurse practitioner-in-training and New Haven resident David McIntosh said that he got involved with the Day Street Park site after signing up to volunteer with the state’s Medical Reserve Corps.

Interested in helping out his fellow New Haveners and putting his medical training to public use during a pandemic, McIntosh signed up and was ultimately assigned to Murphy’s Dwight testing site.

McIntosh said that when he first stared doing nasopharyngeal swabs at Day Street Park, he thought the site was just for Covid tests. He would swab a patient, tell them that they’d receive their results in a matter of days, and then usually never hear from them again. (Other Murphy Medical staffers were responsible for following up with patients about their test results.)

He said he began to suspect that Murphy was testing for more than just the novel coronavirus that causes Covid-19 when the clinic started doing antibody blood tests at the Day Street site.

“He just rattled off a bunch of other things” he wanted to test for through the antibody tests, McIntosh recalled of Murphy. When McIntosh asked why they were testing for so much — sometimes requiring six or seven vials of blood from each person — he said Murphy told him that he wanted to make sure that a patient did not have any other adverse conditions that might make a bout of Covid-19 that much worse.

McIntosh said he ultimately grew disillusioned with the set up when he saw how many people were getting tested, how the testing site was staffed almost entirely by volunteers, and how medical personnel could make upwards of $35 an hour doing similar work at other testing sites across the state.

And so he stopped volunteering.

“If it was a purely altruistic endeavor, I would have been happy with it.” But that didn’t seem to be the case.

“From the way he was talking about the tests and the way his business was growing at such a high rate, I could kind of sense that there was a profit motive.”

McIntosh praised Murphy’s clinic for keeping an exceptionally high standard of cleanliness and in terms of the quality of medical instruments used. He also said he doesn’t think that Murphy was necessarily billing for treatment that wasn’t provided.

“He’s billing for things that happened. He just never really told people that.”

In response to the recent wave of reporting about Murphy in the Independent, the New York Times, and the Stamford Advocate, McIntosh said, ​“I’m disappointed more than anything. These are the kind of profit incentives that increase healthcare costs for everybody. This is a microcosm of the inefficiencies of our current system.”

Another Day Street Park volunteer — who declined to be identified by name for this article because she is ashamed of having been associated with Murphy at all — offered a very similar perspective.

She volunteered through the Medical Reserve Corps because she wanted to help out her fellow city residents in a time of great need. She was assigned to Murphy. And she believed that the site was a Covid-19 testing site only.

“The information that I was given about the process was that we were doing Covid testing, and that the test we were doing is more accurate than the test you would get at CVS.”

She said she does not have any medical background, and therefore did not conduct any of the tests herself, but rather volunteered greeting and helping sign up patients when they arrived at the site.

“If they needed volunteers to staff a private practice, I don’t know if I would have done that,” she said. She thought she was volunteering in a more city-sanctioned, altruistic capacity.

“This year has been so hard,” she said. ​“A bright spot for me was that when things got bad in New Haven, I could sign up for this volunteering” and meet other like-minded New Haveners and help her city weather the storm.

“I regret it now, seeing the bills that people are getting,” she said. ​“I think it’s really bad.”

Murphy Cites Heritage Of ​“Pirates” & ​“Horse Thieves”

Through it all, Murphy has contended that his clinic has done nothing wrong.

He has claimed that his doctors and volunteers provide comprehensive health care assessments that intentionally go beyond the bounds of testing for just the novel coronavirus. That’s to make sure that patients who might suffer from serious complications if they do contract Covid-19 do not already have other ailments that can be sussed out ahead of time through a full panel of viral tests, he has repeatedly said.

That logic is perhaps most fully articulated in a new federal lawsuit filed on Nov. 6 by Murphy and four limited liability companies controlled by the Greenwich doctor — including Murphy Medical Associates LLC, Diagnostic and Medical Specialists of Greenwich LLC, North Stamford Medical Associates LLC, and Coastal Connecticut Medical Group LLC — against the health insurance company Cigna.

The suit accuses the Connecticut-based global insurance goliath of owing Murphy more than $4.6 million dollars in reimbursements for ​“Covid-19 testing-related services” provided to over 4,400 Cigna members or beneficiaries.

“Cigna, perhaps more concerned with ensuring that COVID-19 does not adversely impact its profit margins, has not honored its statutory obligation to reimburse the Murphy Practice for the COVID-19-related testing that it provided to Cigna’s members and beneficiaries since March 2020,” that legal complaint reads.

Murphy argues in that lawsuit that he should be applauded, not vilified, for providing a massive amount of pandemic testing — in municipalities including Greenwich, Stamford, New Canaan, Darien, Fairfield, Bridgeport, New Haven, West Haven, Stratford, and Ridgefield, Connecticut, as well as in Brooklyn, Bedford, and Pound Ridge, N.Y.

