JANIA Y ROSS

NPI 1366159584, individual, Windsor, CT, Social Worker, Clinical

Evidence tier

impossible volume with concurrency

Billed more hands-on hours than a day holds in 2 months, peaking at 17.7 hours per day across 3 billing organizations.
72% of Medicaid dollars are on codes with a history of abuse.

score 83 of 100, rank 717, $480K at stake

Hours billed per day

Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.

month	what was found	hours per day, lower bound	hours per day, at price	hours per day, conservative	per working day	patients	billing organizations	codes	paid
Mar 2024	More hours than a day holds, even counting one unit per claim line	28.2	22.2	14.8	21.6	395	2	90791 90832 90834 90837 90846 90847 T1016	$63K
Apr 2024	More hours than a day holds, even counting one unit per claim line	27.4	26.8	17.8	24.1	375	2	90791 90832 90834 90837 90846 90847 T1016	$73K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	JANIA Y ROSS
Type	Individual
Status	Active
NPI issued	October 28, 2022, last updated May 24, 2024
Practice location	56 POQUONOCK AVE, Windsor, CT 06095-2507, 475-261-0459
Specialties	Social Worker, Clinical (1041C0700X, license 5818 CT) Social Worker, Clinical (1041C0700X, primary, license 12719 CT)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
90837	Psychotherapy, 1 hourhistory of abuse	$423K	72%	$291	$191 (top 5% from $442)	82nd percentile
90834	Psychotherapy, 45 minutes	$114K	19%	$139	$101 (top 5% from $318)	69th percentile
90846	Family psychotherapy without patient, 50 minutes	$18K	3%	$105	$113 (top 5% from $277)	44th percentile
90791	Psychiatric diagnostic evaluation	$16K	3%	$120	$105 (top 5% from $228)	67th percentile
90832	Psychotherapy, 30 minutes	$9K	1%	$73	$59 (top 5% from $239)	too few months to rank
90847	Family psychotherapy with patient, 50 minutes	$5K	1%	$103	$130 (top 5% from $458)	too few months to rank
T1016	Case management each 15 min	$1K	0%	$23	$98 (top 5% from $507)	too few months to rank

In this area

33 providers in Windsor, CT carry an indicator in the public record, with $13.5M at stake between them. The most common is named in an enforcement record, on 12 of them, followed by part of a provider network on 9. 12 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	SHAWN TYSON Hartford, CT, ranked 62	$0	Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated June 21, 2024. No Medicaid payments in the last 12 observed months. and 2 more
1	MINDS CORNERSTONE LLC Wethersfield, CT, ranked 74	$721K	Adjudicated (complaint, pleaded guilty) per a Department of Justice release and an HHS-OIG enforcement record dated January 16, 2025. Medicaid paid $721,009 in the last 12 observed months.
1	HELEN ZERVAS Bristol, CT, ranked 112	$192K	Adjudicated (pleaded guilty, indicted) per a Department of Justice release dated February 11, 2025. Medicaid paid $192,083 in the last 12 observed months.
1	SORAYA SAWICKI Avon, CT, ranked 133	$131K	Adjudicated (sentenced) per a state attorney general release dated June 3, 2025. Medicaid paid $130,870 in the last 12 observed months.
1	MICHAEL PINES Glastonbury, CT, ranked 444	$0	Adjudicated (sentenced, pleaded guilty) per a Department of Justice release dated January 31, 2024. No Medicaid payments in the last 12 observed months. and 1 more
1	THE GEMINI PROJECT, LLC Newington, CT, ranked 446	$0	Adjudicated (pleaded guilty, complaint) per a Department of Justice release dated January 16, 2025. No Medicaid payments in the last 12 observed months. and 1 more
1	COLLABORATIVE COUNSELING CENTER, LLC Hartford, CT, ranked 550	$0	Adjudicated (sentenced) per a state attorney general release dated August 28, 2024. No Medicaid payments in the last 12 observed months.
1	DONALD SALZBERG West Hartford, CT, ranked 575	$0	Adjudicated (sentenced) per a Department of Justice release dated May 9, 2024. No Medicaid payments in the last 12 observed months.

All 33 in CT

Recent enforcement in CT

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementJun 23, 2026

Connecticut Lab and its Owner Pay Over $145K to Settle Allegations of Medicaid Enrollment Fraud

Coastal Diagnostics and its owner made material misrepresentations in a Connecticut Medicaid Provider Enrollment Application by denying any relationship to another enrolled provider, Genco Lab, and then submitted claims for laboratory services.

DOJPleaded guiltyJun 23, 2026

Middletown Man Pleads Guilty to Operating Unlawful Money Transmitting Business

Habib registered a company and opened a bank account through which fraudulent claims were submitted to Medicare Advantage plans for durable medical equipment, including orthotics and braces, that beneficiaries did not request, consent to, or receive, and he wired proceeds to Pakistan without a money transmitting license.

DOJComplaint filedMay 22, 2026

APRN Charged with Defrauding Connecticut’s Medicaid Program

An APRN was charged with submitting fraudulent Medicaid claims for medication management services that were not provided, including for patients who had stopped seeing her or who were hospitalized, incarcerated, or deceased.

DOJSentencedApr 30, 2026

Cheshire Nurse Who Illegally Distributed Controlled Substances is Sentenced

An Advanced Practice Registered Nurse enrolled as a Medicare and Medicaid provider unlawfully distributed amphetamines and benzodiazepines to individuals without legitimate medical need, charging $200 cash for office visits, and Medicaid paid $287.58 for prescriptions written for an undercover agent.

DOJSentencedFeb 10, 2026

Bloomfield Man Sentenced to Federal Prison for Health Care Fraud

Tyson and Epps submitted fraudulent Medicaid claims for psychotherapy counseling sessions that were not provided, billed under Tyson's provider number for services purportedly provided by the suspended Epps, and Tyson provided fraudulent patient records during a Medicaid audit.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.