Overprescribed

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There’s a pill for just about everything. In fact, there were 4.36 billion prescriptions dispensed in the United States in 2015.A Miami psychiatrist did more than just overprescribe medication to his patients, he dispensed anti-psychotic drugs for the purpose of helping his patients game the U.S. citizenship process, and ultimately qualified them for disability benefits they did not deserve.

The mastermind behind the scam wrote prescriptions to support his false diagnoses of mental illness plus other disabilities. Approximately 1,700 patients then used the bogus diagnoses and prescriptions to submit applications to qualify for Social Security disability benefits, which also provide beneficiaries with a monthly stipend for other programs including Medicare, Medicaid, food stamps and housing assistance. (Because of the fake diagnoses, the patients were also exempt from English and civics testing requirements for becoming naturalized citizens.)

The 49-year-old psychiatrist pleaded guilty to health care fraud, immigration fraud and filing false claims. His illegal acts, which defrauded the Medicaid and Medicare programs, plus the Social Security Administration and the U.S. Citizenship and Immigration Services, cost American taxpayers $50 million. Although he did admit to knowing what he did was wrong, he was handed a sentence of 12 years and seven months in federal prison to be followed by three years of probation. He was ordered to repay $50.6 million to the four government agencies. (The doc was also suspended from being a provider under the Medicaid and Medicare programs and surrendered his home, medical office and art collection. That’s a good start.)

As you might guess, the man behind the scam didn’t do it all by himself. He had three other co-conspirators who assisted with the ruse. One man, who was ironically diagnosed with a mental illness, pleaded guilty to his role in the fraudulent operation and was sentenced to six months in prison, three years of probation and ordered to pay nearly $300,000 in restitution to the government. Two other partners in crime also previously pleaded guilty to fraud charges. One received a sentence of four years in prison, three years of probation and has to repay $33 million in restitution. The other criminal got two years and nine months in prison and was ordered to pay $502,000 in restitution.

It also looks like the psychiatrist has turned in his Florida medical license and will help prosecutors track down the 1,700 patients who paid him for bogus diagnoses so they could qualify for government programs. (That was a really smart move on his part. His prison sentence could have been worse.) One thing is for sure, there will be plenty of time for the psychiatrist to self-analyze his criminal actions while behind bars.

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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.