Head Games

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When someone plays head games in a relationship, he or she is clearly acting dishonestly with the intent to cause confusion. This can be disorienting, especially if one person in the relationship trusts the other person to look out for his or her best interests. In a similar manner, patients trust that their doctors have their best interests at heart. Patients are counting on their physicians to provide a treatment plan that ensures they are on the road to recovery. The website Examiner.com reports on a licensed Brooklyn psychiatrist, who took advantage of his Medicare patients and billed the government benefits program for home medical treatment that never occurred.

The story states that the 55-year-old doctor, who was employed by the U. S. Department of Veterans Affairs (VA), also operated a private practice out of his residence while not on duty at the VA. According to court records, over a six-and-a-half year period, the doctor submitted fraudulent claims to the Medicare program for more than $4 million in home medical visits that supposedly occurred while he was away on vacation in China or during the time patients were confined to a hospital. The ”head doctor” received more than $2.8 million in Medicare payments from the scheme. (And, as you can guess, this fraudster did not provide treatment for the majority of his patients – many of whom were elderly Medicare recipients and veterans who justly deserved the benefit.)

The psychiatrist pleaded guilty to defrauding the federal health care system and faces a maximum sentence of 10 years in prison. (It’s probably a given that he will also lose his medical license.)

The VA provides benefits and services that support service members, veterans and their dependents and survivors. These folks have more than paid their dues by risking their lives to protect our country. They deserve the benefits that the VA provides, and it is an injustice when greedy criminals take advantage of the system. Thankfully, this doctor was headed off by the Health and Human Services Administration’s Office of the Inspector General and the Medicare Strike Force – and now he will face a few head games of his own while while serving out his sentence.

Source: Today’s ”Fraud of the Day” is based on the article titled, ”Psychiatrist Pleads Guilty to Defrauding Government Health Care System,” published on Examiner.com on October 31, 2013.

NEW YORK – On Wednesday, the same day that Secretary of Health and Human Services Kathleen Sebelius testified before a congressional panel about ”glitches” in the new Obamacare web site, and her boss President Barack Obama visited Boston, Mass., to boast about the benefits of government-run medical insurance, a physician working for a government agency pleaded guilty in a Brooklyn, N.Y., courtroom to defrauding the federal health care system.

A licensed psychiatrist, Dr. Mikhail L. Presman, working for the U.S. Department of Veterans Affairs (VA), pleaded guilty to health care fraud. He admitted that he falsely billed Medicare for home medical treatment to Medicare beneficiaries and he agreed to forfeit more than $1.2 million in illegal profits.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.