“That this lawsuit needs to be brought at all is a sad commentary on the state of health care in 2020 America,” the complaint begins.

“Put simply, at the start of the COVID-19 pandemic, the Murphy Practice – a cutting edge internal and preventative medical practice based in southwestern Connecticut – was one of the first (if not the first) to answer the call of towns and institutions throughout Fairfield and New Haven Counties, Connecticut, and Westchester County, New York about the desperate need for timely COVID-19 testing.”

Click here to read that lawsuit in full.

In a separate one-page letter released in response to recent reporting, Murphy dismissed the New York Times article as ​“full of inaccuracies and innuendo” for implying that patients have to bear the cost of any of Murphy’s testing.

Click here to read that one-page letter.

And in another, separate, detailed set of responses to the Independent’s requests for comment for this story, Murphy Medical’s attorney, Michael Battema, defended the Greenwich doctor’s pandemic-era practices.

“Since March 9, 2020, MMA [Murphy Medical Associates] has strived to provide the best and appropriate standard of care,” he wrote. ​“MMA has not billed any patients for any Covid related testing and follow up care. MMA has billed insurers for services using codes created by the insurance providers.”

And as for the attorney general’s investigation, Battema pledged cooperation.

“Murphy Medical Associates will fully cooperate with any investigation and is committed to being transparent and answering any questions.”

He also said that Murphy Medical has updated its registration and online materials to ​“provide more transparency on the scope of services we provide and the cost to insurers for those services.”

In response to a request for comment on the Day Street Park volunteers’ perspectives, Battema wrote, ​“Murphy Medical Associates is extremely grateful for the work and efforts of all of its volunteers.”

Battema was also asked about a recruitment video that Murphy posted to his clinic’s YouTube page at the end of March. (Note: Murphy subsequently took down the video from his YouTube page. Battema ordered the Independent to take it down from this article as well, as it is Murphy’s copyrighted material.)

In that video, which you can watch at the top of this article, the doctor describes his motto’s practice as ​“apply the healing hands” and its goal as treating patients, staff, and volunteers like family.

“I want to tell you a little bit about my family,” he says in the video (at around the 1:35 mark).

“My family consists of immigrants and pirates [and] horse thieves. And I knew that that type of person was willing to take risks and be brave. Sure they’re a brigand. Sure they stole some horses on my great-grandfather’s side. But these are all people who worked hard. They worked hard for their family, and they love their family.” Murphy goes on to describe each of the symbols in his practice’s crest.

“Dr. Murphy is proud of his heritage and the generations that came before him who have helped to instill the notion of working hard and trying to do the right thing,” Battema told the Independent. ​“Respectfully, there is significantly more to the 4 minute video than a simple reference to pirates and horse thieves.”

Murphy’s Lawyer: Nothing Fishy, Just ​“BioFire”

In response to the various concerns expressed by the parents of UNH students, Battema wrote that Murphy Medical agreed to test roughly 3,000 UNH students provide same day turnaround for each test.

“The only way MMA was able to meet the demand and turnaround time was by running the labs in-house on MMA’s own laboratory machines,” he wrote, which are called BioFire machines. ​“MMA had no control over the turnaround time of its third party lab partners, and, at that time, it often took a week or more for us to receive the results we sent to other lab resources.”

Battema said that the BioFire machine uses a respiratory panel that tests for numerous respiratory pathogens, including influenza and corona strains.

“By testing for numerous pathogens that coexist and/or have similar indications, the BioFire identifies and eliminates in a single panel test what is causing a patient’s symptoms. The benefit to a comprehensive single panel test is it prevents the need for subsequent additional testing.”

He said that the federal Food and Drug Administration (FDA) granted an emergency use authorization in May 2020 for a BioFire panel that tests for SARS-CoV‑2 plus 20 additional respiratory pathogens ​“with similar indications to Covid-19.

“Thus, for MMA to test for Covid-19 in-house and produce rapid results, MMA can only do so by running the complete BioFire panel. BioFire does not make a ​‘covid-only’ panel.”

He said that Murphy Medical had medically trained doctors, nurses and physician assistants on site who performed the swabs.

“Fast and reliable testing is essential to curbing the spread of this novel coronavirus. By running each test in-house, MMA was able to test thousands of UNH students and return the results of those tests within hours.”

Towers: We Stand By Murphy

One local institution that has decided not to change its partnership with Murphy despite the complaints of potential overbilling and misrepresentation of medical services is Tower One/Tower East.

In his latest Covid-19 update email sent out on Nov. 13, The Towers at Tower Lane President/CEO Gustave Keach-Longo said that he is aware that Murphy Medical was ​“negatively featured” in a recent New York Times article regarding the group’s billing practices.

