What a Quack

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48582190 - female medicine doctor hand holding silver pen writing something on clipboard closeup. medical care, insurance, prescription, paper work or career concept. physician ready to examine patient and help

The American Psychiatric Association explains that psychiatrists are medical doctors who specialize in the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. They can also help with the physical aspects of psychological problems and write prescriptions. (This can help bring restorative health to people who find it hard to navigate everyday life.) A Lebanon, Virginia psychiatrist committed Medicaid fraud by billing a private insurance company for purported psychiatric services provided and Medicaid for prescriptions. While the crime against the insurance program is bad enough, what is more egregious is that he almost caused the demise of one of his patients while lining his pockets in Medicaid benefits he did not deserve.

The psychiatrist in today’s fraud article was a selfish man who preyed upon one of his female patients. While working for an Abington, Virginia-area medical group, he billed a private insurance carrier for psychiatric services he supposedly provided over two years. During that time a sexual relationship started between the two and when the doctor ended it, the patient attempted suicide.

Further research into the case shows that while the relationship was ongoing, the doctor purchased alcohol for his client and encouraged her to drink with him, all while prescribing medication that should not be mixed with alcohol. (What a nice guy. He messed with her mental and physical states – the two things he was hired to heal.) During the two-year relationship, the psychiatrist billed United Healthcare $1,508 for psychiatric care and Medicaid for $9,313 in prescriptions. (Obviously, there was no legitimate counseling occurring, just devastating manipulation.)

The 62-year-old (who was definitely old enough to know better) pleaded guilty to Medicaid fraud. He was sentenced to seven months in prison and must serve a two-year term of supervised release. He is also required to pay a $25,000 fine in addition to restitution of $3,131.20. (How about paying for the damage he did to his victim? I doubt he could afford it.)

Fortunately for everyone else, the Virginia psychiatrist agreed to never practice medicine again. (His medical and DEA registration have been revoked.) Let’s hope this quack can receive a much needed psychiatric evaluation while serving time behind bars and get the help that he needs.

Today’s “Fraud of the Day” is based on an article entitled, “Southwest Virginia psychiatrist sentenced to prison for healthcare, wire fraud,” posted on WJHL.com on January 9, 2019.

ABINGDON, VA (WJHL) – Psychiatrist Alberto Cervantes was sentenced to 7 months in prison on Wednesday. Cervantes pleaded guilty to defrauding Virginia Medicaid and United Healthcare by billing insurance programs while carrying out a sexual relationship with one of his patients.

Cervantes was formerly employed by Mountain States Medical Group and Russell County Medical Center as a psychiatrist, where the sexual relationship started.

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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.