Feel Good Story of The Day.
Psychiatric providers in Pennsylvania, Vermont, and Texas feel pressure from federal and state prosecutors
September 15, 2015 | By Evan Sweeney
Mental health providers across the country were faced with convictions and fraud investigations last week, leading to some contentious litigation with state enforcement officials.
In Pennsylvania, a messy legal battle has unfolded between Lehigh Valley Community Mental Health Centers Inc. and the state, according to The Morning Call. The Community Mental Health Centers is suing the state for withholding payments after prosecutors alleged the mental health chain improperly billed for psychiatric services to the tune of $75 million. The suit also names Magellan Behavioral Health of Pennsylvania Inc., which terminated its contract with the Community Mental Health Centers following fraud allegations. The owners of the chain claim Magellan's actions created unnecessary hardship for patients based on unsubstantiated fraud allegations.
Earlier this year, New Mexico came under fire for pulling Medicaid funding on 15 mental health providers in the state following allegations of improper billing. Months later the state Senate passed a bill preventing the state from prematurely cutting of Medicaid funding for providers.
Elsewhere in Pennsylvania, a psychiatrist practicing in Reading pleaded guilty to Medicaid fraud and writing prescriptions while his medical license was suspended,according to the Reading Eagle. During his 32-day suspension, Jopinda R. Harika, M.D., saw 565 patients and wrote 450 prescriptions.
Meanwhile, in Houston, Texas, a psychiatrist tied to Riverside General Hospital's $158 million Medicare fraud scheme was convicted for her role in submitting fraudulent claims for partial hospitalization program services, according to a Department of Justice (DOJ) announcement. Prosecutors showed that Sharon Iglehart personally billed for psychotherapy treatments that she never provided, and then falsified patient records.
Iglehart joins 12 others that have been convicted for their role in the scheme,including three hospital executives who were sentenced earlier this summer to 115 years collectively.
Finally in Vermont, Brattleboro Retreat, one of the state's largest mental health and addiction recovery providers, is facing a criminal fraud investigation by the state attorney general's office, according to the Associated Press. The probe follows a whistleblower complaint that the hospital, which received $65 million from Medicaid last year, would change overcharges on patient accounts to zero. Attorney General William Sorrell told the AP the investigation "is not narrow in scope."
For more:
- here's The Morning Call article
- read the Reading Eagle article
- see the DOJ announcement
- here's the AP story
- here's The Morning Call article
- read the Reading Eagle article
- see the DOJ announcement
- here's the AP story
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New Mexico toes the thin line between overzealous detection and legitimate fraud prevention
NM Senate passes bill to prevent prematurely cutting off Medicaid funding to providers
Riverside sentencings should serve as warning shot to healthcare executives
Mental health scams target Medicare and Medicaid
Thank You Mr Sweeny and FHP AF.
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