He wrote that the Towers started working with Murphy on Covid-19 testing on the recommendation of the city in early June, ​“long before widespread testing became available.”

“The testing services Dr. Murphy has made widely available at The Towers has been truly outstanding,” he continued. ​“The frequent testing remains a key piece of our protocols to keep our community health.”

He wrote that Murphy Medical tests roughly 550 people each week at the Towers — including residents, caregivers, staff and visitors. Thanks to that testing, ​“we have been able to catch numerous COVID cases entering our building early. By doing so, we are preventing community spread within The Towers.”

Keach-Longo stressed that anyone who has needed a test from Murphy has received one regardless of whether or not they have insurance.

“To date, we have not had any significant issues with anyone having to pay for Murphy’s services with their own out-of-pocket funds related to deductibles or copays,” he wrote. ​“Our top priority, especially during this new surge in cases in our local area, is doing everything possible to keep our residents safe.”

Keach-Longo concluded that the Towers rely on frequent on-site testing that is accurate and quickly turned around.

“Without this essential tool, our residents would need to return to the practice of remaining in their apartments as they had to in the spring and early summer,” he wrote. ​“Due to our testing practices, our residents now have the ability to attend social-distanced programs and remain safe while doing so. We will continue to monitor this and, as always, advocate for our residents and staff.”

Lawsuit: It’s Cigna’s Fault

And then there’s Murphy’s lawsuit against Cigna. Filed in the U.S. District Court of Connecticut on Nov. 6, Murpy and his various holding companies assert that the Connecticut-based insurance giant is the true bad guy in this pandemic, not the doctors trying to ramp up testing to meet the general public’s need. (Cigna’s spokesperson did not respond to multiple email requests for comment about the suit by the publication time of this article.)

The suit states that Murphy’s businesses ​“invested hundreds of thousands of dollars to transform its traditional medical practice to set up COVID-19 testing sites throughout southwestern Connecticut and the Hudson Valley. These sites – which were erected virtually overnight – were designed to provide efficient drive and/or walk-through COVID-19 testing to patients with symptoms or suspected exposure. These testing sites were unquestionably the first line of defense against the pandemic.”

It also states that Murphy’s practice spent hours and hours researching peer-reviewed and other expert literature to determine how best to fulfill its Covid-19 testing mission.

That research led Murphy to believe that a simple, rapid Covid-19 polymerase chain reaction (PCR) test ​“is insufficient for treating potentially infected patients,” the suit contends. ​“Rather, to comply with the most up-to-date clinical guidance, and to provide complete and thorough patient care, testing for other potential viruses and bacteriological diseases had to simultaneously be performed. And, for patients who tested positive for COVID-19 – or who had COVID-19 antibodies in their system – blood testing had to be performed to determine the potentially life-threatening damage that the virus was doing or had done to the body’s organs and systems.”

So that’s what the practice has done. Thousands upon thousands of times over the past eight months.

The suit states that, from March 1 through Oct. 31, Murphy’s practice has ​“engaged in over 65,000 encounters with patients, and collectively tested and provided medical treatment and care to over 28,000 of those patients.” It says that Murphy has tested approximately 3,00 uninsured patients as well.

Cigna, the lawsuit asserts, has not honored its obligation to reimburse Murphy for the Covid-19 testing provided to date.

They are obligated to do so thanks to the federal Families First Coronavirus Response Act and the CARES Act, the lawsuit states, which mandate that health plans cover Covid-19 related testing without any cost-sharing passed along to patients.

Cigna has not paid Murphy over $4.6 million due related to his testing of over 4,400 Cigna members or beneficiaries, the lawsuit reads.

“Cigna has instead engaged the Murphy Practice in a paperwork war of attrition,” the suit states. They’ve allegedly done that through making ​“voluminous medical records and audit requests in a clear effort to overwhelm the Murphy Practice and to delay its payment obligations indefinitely.”

But Cigna’s alleged offenses don’t end there, according to the lawsuit.

“Finally, adding insult to injury, Cigna has – in a cynical attempt to divert attention away from its wrongful conduct – made defamatory and malicious statements about the Murphy Practice and Dr. Murphy to its patients and others,” the lawsuit reads.

“For all these reasons, the Murphy Practice and Dr. Murphy are entitled to compensatory damages and the declaratory and other relief requested herein.”

Those damages include $4,680,326 in damages, plus interest, as well as other compensatory and punitive damages.

New New Haven Office Opening Soon

Despite the swirl of drama and the sundered contract with the city, Murphy Medical still plans on opening up a new office in the Elm City soon.

Battema said that both he and Murphy were born in New Haven, and that Murphy Medical ​“has a strong attachment and loyalty to the Elm City.”

“MMA is committed to providing testing and other diagnostic services to those residents in New Haven who need it most,” he continued. ​“MMA will be opening at 1423 Chapel Street this week.”